ABSTRACT
AIM: To document ocular outcome in premature infants with intraventricular haemorrhages (IVH). METHODS: 68 preterm infants with IVH were examined. RESULTS: Mean gestational age was 28.1 weeks (range 24-35). Mean birth weight was 1045.9 g (630-2240). Mean follow up was 54.6 months (6-150). IVH is graded from 1 to 4 based on the severity of haemorrhages. The incidence of ocular abnormalities was compared between low grade IVH (grade 1 and 2) and high grade IVH (grade 3 and 4). Of the 68 infants with IVH, ROP occurred in 33 infants (48.5%); 13 (43.3%) had low grade IVH; 20 (52.6%) had high grade IVH. Strabismus developed in 30 infants (44.1%); 14 (46.6%) had low grade IVH; 16 (42.1%) had high grade IVH. Infants with high grade IVH were at significant greater risk than infants with low grade IVH for the development of optic atrophy (31.5% v 16.6%), hydrocephalus (57.8% v 10%). CONCLUSION: This study highlights the serious significance of all grades of IVH with the higher incidence of optic atrophy and hydrocephalus with high grade IVH.
Subject(s)
Cerebral Hemorrhage/complications , Eye Diseases/etiology , Infant, Premature , Cerebral Hemorrhage/diagnosis , Cerebral Palsy/etiology , Child , Child, Preschool , Eye Diseases/diagnosis , Female , Humans , Hydrocephalus/etiology , Infant , Infant, Newborn , Male , Nystagmus, Pathologic/diagnosis , Nystagmus, Pathologic/etiology , Optic Atrophy/diagnosis , Optic Atrophy/etiology , Prognosis , Retinopathy of Prematurity/diagnosis , Retinopathy of Prematurity/etiology , Risk Factors , Severity of Illness Index , Strabismus/diagnosis , Strabismus/etiology , Vision, Low/diagnosis , Vision, Low/etiologyABSTRACT
AIM: To examine outcome among children with refractive accommodative esotropia. METHODS: Children with accommodative esotropia associated with hyperopia were included in the study. The features studied were ocular alignment, amblyopia, and the response to treatment, binocular single vision, requirement for surgery, and the change in refraction with age. RESULTS: 103 children with refractive accommodative esotropia were identified. Mean follow up was 4.5 years (range 2-9.5 years). 41 children (39.8%) were fully accommodative (no manifest deviation with full hyperopic correction). The remaining 62 children (60.2%) were partially accommodative. At presentation 61.2% of children were amblyopic in one eye decreasing to 15.5% at the most recent examination. Stereopsis was demonstrated in 89.3% of children at the most recent examination. Mean cycloplegic refraction (dioptres, spherical equivalent) remained stable throughout the follow up period. The mean change in refraction per year was 0.005 dioptres (D) in right eyes (95% CL -0. 0098 to 0.02) and 0.001 D in left eyes (95% CL -0.018 to 0.021). No patients were able to discard their glasses and maintain alignment. CONCLUSIONS: Most children with refractive accommodative esotropia have an excellent outcome in terms of visual acuity and binocular single vision. Current management strategies for this condition result in a marked reduction in the prevalence of amblyopia compared with the prevalence at presentation. The degree of hyperopia, however, remains unchanged with poor prospects for discontinuing glasses wear. The possibility that long term full time glasses wear impedes emmetropisation must be considered. It is also conceivable, however, that these children may behave differently with normal and be predestined to remain hyperopic.
