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[A pilot study of ocular diseases screening for neonates in China]
Wen-ying Nie1, Han-rong Wu, Yi-sheng Qi
1Department of Child and Adolescent Health & Maternal and Child Health Care, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430030, China. goodddd@163.com
Insights
Newborn eye disease screening identified 12 conditions in over 15,000 infants, with a prevalence of 8.22%. Early detection and intervention are crucial for managing neonatal ocular diseases effectively.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Context:
- Neonatal eye diseases pose significant risks to infant vision.
- Effective screening protocols are essential for early detection and management.
- Previous studies have highlighted the need for comprehensive newborn eye examinations.
Purpose:
- To evaluate clinical strategies for screening newborn eye diseases.
- To determine the incidence of various ocular conditions in neonates.
- To assess the feasibility and effectiveness of newborn eye screening programs.
Summary:
- A screening program involving 15,398 newborns detected 12 different eye diseases with an overall prevalence of 8.22%.
- Congenital conditions included persistent pupillary membrane (4.702%) and congenital cataract (0.097%).
- Acquired conditions such as neonatal conjunctivitis (2.539%) and retinopathy of prematurity in premature infants were also identified.
Impact:
- The study demonstrates that newborn eye disease screening is both feasible and effective.
- Early intervention strategies can significantly improve outcomes for affected neonates.
- Findings support the implementation of routine eye screenings to monitor and control neonatal ocular diseases.
Objective:
To explore the clinical strategies for the screening of newborn eye diseases and obtain information concerning the incidence of newborn ocular diseases.
Methods:
Newborns in a baby-friendly nursery were evaluated for mass screening of eye diseases 2 to 7 days after birth (including reaction to light stimulation, external ocular examination and test for pupil red reflex) and those with abnormalities were subjected to diagnostic examination (external ocular examination with a hand-held slit-lamp, pupil red reflex and mydriatic examination). Newborns in neonatal intensive care unit (NICU) were subjected to screening 5 to 14 days after birth and then, together with those with high risk factors, received a comprehensive examination for screening and diagnostic purposes. The suspected cases were referred to department of ophthalmology for definite diagnosis.
Results:
Among the 15,398 (91.65%) newborns who were enrolled the screening program, 12 different eye diseases (involving 1266 cases) were detected, with a prevalence of 8.22%. Of these eye diseases, 7 were congenital ocular diseases, involving 809 cases (5. 254%) and including congenital ptosis in 2 cases (0.013%), congenital corneal opacity in 6 cases (0.039%), persistent pupillary membrane in 724 cases (4.702%), congenital cataract in 15 cases (0.097%), persistent hyaloid artery in 54 cases (0.351%), obstruction of nasolacrimal duct in 7 cases (0.046%) and lacrimal gland prolapse in 1 cases (0.007%). Five different diseases (457 cases, 2. 968%) detected were acquired in nature, including neonatal conjunctivitis in 391 case (2.539%), vitreous hemorrhage in 6 cases (0.039%), retinal hemorrhage in 34 cases (0.221%), and neonatal dacryocystitis in 23 cases (0.149%). Of 27 premature babies with body weight lower than 1500 g, 3 had retinopathy of prematurity (ROP, 6 eyes involved).
Conclusions:
Early intervention is of great importance for the prevention and treatment of neonatal ocular diseases. The screening of newborn ocular diseases is not only feasible but also effective in the monitoring and control of the eye diseases in neonates.
