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Strabismus, binocular functions and ocular motility in children with hydrocephalus

Eva Aring1, Susann Andersson, Anna-Lena Hård

  • 1Department of Ophthalmology, Institute of Clinical Neuroscience, The Sahlgrenska Academy of Göteborg University, Göteborg, Sweden. eva.aring@vgregion.se

Strabismus
|June 15, 2007
PubMed

Insights

Children surgically treated for hydrocephalus before age one often develop vision problems like heterotropia and motility defects. Early onset hydrocephalus increases the risk of these orthoptic abnormalities more than other factors.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Neuroscience

Background:

  • Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
  • Surgical intervention, often involving shunts, is common in infants with hydrocephalus.
  • The long-term visual and ocular motor consequences in this population require further investigation.

Purpose of the Study:

  • To assess orthoptic status, including heterotropia, heterophoria, head posture, nystagmus, stereo acuity, ocular motility, and near point of convergence (NPC).
  • To evaluate these parameters in children with hydrocephalus treated surgically before one year of age.
  • To determine the influence of hydrocephalus onset, etiology, shunt revisions, and ventricle size on these outcomes.

Main Methods:

  • A population-based study involving 75 children with hydrocephalus treated before one year of age.
  • Comparison of findings with an age- and sex-matched control group (n=140).
  • Statistical analysis to identify significant differences and correlations.

Main Results:

  • Children with hydrocephalus exhibited significantly higher rates of heterotropia (68.9% vs 3.6%), abnormal head posture (41.3% vs 0%), nystagmus (44.0% vs 0%), reduced stereo acuity (33.8% vs 97.1%), and ocular motility defects (69.7% vs 0.7%) compared to controls.
  • Early onset hydrocephalus (at birth) was associated with increased heterotropia, esotropia, abnormal head posture, and motility defects.
  • Etiology, number of shunt revisions, and ventricle size did not significantly impact the investigated variables.

Conclusions:

  • Surgical treatment for hydrocephalus in infancy frequently leads to orthoptic abnormalities.
  • The age of hydrocephalus onset is a more critical factor for developing orthoptic issues than etiology, shunt revisions, or ventricle size.
  • Early detection and management of visual and ocular motor problems are crucial in children with hydrocephalus.
Abstract

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