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Causes of severe visual impairment in infants and methods of management
Zuhal Ozen Tunay1, Zeynep Ustunyurt2, Aysun Idil3
1University of Health Sciences, Zekai Tahir Burak Education and Research Hospital, Department of Ophthalmology, Ankara, Turkey. zuhaltunay@gmail.com.
Insights
Cerebral visual impairment (CVI) is the leading cause of severe visual impairment (SVI) in infants. Most cases are preventable, with optic interventions and visual stimulation therapy being key management strategies.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Severe visual impairment (SVI) in infants presents significant challenges for development and quality of life.
- Understanding the etiological factors and effective management strategies is crucial for early intervention.
Purpose of the Study:
- To investigate the primary causes of SVI in infants under two years of age.
- To review and analyze the management approaches for SVI in this pediatric population.
Main Methods:
- Retrospective review of 2657 infant patient records from January 2014 to July 2019.
- Analysis of 148 infants diagnosed with SVI, focusing on demographics, affected sites, diagnoses, co-occurring deficiencies, and management strategies.
- Categorization of diagnoses into avoidable and unavoidable causes and evaluation of management from a low vision habilitation perspective.
Main Results:
- Cerebral visual impairment (CVI) was the most frequent diagnosis in both preterm (39.1%) and term (11.4%) infants.
- Avoidable causes accounted for 79.7% of SVI cases; 30% of infants had multiple disabilities, rising to 94% in those with CVI.
- Common management involved optic interventions, visual stimulation therapy, and medical/surgical treatments.
Conclusions:
- CVI is the predominant cause of SVI in infants, regardless of prematurity.
- The high incidence of multiple disabilities associated with CVI underscores the need for comprehensive care.
- Optic interventions and visual stimulation therapy are the most frequently employed management methods for infant SVI.
Objectives:
To examine the causes of severe visual impairment (SVI) in infants below the age of 2 years and to review management methods.
Methods:
The data of 2657 patients followed between January 2014 and July 2019 were reviewed, and 148 (5.6%) infants who had SVI were enrolled. Data including age, gender, affected anatomical site, diagnosis, presence of any non-ophthalmological deficiencies, and methods of management were reviewed. The diagnoses were investigated in the categories of avoidable and unavoidable basis. The methods of management were analysed from the perspective of low vision habilitation.
Results:
The mean age at first eye examination was 6.61 ± 5.25 months, and 84 (56.7%) infants were male. Of the 148 infants, 69 (46.6%) were premature. Cerebral visual impairment (CVI) was the most common diagnosis in both preterm (39.1%) and term (11.4%) infants. Delayed visual maturation, optic nerve pathologies, oculocutaneous albinism, and congenital cataract were the other frequent causes. The rate of multiple disabilities was 30% in the whole group and 94% in infants with CVI. Most of the babies had a normal-appearing globe (43.3%). Retina was affected in 23.7% of the infants. Avoidable causes were identified in 79.7% of the infants. The used methods of management were optic interventions, visual stimulation therapy, medical and/or surgical treatment.
Conclusions:
CVI was found the most common cause of SVI in both preterm and term-born infants, and the higher rate of multiple disabilities in these infants was remarkable. Optic interventions and visual stimulation therapy were the most common methods of management.
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