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Updated: Jul 28, 2026
A Method to Quantify Visual Information Processing in Children Using Eye Tracking
Published on: July 9, 2016
Visual function at school age in children with neonatal encephalopathy and low Apgar scores
E Mercuri1, S Anker, A Guzzetta
1Department of Paediatrics, Hammersmith Campus, Imperial College School of Medicine, London, UK. e.mercuri@ic.ac.uk
Insights
Neonatal encephalopathy can cause visual impairments in school-aged children, with severity linked to brain lesion extent. Early visual assessments reliably predict long-term visual function outcomes.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Developmental Neuroscience
Background:
- Neonatal encephalopathy (NE) is a serious condition affecting newborns.
- Visual impairment is a potential complication of NE.
- Long-term visual outcomes in children with NE require further investigation.
Purpose of the Study:
- To evaluate various visual functions in school-aged children with a history of NE.
- To correlate visual function with brain imaging findings (MRI).
- To assess the predictive value of early-life visual assessments for school-age outcomes.
Main Methods:
- A cohort of 39 full-term infants with NE, low Apgar scores, and abnormal neonatal imaging was studied.
- Visual function tests (crowding acuity, stereopsis, visual fields) were administered at school age.
- Results were compared with brain MRI and prior visual assessments at 5 and 12 months (available for 24 children).
Main Results:
- 41% (16/39) of children exhibited abnormal visual function at school age.
- Abnormal visual function correlated with the severity of brain lesions.
- Moderate/severe basal ganglia lesions and severe white matter changes were consistently linked to visual impairment.
Conclusions:
- Visual impairment in children with NE is associated with the extent and location of brain lesions.
- Normal MRI or minimal lesions generally predicted normal vision.
- Early visual assessments (by 1 year) were reliable predictors of school-age visual function.
Objective:
To assess different aspects of visual function at school age in children who suffered from neonatal encephalopathy.
Method:
Thirty nine full term infants with neonatal encephalopathy, low Apgar scores, and early neonatal imaging were studied using a battery of tests assessing different aspects of visual function (crowding acuity, stereopsis, visual fields) at school age. The results were compared with brain magnetic resonance imaging (MRI) findings and, when possible, with the results of the assessment of visual function performed at 5 and 12 months, available in 24 of the 39 children examined at school age.
Results:
Sixteen of the 39 children (41%) had abnormal results at school age in at least one of the visual tests used. Seven of these 16 were untestable on all tests. The remaining 23 children (59%) had normal results.
Conclusions:
The presence and severity of visual impairment was related to the severity of brain lesions. Moderate or severe basal ganglia lesions and severe white matter changes were always associated with abnormal visual function. Infants with normal MRI, minimal basal ganglia lesions, and minimal or moderate white matter involvement tended to have normal vision. It was also found that the assessment of visual function performed in the first year was a reliable indicator of visual function at school age. With two exceptions, the results on the 5 month visual assessment were predictive of visual outcome at school age. In the remaining two cases, a normal visual outcome at 5 years was associated with visual abnormalities at 5 months but these had already normalised by the age of 1 year.
