Eye changes in cerebral palsy

ABSTRACT

This study was conducted to evaluate the different eye changes in cerebral palsied [cp] children. It included 70 CP children [45 boys and 25 girls] among those attending the Pediatric Neurology Outpatient Clinic at Alexandria University Children's Hospital with age range from 4 to 96 months. Cerebral palsy was due to perinatal causes in 57.1% of cases while postnatal and prenatal causes accounted for 28.6% and 5.7% respectively. The etiology of CP was unknown in 8.6% of cases. Most of the cases were of the spastic type [62.8%]. Dyskinetic CP accounted for 14.3%; ataxic CP for 14.3% and the mixed type accounted for 8.6%. The majority of cases were profoundly handicapped [55.7%]. Multiply handicapped CP children accounted for 92.9% while those with a single other deficit were 7.1%. Visual problems occurred in 64.3% of cases. These included bilateral cataract in 1.4%, ocular motility disorders in 51.4%, refractive errors in 58.6% and abnormal fundoscopy in 14.3%. Sixteen cases had examination of their visual evoked responses [VERs]. Abnormal VERs occurred in 43.7% of them. Visual problems were significantly higher in CP cases due to perinatal causes [P<0.05]. Also, visual problems were significantly higher among the spastic group [P<0.05]. Thorough ophthalmological assessment should be done as early as possible for all cases at high risk of CP or already having established CP and should be done periodically for early detection and proper management of the associated visual problems to limit their handicap. Visual evoked responses' examination is a valuable diagnostic tool for early detection of cortical visual impairment in CP cases