Visual impairment in very low birthweight children
a Institute of Child Health,
Liverpool University, Alder Hey Children's
Hospital, Liverpool L12 2AP, b Department of Orthoptics,
University of Liverpool, c Department of Child Health, Bristol Maternity
Hospital, Bristol
Correspondence to: Dr Andrew Powls.
Accepted 5
November 1996
AIMS
To compare the visual function of a cohort of
very low birthweight (VLBW) children in early adolescence with that of
their normal birthweight peers; to correlate visual impairment in this group with available perinatal data; and to examine the relation between the visual ability of VLBW children and their cognitive and
motor skills.
METHODSAs part of a long term neurodevelopmental
study, 137 VLBW children and 163 normal birthweight controls were
visually assessed between the ages of 11 and 13 years. Their eyes were
examined for strabismus and movement disorders, and the use of visual
correction for refractive errors was noted. Measures were made of
visual acuity, stereopsis, and contrast sensitivity. All children had standardised tests of motor ability and cognitive skills. Perinatal data, including cranial ultrasonography results, had been obtained from
the children's notes. No data were available however, regarding retinopathy of prematurity as screening was not established when these
infants were born.
RESULTSOn all measures, the visual function of
the VLBW children was poorer than that of the controls. Reduced visual
function was present in 63.5% of VLBW children compared with 36% of
controls. Poor contrast sensitivity and strabismus were predictive of
poor motor skills in the VLBW children. Poor contrast sensitivity and poor visual acuity (at 0.3 metres) were
predictive of lower IQ. Low birthweight, intraventricular
haemorrhage, intrauterine growth retardation and low 1 minute Apgar scores predicted reduced visual function.
CONCLUSIONSVLBW children have a high incidence of
impaired vision. Stereopsis and contrast sensitivity are useful
additions to the screening of this high risk group. They identified
impaired vision that was not detected by normal screening and were
related to impaired neurodevelopmental outcome.
© 1997 by Archives of Disease in Childhood
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