Delayed visual attention caused by high myopic refractive error

Kimberly M Winges1, Ursula Zarpellon, Chuan Hou

  • 1Smith-Kettlewell Eye Research Institute, 2318 Fillmore Street, San Francisco, CA 94115, USA.

Strabismus
|July 16, 2005
PubMed

Insights

Delayed visual maturation (DVM) in infants may be caused by uncorrected high myopia. Prompt refractive error assessment is crucial for diagnosing visually unresponsive infants and ensuring timely treatment.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Developmental Pediatrics

Background:

  • Delayed visual maturation (DVM) is a diagnosis of exclusion for infants with poor visual behavior despite normal objective acuity.
  • The etiology of DVM is complex, with various neurodevelopmental and ocular factors implicated.
  • DVM is typically diagnosed retrospectively after visual recovery.

Observation:

  • Two infants presented with symptoms consistent with DVM, exhibiting unresponsiveness to visual stimuli from birth.
  • Objective testing revealed normal visual acuity, but both infants were later found to have significant high myopia.
  • Patient 1 had -4 D (right eye) and -5 D (left eye); Patient 2 had -9 D in both eyes.

Findings:

  • Immediate improvement in visually-directed behavior was observed in both infants upon spectacle correction.
  • This suggests that high refractive error, specifically high myopia, was the primary cause of their apparent visual inattention.
  • The findings challenge the traditional understanding of DVM and its potential causes.

Implications:

  • High myopia should be considered in the differential diagnosis of infants presenting with delayed visual maturation or apparent blindness.
  • Early and accurate refractive error assessment is critical for timely intervention in such cases.
  • This study may improve diagnostic approaches for infants with visual impairments.

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