Motor skills of children with unilateral visual impairment in the Infant Aphakia Treatment Study
Marianne Celano1, E Eugenie Hartmann2, Lindreth G DuBois1
1Emory University School of Medicine, Atlanta, GA, USA.
Insights
Children with unilateral congenital cataracts show delayed motor skills at 4.5 years. Better vision in either eye, not just the treated one, predicts improved motor functioning, impacting development.
Area of Science:
- Pediatric ophthalmology
- Developmental pediatrics
- Motor development
Background:
- Unilateral congenital cataracts require early intervention, often involving intraocular lens (IOL) or contact lens (CL) treatment.
- The long-term impact of such treatments on a child's overall motor functioning is not fully understood.
Purpose of the Study:
- To evaluate motor skills in 4.5-year-old children treated for unilateral aphakia.
- To investigate the relationship between visual acuity, stereopsis, and motor performance in this cohort.
Main Methods:
- The Infant Aphakia Treatment Study enrolled 104 children (53% female) with unilateral aphakia.
- Motor skills were assessed using the Movement Assessment Battery for Children--Second Edition (MABC-2).
- Visual acuity and stereopsis were measured, with visual acuity operationalized as logMAR values.
Main Results:
- No significant differences in MABC-2 scores were found between IOL and CL treatment groups.
- Mean MABC-2 scores were below normative levels, indicating delayed motor functioning.
- Better visual acuity in either eye, rather than the treated eye alone, predicted motor skills.
Conclusions:
- Children treated for unilateral congenital cataracts may exhibit delayed motor functioning at 4.5 years.
- This delay could potentially impact social and academic development.
- Visual input from the better-seeing eye plays a crucial role in motor development.
Aim:
To assess motor functioning in children aged 4 years 6 months enrolled in the Infant Aphakia Treatment Study, and to determine contributions of visual acuity and stereopsis to measured motor skills.
Method:
One hundred and four children (53% female) with unilateral aphakia randomized to intraocular lens or contact lens treatment were evaluated at 4 years 6 months (age range 4y 6mo-4y 11mo) for monocular recognition visual acuity, motor skills, and stereopsis by a traveling examiner masked to treatment condition. Motor skills were assessed with the Movement Assessment Battery for Children--Second Edition (MABC-2). Visual acuity was operationalized as log10 of the minimum angle of resolution (logMAR) value for treated eye, best logMAR value for either eye, and intraocular logMAR difference.
Results:
Student's t-tests showed no significant differences in MABC-2 scores between the intraocular lens and contact lens groups. The mean total score was low (6.43; 18th centile) compared with the normative reference group. Motor functioning was not related to visual acuity in the treated eye or to intraocular logMAR difference, but was predicted in a regression model by the better visual acuity of either eye (usually the fellow eye), even after accounting for the influence of age at surgery, examiner, orthotropic ocular alignment, and stereopsis.
Interpretation:
Children with unilateral congenital cataract may have delayed motor functioning at 4 years 6 months, which may adversely affect their social and academic functioning.
