Eye malformations in children with heavy alcohol exposure in utero

Elizabeth Y Flanigan1, Sofia Aros, Maria Ferraz Bueno

  • 1Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

Insights

Children exposed to heavy prenatal alcohol but without fetal alcohol syndrome (FAS) show no increased risk of eye abnormalities. Eye exams are unlikely to diagnose alcohol-related damage in these cases.

Area of Science:

  • Ophthalmology
  • Prenatal Alcohol Exposure
  • Pediatric Health

Background:

  • Fetal alcohol syndrome (FAS) is associated with significant ophthalmologic defects.
  • The risk of eye abnormalities in children exposed to high levels of alcohol prenatally but without FAS is not well-defined.

Purpose of the Study:

  • To investigate whether children with heavy prenatal alcohol exposure, but without FAS, exhibit eye abnormalities.
  • To determine if eye examinations are useful for diagnosing alcohol-related damage in children not meeting FAS criteria.

Main Methods:

  • Screened pregnant women for alcohol consumption (> 2 oz absolute alcohol/day).
  • Followed 43 exposed offspring and 55 controls (ages 4-9 years) with masked, standardized ophthalmologic examinations.

Main Results:

  • No significant differences in visual acuity, refractive errors, ptosis, epicanthal folds, or short palpebral fissures between groups.
  • Normal biomicroscopy in exposed subjects; cataracts found in 4% of controls, none exposed.
  • Arterial tortuosity observed in 16% of exposed and 15% of controls; optic nerve hypoplasia absent in all.

Conclusions:

  • Ophthalmologic risks associated with prenatal alcohol exposure appear limited to children diagnosed with FAS.
  • Children exposed to high levels of alcohol prenatally who do not develop FAS do not present with increased eye abnormalities.
  • Eye examinations are unlikely to aid in diagnosing suspected alcohol-related damage in children without FAS.
Abstract