Possible linkage between visual and motor development in children with cerebral palsy

The purpose of this study was to examine ophthalmic disorders associated with neurological disorders in children with cerebral palsy.

Children clinically diagnosed as cerebral palsy with supportive abnormal magnetic resonance imaging results were included in this prospective study. All participants were recommended to have comprehensive ophthalmic exams. To assess motor function, the Gross Motor Function Classification System and the Gross Motor Function Measure were used. To assess motor and cognitive function, the Bayley Scales of Infant Development-II was used.

Forty-seven children completed all the evaluations and the data were analyzed. Ametropia was seen in 78.7% and strabismus was seen in 44.7% of the 47 children. When subjects were divided into severely impaired and mildly impaired groups based on Gross Motor Function Classification System level, ametropia was more prevalent in the severely impaired than the mildly impaired (95.8% versus 60.9%, P < 0.05). According to quantitative analysis, the severity of gross motor impairment correlated with the degree of refractive error in the subjects older than 36 months (r = -0.65 for the Bayley Scales of Infant Development-II motor scale, P < 0.05).

Based on these findings, children with cerebral palsy with poor gross motor function have a high possibility of severe refractive disorder that becomes evident from 36 months after birth. These results suggest that brain injury and impaired motor development negatively affect ophthalmic development. Hence, an ophthalmic examination is recommended for young children with cerebral palsy to start early management.