Related Experiment Video
Updated: Aug 28, 2025
The Use of Trace Eyeblink Classical Conditioning to Assess Hippocampal Dysfunction in a Rat Model of Fetal Alcohol Spectrum Disorders
Published on: August 5, 2017
Eye Abnormalities in Children with Fetal Alcohol Spectrum Disorders: A Systematic Review
Tracey W Tsang1, Amy Finlay-Jones2,3, Kerrin Perry1
1The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Westmead, NSW, Australia, and Sydney Children's Hospital Network, Kids Research, Westmead, Australia.
Insights
This systematic review highlights common eye abnormalities in children with prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders (FASD). Early eye examinations are crucial for timely diagnosis and management of these vision issues.
Area of Science:
- Ophthalmology
- Developmental Pediatrics
- Public Health
Background:
- Eye abnormalities are recognized complications of fetal alcohol spectrum disorders (FASD).
- A comprehensive systematic review adhering to PRISMA guidelines is needed to consolidate existing evidence on the prevalence and range of these ocular conditions.
- Prenatal alcohol exposure (PAE) can lead to a spectrum of developmental issues, including significant visual impairments.
Approach:
- Systematic literature search of electronic databases and manual citation tracking.
- Inclusion of observational studies reporting quantitative data on eye abnormalities in children with PAE and/or FASD.
- Pooled prevalence and statistical comparisons were calculated for identified ocular conditions.
Key Points:
- Short palpebral fissure length (66.1%), visual impairment (55.5%), epicanthus (53.5%), and subnormal stereoacuity (53.0%) were among the most prevalent eye abnormalities.
- Abnormal retinal tortuosity (50.5%), impaired fixation (33.3%), telecanthus (31.7%), optic nerve hypoplasia (30.2%), and small optic discs (27.0%) were also frequently reported.
- Children with FASD exhibited higher rates of strabismus, subnormal vision, ptosis, short palpebral fissure length, microphthalmos, smaller optic disc area, and retinal vessel tortuosity compared to controls.
Conclusions:
- Ocular and visual assessments are essential for children with PAE and suspected or diagnosed FASD.
- Early identification of eye abnormalities facilitates optimal management and intervention strategies.
- This review provides the first comprehensive overview of the spectrum and frequency of eye abnormalities associated with PAE/FASD.
Purpose:
Although eye abnormalities are reported in fetal alcohol spectrum disorders (FASD), no systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines has been undertaken. Our aim was to document the range and prevalence of eye abnormalities reported in children with prenatal alcohol exposure (PAE) and/or FASD.
Methods:
Searches of electronic databases and manual searches. Eligible articles were observational studies in children with PAE and/or FASD; peer reviewed journal articles in the English language; and studies reporting quantitative or frequency data on functional/structural eye abnormalities. Pooled prevalence, odds ratio, and mean differences were calculated.
Results:
Of the 1,068 retrieved articles 36 were eligible, including articles on children with diagnosed fetal alcohol syndrome/FASD (N = 31); PAE (N = 3); and FASD or PAE without FASD (N = 2). Structural and functional eye abnormalities were identified, the most prevalent being short palpebral fissure length (66.1%), visual impairment (55.5%), epicanthus (53.5%), subnormal stereoacuity (53.0%), abnormal retinal tortuosity (50.5%), impaired fixation ability (33.3%), telecanthus (31.7%), optic nerve hypoplasia (30.2%), and small optic discs (27.0%). Compared to non-exposed controls, strabismus, subnormal vision, ptosis, short palpebral fissure length, microphthalmos, smaller optic disc area, and retinal vessel tortuosity were more prevalent in children with FASD.
Conclusions:
Examination of eyes and vision should be considered in children with PAE and suspected or diagnosed FASD to enable early identification and optimal management. This first comprehensive, systematic literature review demonstrates the variety and frequency of eye abnormalities reported in PAE/FASD.
