Ocular findings in cerebral palsy patients undergoing orthopedic surgery

To investigate the prevalence and clinical features of ocular abnormalities in patients with cerebral palsy (CP) and the association with gross motor function.

A complete ophthalmologic examination was performed in 88 consecutive patients with CP before and during orthopedic surgery in a tertiary hospital from July 2008 to March 2010. The prevalence and clinical features of ocular abnormalities and the association with gross motor function state were investigated.

Seventy-eight patients (89%) had ocular abnormalities. Refractive errors were found in 53 patients (60%). Strabismus including exotropia (50%), esotropia (9%), and hypertropia (9.1%) was found in 52 patients (59%). Posterior segment abnormalities were found in 19 patients (22%), cornea and lens abnormalities in 8 patients (9%), and epiblepharon in 5 patients (6%). Among 57 patients whose visual acuity could be measured, best-corrected visual acuity of the better eye was ≤ 20/40 in 18 patients (32%) and ≤ 20/200 in 3 patients (5%). Objective vision-impairing ocular abnormalities and vertical strabismus were significantly associated with poor gross motor function before orthopedic surgery.

Ocular abnormalities were present in the majority of CP patients and patients with poor gross motor function were more likely to be afflicted with vision-impairing ocular abnormalities. Ophthalmologic evaluation is deemed necessary in CP patients, especially in those with poor motor function.