Delayed visual attention caused by high myopic refractive error

Delayed visual maturation (DVM) is usually a retrospective diagnosis given to infants who are born with no or poor visually-directed behavior, despite normal acuity on objective testing, but who recover months later. This condition can be organized into several types based on associated neurodevelopmental or ocular findings, but the etiology of DVM is probably complex and involves multiple possible origins. Here we report two infants who presented with delayed visual maturation (attention). They were visually unresponsive at birth but were later found to have high myopic errors. Patient 1 had -4 D right eye, -5 D left eye. Patient 2 had -9 D o.u. Upon spectacle correction at 5 and 4 months, respectively, both infants immediately displayed visually-directed behavior, suggesting that a high refractive error was the cause of inattention in these patients. These findings could add to knowledge surrounding DVM and the diagnosis of apparently blind infants. Findings presented here also indicate the importance of prompt refractive error measurement in such cases.