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Published on: October 24, 2019
The effects of preterm birth on visual development
Myra Ps Leung1, Benjamin Thompson1,2, Joanna Black1
1School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand.
Insights
Children born very preterm face higher risks of vision and brain development issues. Early detection of common visual deficits is crucial, but subtle cortical processing problems may require further investigation.
Area of Science:
- Developmental neuroscience
- Ophthalmology
- Pediatrics
Background:
- Children born very preterm exhibit increased risks for abnormal visual and neurological development compared to full-term infants.
- Preterm birth is linked to retinopathy of prematurity and can impact brain structures crucial for visual information processing.
Purpose of the Study:
- To highlight vision problems in preterm children beyond those typically detected by routine screenings.
- To emphasize the potential long-term impact of visual processing deficits on learning, attention, and cognition.
Main Methods:
- Review of existing literature on visual and neurological development in preterm infants.
- Analysis of common and less-detected visual impairments associated with preterm birth.
- Exploration of the link between visual processing deficits and neurodevelopmental outcomes.
Main Results:
- While common visual deficits (e.g., reduced acuity, strabismus) are often identified, subtle issues like impaired contrast sensitivity and cortical processing deficits may be missed.
- Impairments in dorsal stream visual functions, such as motion perception and visuomotor integration, can persist into adolescence and adulthood.
- These visual impairments may contribute to learning difficulties (reading, math), attention deficits, and cognitive challenges in individuals born preterm.
Conclusions:
- Routine vision screening may not capture all visual deficits in preterm children.
- Understanding the mechanisms of visual impairment is vital for developing targeted interventions.
- Addressing these visual challenges could improve overall neurodevelopmental outcomes for preterm infants.
Abstract:
Children born very preterm are at a greater risk of abnormal visual and neurological development when compared to children born at full term. Preterm birth is associated with retinopathy of prematurity (a proliferative retinal vascular disease) and can also affect the development of brain structures associated with post-retinal processing of visual information. Visual deficits common in children born preterm, such as reduced visual acuity, strabismus, abnormal stereopsis and refractive error, are likely to be detected through childhood vision screening programs, ophthalmological follow-up or optometric care. However, routine screening may not detect other vision problems, such as reduced visual fields, impaired contrast sensitivity and deficits in cortical visual processing, that may occur in children born preterm. For example, visual functions associated with the dorsal visual processing stream, such as global motion perception and visuomotor integration, may be impaired by preterm birth. These impairments can continue into adolescence and adulthood and may contribute to the difficulties in learning (particularly reading and mathematics), attention, behaviour and cognition that some children born preterm experience. Improvements in understanding the mechanisms by which preterm birth affects vision will inform future screening and interventions for children born preterm.
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