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Refractive error in premature infants
Yokrat Ton1, Yigal S Wysenbeek, Abraham Spierer
1Sapir Medical Center, Department of Ophthalmology, Meir Hospital, Kefar Sava, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel. barakton@013.net.il
Insights
Refractive errors are common in premature infants, affecting 89% within six months. Hyperopia is the most frequent type, and the error increases with age but is not linked to birth weight or gestational age.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Neonatology
Background:
- Refractive errors in infancy can impact visual development.
- Premature infants are a population at risk for visual impairments.
- Understanding refractive error progression in early life is crucial for timely intervention.
Purpose of the Study:
- To determine the incidence and degree of refractive error in premature infants (2 weeks to 6 months) without retinopathy of prematurity.
- To investigate correlations between refractive error and age at examination, birth weight, and gestational age.
Main Methods:
- An observational, cross-sectional study involving 390 premature infants.
- Cycloplegic retinoscopy was used to measure eye refraction.
- Perinatal variables were analyzed for correlation with refractive error.
Main Results:
- 89% of infants exhibited refractive errors; 11% were emmetropic.
- Hyperopia was prevalent (76.8%), myopia (11.9%), and astigmatism (24.4%).
- Refractive error positively correlated with age at examination (P = 0.001) but not with birth weight or gestational age.
Conclusions:
- The high incidence of refractive error (89%) in premature infants necessitates regular eye screening.
- Hyperopia is the predominant refractive error in this cohort.
- Age at examination is a significant factor in refractive error development, unlike birth weight or gestational age.
Purpose:
To determine the incidence and the degree of refractive error between the ages of 2 weeks and 6 months in premature infants without retinopathy of prematurity and to seek a correlation between refractive error and age at examination, birth weight, or gestational age.
Subjects And Methods:
In this observational cross-sectional study, eye refraction in 390 premature infants, with no ocular pathology, was measured by cycloplegic retinoscopy at the age of 2 weeks to 6 months. A correlation was sought between refractive error and perinatal variables.
Results:
Of the 390 infants reviewed, 347 (89%) had a refractive error and 43 (11%) were emmetropic in both eyes. Most of the infants were hyperopic (76.8%). Myopia was observed in only 11.9%. Astigmatism was found in 24.4% of the infants. The mean age at examination was 2.1 +/- 1 months; the mean birth weight was 1639 +/- 444 g, and the mean gestational age at birth was 32.2 +/- 2.4 weeks. The mean spherical equivalent of refraction was +1.56 +/- 1.82 diopters (D) in the right eye and +1.55 +/- 1.78 D in the left eye. Refractive error was positively correlated with age at examination ( R = 0.16, P = 0.001). The mean refractive error was +1.24 D in infants aged 1 month or less and reached +2.50 D at the age of 4 to 6 months. Refractive error was not correlated with birth weight or gestational age.
Conclusions:
The incidence of refractive error in premature infants without retinopathy of prematurity in the first 6 months of life may be as high as 89%. Most of these infants are hyperopic. Eye refraction is correlated with age at examination, but not with birth weight or gestational age.
