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Comprehensive Ocular Examination of Healthy Newborns in the Middle East
Syed M A Ali1,2,3, Iviano Ossuetta2, Annegret Dahlmann-Noor4
1Moorfields Eye Hospital Centre, Abu Dhabi, United Arab Emirates.
Insights
Comprehensive eye exams in healthy infants revealed significant ocular abnormalities, including nasolacrimal duct obstruction and refractive errors. These conditions often go undetected by standard newborn screenings, highlighting the importance of specialized pediatric eye evaluations.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Perinatal ocular diseases can impact infant vision and development.
- Routine newborn screenings may not detect all ocular abnormalities.
- Early detection and intervention are crucial for managing pediatric eye conditions.
Purpose of the Study:
- To determine the prevalence of ocular diseases in healthy infants undergoing comprehensive eye examinations.
- To identify specific types of ocular abnormalities found in this cohort.
- To emphasize the value of specialized eye assessments beyond basic screenings.
Main Methods:
- A prospective study was conducted at a referral eye center in the Middle East.
- Healthy, full-term infants were referred for comprehensive ocular examinations, including red-reflex testing, external, anterior, and dilated posterior segment evaluations, and refraction.
- Data were collected on referral reasons, attendance rates, and identified ocular conditions.
Main Results:
- Of 1220 examined infants, 13.4% had ocular abnormalities in 10.2% of eyes.
- The most common conditions were nasolacrimal duct obstruction (36%) and refractive errors (32.3%).
- Less common findings included congenital cataract (0.3%), ptosis (0.2%), and various retinal abnormalities.
Conclusions:
- Comprehensive ocular examinations in healthy infants detect a substantial number of ocular abnormalities.
- Standard red-reflex testing is insufficient for identifying all potential vision-threatening conditions.
- Specialized pediatric eye care is essential for early diagnosis and management of perinatal eye diseases.
Abstract:
: To report the prevalence of the perinatal ocular disease in healthy infants referred to a referral eye centre in the Middle East region for comprehensive ocular examinations.: All healthy full-term babies born at a tertiary care women's and children hospital were referred to Moorfields Eye Hospital Centre in Abu Dhabi (MEHCAD), the United Arab Emirates for comprehensive ocular examination between January 2018 and April 2019. The examination included red-reflex testing, external, anterior and dilated posterior segment examination, and refraction.: Out of 6836 newborns, 4719 (69%) were not referred due to lack of national insurance (n = 3089), out of network referral (n = 1405), required ROP screening (n = 220) and identification of systemic diagnosis (n = 5). Of 2117 eligible referrals 897 (42%) babies were not examined because they either did not attend (890) or had a double booking for ROP screening (7); hence, 1220 babies (56%) were examined. Their mean age was 39 ± 16 days, and 48.8% were male, 51.2% were female. One hundred and sixty-four (13.4%) babies had an ocular abnormality in 249 (10.2%) eyes. The commonest abnormalities were nasolacrimal duct obstruction (36%) and refractive errors in 53 patients (32.3%). Congenital cataract and ptosis were present in four (0.3%) and three (0.2%) babies, respectively. The commonest retinal findings were intra-retinal haemorrhages (1.4%). Other posterior pole abnormalities included optic disc pit (0.08%) and myelinated nerve fibers (0.08%). One eye (0.08%) had a congenital macular hole.: Comprehensive ocular examinations of healthy infants identifies a number of ocular abnormalities that would not be detected using red-reflex testing by a paediatrician or nurse.
