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Findings of perinatal ocular examination performed on 3573, healthy full-term newborns
Li-Hong Li1, Na Li, Jun-Yang Zhao
1Maternal and Children’s Hospital, Kunming, Yunnan, China.
Insights
Newborn eye exams detected significant ocular pathology in 24.4% of healthy infants. Retinal hemorrhages were the most common finding, with 6.02% considered potentially sight-threatening. Further research is needed to understand long-term impacts.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Routine newborn eye examinations are crucial for early detection of ocular pathologies.
- Identifying visual impairments in newborns can prevent long-term vision loss.
- Understanding the prevalence of specific ocular conditions in healthy full-term infants is important for clinical practice.
Purpose of the Study:
- To document the findings of a newborn eye examination program.
- To detect ocular pathology in healthy full-term newborns.
- To establish the prevalence of various eye conditions in the neonatal population.
Main Methods:
- A cross-sectional study was conducted on healthy full-term newborns.
- Ocular examinations were performed within 42 days of birth.
- Utilized tools included flashlight, retinoscope, slit lamp, and wide-angle digital retinal imaging (RetCam).
Main Results:
- 3573 healthy newborns were examined, with 24.4% showing abnormalities.
- Retinal hemorrhages were the most common finding (21.52%), with 6.02% considered significant.
- Other detected conditions included subconjunctival hemorrhage, microphthalmos, corneal leukoma, and congenital cataract.
Conclusions:
- Newborn eye examinations effectively detect significant ocular pathologies.
- Neonatal retinal hemorrhages, though common, may impact visual development.
- Prospective studies with long-term follow-up are recommended to assess the impact of these findings.
Objective:
To document the findings of a newborn eye examination programme for detecting ocular pathology in the healthy full-term newborn.
Methods:
This is a cross-sectional study of the majority of newborns born in the Kunming Maternal and Child Healthcare Hospital, China, between May 2010 and June 2011. Infants underwent ocular examination within 42 days after birth using a flashlight, retinoscope, hand-held slit lamp microscope and wide-angle digital retinal image acquisition system. The retinal fundus examination utilised the RetCam wide-field digital imaging system (Clarity Medical Systems, Pleasanton, California, USA). The external eye, pupillary light reflex, red reflex, opacity of refractive media, anterior chamber and posterior segments were also examined.
Results:
A total of 3573 healthy full-term newborns were enrolled and examined in the programme. There was detection of 871 abnormal cases (24.4%). The majority of abnormal exams were 769 (21.52%) retinal haemorrhages. Of these, there were 215 cases of significant retinal haemorrhage, possible sight threatening or amblyogenic, representing 6.02% of the total. In addition, 67 cases (1.88%) involved macular haemorrhage. The other 107 cases (2.99%) with abnormal ocular findings included subconjunctival haemorrhage, congenital microphthalmos, congenital corneal leukoma, posterior synechia, persistent pupillary membrane, congenital cataract, enlarged C/D ratio, retinal hamartoma versus retinoblastoma, optic nerve defects, macular pigment disorder and non-specific peripheral retinopathy.
Conclusion:
Ocular examination of healthy newborns leads to the detection of a significant number of ocular pathologies. The most commonly discovered ocular abnormality during examination of the newborns in this study is retinal haemorrhage. The long-term impact of these findings is unknown. Although presumed by some to benign, neonatal retinal haemorrhages due to birth trauma could be involved in altering visual development. Further work, including prospective examination of newborns with long-term follow-up, is needed and supported by our findings.
