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Raised in Darkness: A 7-Month-Old With Nystagmus From Severe Visual Deprivation
Cynthia H Ho1, Jasmine Zargarpour, Michèle Evans
1From the *Departments of Internal Medicine and Pediatrics, Keck School of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles; †Department of Pediatrics, Kaiser Permanente South Bay Medical Center, Harbor City; and ‡Department of Pediatrics, Kaiser Permanente Sacramento/Roseville Medical Center, Lincoln, CA.
Insights
Child neglect, particularly educational neglect, is a significant issue. This case highlights acquired nystagmus in an infant due to prolonged visual deprivation from neglect.
Area of Science:
- Pediatrics
- Ophthalmology
- Child Maltreatment
Background:
- Child neglect is the most prevalent form of child maltreatment, constituting 60% of reported cases.
- Educational neglect represents half of all child neglect cases, while physical and emotional neglect comprise a quarter.
Observation:
- A 7-month-old infant presented with signs of physical and emotional neglect, including failure to thrive and global developmental delay.
- The infant exhibited excessive quietness and a gastric lactobezoar.
- A fine, lateral nystagmus was observed, suspected to be caused by prolonged periods in darkness.
Findings:
- This case is the first to report acquired nystagmus resulting from visual deprivation secondary to child neglect.
- The infant's nystagmus is likely a direct consequence of environmental neglect.
Implications:
- This case underscores the severe and varied physical manifestations of child neglect.
- It highlights the importance of recognizing ophthalmological signs as indicators of neglect.
- Early identification and intervention are crucial to prevent long-term consequences of child neglect.
Abstract:
Child neglect is the most common form of child maltreatment and accounts for 60% of all cases reported to child protective services. Whereas physical and emotional neglect account for a quarter of the reported cases of child neglect, educational neglect accounts for half of the cases. We describe a 7-month-old infant with several manifestations of physical and emotional neglect including excessive quietness, failure to thrive, global developmental delay, and a gastric lactobezoar. In addition, our patient had a fine, lateral nystagmus likely due to being kept in the dark for long periods. To our knowledge, this is the first reported case of acquired nystagmus due to visual deprivation from child neglect.
