日本視能訓練士協会誌

Refractive errors of 459 children, between the ages of three and five, were determined by a new photorefractmetry.
This instrument is an updated version of Kaakinen's method. To analyze children's refractive errors instantly, instead of camera and films that consisted in a previous version's simplified photorefractmetry, we utilized a video-camera and a frame-memory for this instrument.
This instrument could be utilized for all children. The refractive errors that were in need of treatments, especially anisometropia, were detected practically.
We suggest the possibility of this instrument playing an important role in an early diagnosis and a management of amblyopia.

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Studies on 26 individuals associated with psychogenic visual disturbances were carried out with special emphasis on their living environment as a causative factors.
When first seen, all patients compained of decreased visual acuity, in addition in some cases abnormalities of visual field and accommodation were observed. During the period of follow up from six months to 27 months, all cases showed the improvement in both visual acuity and visual field. As to the state of accommodation, 12 patients (46%) showed either hyper- or hypo- accommodation. Four patients showed siginificant decrease in the refraction after instillation of mydriacye. From these results, it is possible to assume that psychogenic visual disturbances may have a certain relation to the abnormalities of accommodation. We considered it was caused by an imbalance in the autonomic nervous of difficultes in adapting to the surrounding environment such as in school or in family.
From these results, we stress the importance of the examination of accommodation in the diagnosis and treatment of the psychogenic visual disturbances.

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Spatial frequency VEP was carried out to analysis a pathophysiological status of strabismic amblyopia. VEP was evoked by white and black vertical gratings at 0.47, 0.94, 1.94, 3, 88 and 7.76c/deg.
In normal subjects, VEP response was maximal at 3.88c/deg.
Anisometropic amblyopia had poor response at all gratings before pleoptics (AV: 0.2-0.6), however it could be normalized with good visual acuity (VA: 1.0↑).
In strabismic amblyopia, the large potential tipically appeared at low spatial frequency (0.47-0.94c/deg) rather than high spatial frequency at first (VA: 0.09-0.6). After pleoptics (VA: 1.0↑), VEP response could be better than first at high spatial frequency, although the dominancy of low spatial frequency was still remain.
Through this study, it was suspected that strabismic amblyopia had remarkably decrease of X-cell activity and survaival of Y-cell. Spatial frequency VEP was valuable tools in the treatment of amblyopia.

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