DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214553

Ocular manifestations in children with developmental delay in an eye hospital of northern Bangladesh

Rokhsana Afroze, Khairul Islam, Sajidul Huq

Abstract


Background: The aim of this study was to identify common ocular manifestations in children with developmental delay in an eye hospital of northern part of Bangladesh.

Methods: It was a retrospective medical record review of children with developmental delay who attended the pediatric ophthalmology department in an eye hospital from January 2019 to December 2019. Data were collected for their age, gender, past medical history, ophthalmic examination findings and systemic problems. Ophthalmic examination included examination of lid and adnexa, anterior and posterior segment examination and assessment of squint and refraction.

Results: Medical records of 102 with developmental delay were identified and studied (59 boys and 43 girls, mean age 1.57 years, 53.9% aged <1 year). Of these children, 44 (43.1%) were referred by the pediatricians. The most common past medical histories were perinatal asphyxia (42.2%), history of convulsion (30.4%), neonatal seizures (9.8%) and history of speech delay (1%). On ophthalmic examination, 30 (29.5%) had poor vision, 20 (19.6%) had refractive error, 23 (22.5%) had Strabismus and 11 (10.8%) had nystagmus. Optic atrophy was also observed among 11 children (10.8%).

Conclusions: Ocular manifestations are commonly seen in children with developmental delay which can be cause of severe visual impairment and overall disability in later life. Hence an early ophthalmologic screening and intervention in these children by developing good referral network between ophthalmologist and pediatricians can help to substantially improve the developmental and academic achievement.

 


Keywords


Developmental delay, Optic atrophy, Refractive error, Strabismus

Full Text:

PDF

References


Brown KA, Parikh S, Patel DR. Understanding basic concepts of developmental diagnosis in children. Transl Pediatr 2020;9(1):S9-22.

Choo YY, Agarwal P, How CH, Yeleswarapu SP. Developmental delay: identification and management at primary care level. Singapore Med J. 2019;60(3):119-23.

Teutsch SM, McCoy MA, Woodbury RB, Welp A. the impact of vision loss. In: Making eye health a population health imperative: vision for tomorrow. National Academies Press; 2016.

Allen LR, Kelly BB, eds. Child Development and Early Learning. In: Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation. Washington (DC): National Academies Press (US); 2015.

Wu HJ, Tsai RK. Ocular manifestations in children with developmental delay preliminary report. Kaohsiung J Med Sci. 2000;16(8):422-8.

Reena A, Lekshmy SR, Lekshmi HM, Bindu K. Ophthalmic manifestations in children with delayed milestones- a clinical study. 243 Retinoblastoma. 2009:264.

Katoch S, Devi A, Kulkarni P. Ocular defects in cerebral palsy. Indian J Ophthalmol. 2007;55(2):154-6.

Akinci A, Oner O, Bozkurt OH, Guven A, Degerliyurt A, Munir K. Refractive errors and ocular findings in children with intellectual disability: a controlled study. J AAPOS. 2008;12(5):477-81.

Smitha KS, Harshavardhan P, Patil SB, Bhagyajyoti BK, Sheetal VG, Kathyayini SV. Prevalence of ocular manifestations in children with developmental delay. Med Innovatica. 2014;3:42.

Solomon CB, Bindu N, Raju KV, George MS. Ocular association in children with developmental delay. Kerala J Ophthalmol. 2011;23:367–71.

Sandfeld Nielsen L, Skov L, Jensen H. Visual dysfunctions and ocular disorders in children with developmental delay. I. prevalence, diagnoses and aetiology of visual impairment. Acta Ophthalmol Scand. 2007;85(2):149-56.

Sandfeld Nielsen L, Skov L, Jensen H. Visual dysfunctions and ocular disorders in children with developmental delay. II. Aspects of refractive errors, strabismus and contrast sensitivity. Acta Ophthalmol Scand. 2007;85(4):419-426.

Fledelius HC, Stubgaard M Changes in refraction and corneal curvature during growth and adult life. Acta Ophthalmol Scand. 1986;64:487-91.

Villarreal MG, Ohlsson J, Abrahamsson M, Sjostrom A, Sjostrand J. Myopization: the refractive tendency in teenagers. Prevalence of myopia among young teenagers in Sweden. Acta Ophthalmol Scand. 2000;78:177-81.

Ohlsson J, Villarreal G, Sjostrom A, Cavazos H, Abrahamsson M, Sjostrand J. Visual acuity, amblyopia and ocular pathology in 12- to 13-year-old children in Northern Mexico. J AAPOS. 2003;7:47-53.

Bankes JLK. Ocular problems of mentally handicapped children. Aust J Ophthalmol. 1947;2:71-4.

Black P. Visual disorders associated with cerebral palsy. Br J Ophthalmol. 1982;66:52.

Erkkila H, Lindberg L, Kallio AK. Strabismus in children with cerebral palsy. Acta Ophthalmol Scand. 1996;74:636-8.

Flett P, Saunders B. Ophthalmic assessment of physically disabled children attending a rehabilitation school. J Paediatr Child Health. 1993;29:132-5.

O’Connor A, Stephenson T, Johnson A, Tobin MJ, Ratib S, Fielder AR. Strabismus in children of birthweight less than 1701 g. Arch Ophthalmol. 2002;120:767-73.

Ozturk T, Er D, Yaman A, Berk AT. Changing trends over the last decade in the aetiology of childhood blindness: A study from a tertiary referral centre. Br J Ophthalmol. 2016;100:166‑71.

Chong C, Dai S. Cross‑sectional study on childhood cerebral visual impairment in New Zealand. Eye. 2008;22:905‑11.

Matsuba CA, Jan JE. Long‑term outcome of children with cortical visual impairment. Dev Med Child Neurol. 2006;48:508‑12.

McClelland J, Saunders KJ, Hill N, Magee A, Shannon M, Jackson AJ, et al. The changing visual profile of children attending a regional specialist school for the visually impaired in Northern Ireland. Ophthal Physiol Opt. 2007;27:556‑60.

Thomas M, Vaishnavi R, Gayathri N, Muthayya M, Ninan B. Retrospective analysis of ophthalmic ailments in children attending the child development unit in a tertiary care hospital in South India. J Evol Med Dent Sci. 2016;5(46):2934-8.