赤ちゃんの目の病気

子供

赤ちゃんは、目が未発達な状態で生まれてきます。

生まれたとき、眼球そのものはほぼ完成していますが、見たものを大脳に伝える機能は未熟で、新生児のときの視力は０・０１程度ともいわれています。

その後、生後２８３ヵ月で左右に動くものを目で追えるようになり、続いて上下に動くものを見るようになります。

お座りができるようになると立体的にものをとらえられるようになり、６才ごろになるとものを見る機能が完成してきます。

このページでは、赤ちゃんがかかりやすい目の病気について掲載しています。

ちゃんと見えているかチェックしてみて

おたふくかぜの症状

赤ちゃんは、ものを見ることの積み重ねで視力を獲得していきます。

視機能が正常に発達するためには、

①斜視などの兆候がなく眼球の位置
が正常である

②遠視、近視、乱視などの屈折異常
がない

③視力が左右等しい

ことが大切です。見え方がおかしくても言葉で訴えることができない赤ちゃんの場合、気づきにくいことも多いものですが、ものを見るときの目つきや角度からようすがおかしいと感じたときは、早めに眼科を受診してください。

また、３才ころには視力測定も可能になりますから、視力検査が行われる３才児健診は、必ず受けるようにしましょう。

先天性鼻涙管閉塞〈涙目〉（せんてんせいびるいかんへいそく）

目やに

主な症状：涙目・目やに

先天性鼻涙管閉塞はこんな病気

生まれつき、涙の通り道が詰まっている

目がしらから鼻への涙の通り道である鼻涙管に、生まれつき薄い膜が残っており、鼻涙管が詰まって涙が鼻に抜けず、目にいつも涙や目やにがたまっています。

先天性鼻涙管閉塞の症状

涙目や目やにが続く

つねに涙目で、目やにがたまっています。また、たまった涙に細菌が感染すると涙嚢炎（るいのうえん）を起こし、目がしらと目の付け根を軽く押すと黄色いうみが出てくることがあります。

先天性鼻涙管閉塞の治療とケア

洗浄やマッサージ、簡単な手術を

抗生物質の点眼や、涙嚢の洗浄やマッサージで治るかどうかようすを見ます。

治らないときは、ブジーという細い針金を鼻涙管に通して膜を破る手術を行います。

睫毛内反症〈逆さまつげ〉（しょうもうないはんしょう〈さかさまつげ〉）

さかさまつげ

睫毛内反症はこんな病気

まつげが角膜を刺激する

赤ちゃんのまぶたは水分や脂肪が多くはれぼったいため、まつげが内側を向いてしまいやすいのです。

そのため、まつげが角膜を刺激して充血や目やになどが出ます。

睫毛内反症の症状

目やにや涙目、目の充血が見られる

しきりに目をこすったり、まばたきのときにうっとうしそうにします。

目が充血したり、涙目になったり、目やにが出ることも。

睫毛内反症の治療とケア

気になるときは眼科へ

成長とともに目のはればったさがなくなってくると、ほとんどは自然に治ります。

目やにや充血がひどかったり、目をしきりにこするときは眼科へ。

点眼薬が処方されます。

斜視〈しゃし〉

斜視

主な症状：目の向きがおかしい

斜視はこんな病気

黒目が内側や外側に寄っている

黒目が内側や外側に寄っている状態で、一方の眼球が内側に寄っている「内斜視」と、外側を向いている「外斜視」、片目が上か下にずれる「上下斜視」があります。

さらに、内斜視には、生後まもなくから１才ごろまでに起きる乳児内斜視、生後６ヵ月ごろから起き、遠視が強いこ
とが原因の調節性内斜視などがあります。

斜視の症状

視力の発達が妨げられる

一方の黒目の中心は対象物のほうを向いているのに、もう一方の目が内側や外側を向いています。

このため、視力の発達に影響が起こります。

斜視の治療とケア

矯正や手術などで治療

両目で正しく見る練習や、斜視のほうで見る機能矯正のほか、症状によっては黒目の向きを正しくする手術を行うことがあります。

仮性斜視（偽斜視）

斜視に見えても本当の斜視でないことがあり、これを「仮性斜視（偽斜視）」と呼んでいます。

赤ちゃんは一般的に鼻の付け根の部分が低く、その部分に皮膚がかぶさって目と目の間が広くなり、内斜視のように見えることがあるのです。

心配なら鼻の付け根をつまんでみてください。

両目とも黒目が真ん中にあるようなら大丈夫です。

成長に伴って顔つきが変わり、鼻が高くなってくると、自然に黒目が目の中央に位置するようになってきます。

こうなると仮性斜視は少しずつ気にならなくなります。

弱視〈じゃくし〉

弱視

主な症状：視力が発達しない

弱視はこんな病気

目のトラブルで視力が発達しない

斜視、遠視、乱視、眼瞼下垂、白内障などの目の病気が原因で、光が網膜まで届かず、視力が発達しない状態です。

視力はものを見ることの積み重ねで発達するため、よく見えない状態が続くと、弱視になってしまいます。

弱視の症状

ものが見えにくいようすがある

よく転ぶ、つまずく、などの勣きが見られたり、近くを見るときに頭を傾けたり、異常に近づいてものを見たりします。

弱視の治療とケア

めがねや訓練で視力を回復

原因を調べ、めがねをかけたり、弱視のあるほうの目でものを見させる矯正法などで視力を回復させます。

早期治療が大事なので、おかしいと思ったら早めに病院へ連れて行ってください。

先天性白内障〈せんてんせいはくないしょう〉

先天性白内障

主な症状：視力が発達しない

先天性白内障ってこんな病気

先天的に水晶体が白く濁る

生まれつき水晶体が白く濁っています。

妊娠初期のママの風疹感染や遺伝でも発症しますが、原因不明のケースも多くあります。

先天性白内障の症状

目つきがおかしく、目でものを追わないことも

水晶体が白く濁り、目つきがおかしいことで気づきます。

片目の場合もありますが、多くは両目に見られます。

ものを目で追わなかったり、眼球が揺れるように動く状態が見られます。

先天性白内障の治療とケア

手術で水晶体の濁りを取ることも

重症の場合は、早めに水晶体の濁りを取る手術をし、術後はめがねやコンタクトレンズで矯正します。

軽症の場合は定期的に検査を受けるだけでいい場合もあります。

先天緑内障〈せんてんせいりょくないしょう〉

先天緑内障

主な症状；視力が発達しない

先天性緑内障ってこんな病気

先天性の異常で眼圧が高くなる

目の中にある房水の出口に異常があり、黒目が圧迫されて視力に影響が出ます。

片目だけのケースと、両目のケースがあります。

先天性緑内障の症状

視力が低下し、転んだりする

眼圧が異常に高くなり、視力が低下します。

転んだり、ものを見るときに異常に近づいたりします。

進行すると黒目が大きくなり、さらにひどくなると、黒目－が白く濁ります。

先天性緑内障の治療とケア

早期に発見して手術で治療

手術で治療。手遅れになると、失明のおそれもあり、早めに発見することが重要です。

目だつ症状が黒目が大きくなることだけというケースもあり、気になるときは早めに眼科へ。

屈折異常【遠視・近視・乱視】くづせついじょう（えんし・きんし・らんし）

屈折異常

主な症状：ものが見えにくい

屈折異常【遠視・近視・乱視】ってこんな病気

目に光が入るときの屈折異常

水晶体の屈折力や眼球の大きさに異常があるため、網膜の上に正しく像を結べず、ものが見えにくい状態です。

症状によって、遠視・近視・乱視の３つのタイプがあります。

屈折異常【遠視・近視・乱視】の症状

タイプによってものの見え方に影響が

遠視……網膜の後ろで像を結ぶため、遠くも近くもよく見えません。

視力が発達しないため、弱視や調節性内斜視の原因になることもあります。

近視……網膜の手前で像を結ぶため、遠くはぼんやりとしていますが、近くははっきり見えます。

乱視……ものがだぶって見えるため、目が疲れやすく弱視の原因になることがあります。

いずれの場合も、ものを見るときの姿勢がおかしい、目つきがおかしい、落ち着かない、つまずいたり転びやすいなど

屈折異常【遠視・近視・乱視】の治療とケア

めがねで視力を矯正

状態に合つためがねで矯正して、目を使う訓練をしながら視力がつくようにしていきます。

強い近視や、左右の視力の差が著しい場合は視力がほぼ完成する６才くらいから矯正を行います。

眼瞼下垂〈がんけんかすい〉

眼瞼下垂

主な症状：まぶたが上がらない

眼瞼下垂ってこんな病気

まぶたの筋肉の異常が原因

まぶたを引き上げる筋肉（眼瞼挙筋）が生まれつき弱く、上まぶたが垂れ下がったままで、上がらなくなります。

眼瞼下垂の症状

まぶたが垂れ下かっている

つねにまぶたが下がったままで、上ま
ぶたが上がりません。

下がりぐあいの程度はさまざまです。

片方の目だけに起こる場合と、両目に起こる場合があります。

眼瞼下垂の治療とケア

視力に影響するときは手術を

まぶたの下がりぐあいで、手術が必要かとうかを決めます。

日常生活に差し支えがなければ、ようすを見ます。

まぶたが瞳孔にかかっている場合は、ものを見ることができず、視力の発達が損なわれるおそれがあるので、早めに手術して治します。

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