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Longterm oculomotor and visual function in spina bifida cystica: a population-based study
Elizabeth Caines1, Margareta Dahl, Gerd Holmström
1Department of Ophthalmology, University Hospital, Uppsala, Sweden. elizabeth.caines@akademiska.se
Insights
Children with spina bifida cystica often experience visual and oculomotor issues, including strabismus and refractive errors. Regular ophthalmological examinations are crucial for early detection and management of these vision problems.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Spina bifida cystica, encompassing myelomeningocele and myeloschisis (MMC), is a complex congenital condition.
- Visual and oculomotor development can be affected in children with MMC.
Purpose of the Study:
- To document and describe the development of visual and oculomotor functions in children with spina bifida cystica (MMC).
- To emphasize findings in a 12-14 year follow-up group.
Main Methods:
- Twenty children (aged 12-14 years) with MMC and Chiari-related malformations underwent ophthalmological examinations.
- Evaluated visual acuity, refractive error, ocular motility, nystagmus, accommodation, convergence, color vision, and stereo acuity.
Main Results:
- Subnormal vision was present in 29% of children, but no child was visually impaired.
- Manifest strabismus (52%) and significant refractive errors (81%) were common.
- Defective accommodation (10 children), nystagmus (9 children), and optic atrophy (2 children) were noted.
Conclusions:
- The high incidence of ocular disturbances in children with spina bifida necessitates regular ophthalmological investigation.
- Early and consistent follow-up is vital for managing visual and oculomotor deficits in this population.
Purpose:
To document and describe the development from birth of visual and oculomotor functions in a group of children with spina bifida cystica (myelomeningocele and myeloschisis [MMC]). The emphasis in this study is on findings at 12-14 year follow-up.
Methods:
Twenty children aged 12-14 years with myelomeningocele and Chiari-related malformations were examined by an orthoptist and a paediatric ophthalmologist. A further child who did not wish to participate actively in the study is also reported. Visual acuity for near and distance, refractometer readings in cycloplegia, the presence of ocular motility disorders and nystagmus were recorded. Accommodation, convergence, colour vision and stereo acuity were assessed and the fundus and media were examined.
Results:
Six children (29%) in the study group had subnormal vision, although no child was visually impaired. Eleven (52%) showed manifest strabismus and 17 (81%) had a significant refractive error. Near visual acuity was normal in nearly all the children, but accommodation was defective in 10. Nine children had nystagmus and two had optic atrophy. No visual field defects were found.
Conclusions:
The high incidence of ocular disturbances in children with spina bifida highlights the importance of regular ophthalmological investigation and follow-up.
