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Ocular Findings in Children with Headache
Lisa Y Lin1,2, Wei Pan3, Gui-Shuang Ying3
1Department of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Ophthalmic Epidemiology
|September 20, 2022
Summary
A significant number of children experiencing headaches have underlying ocular issues. An eye exam is crucial for diagnosing treatable conditions and potential intracranial problems in pediatric headache patients.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Headaches are a common complaint in children.
- Identifying the underlying cause is crucial for effective management.
- Ophthalmological factors can contribute to or indicate serious neurological conditions.
Purpose of the Study:
- To determine the prevalence of ophthalmological findings in children presenting with headaches.
- To identify ocular conditions that may cause headaches or suggest occult neurological disease.
Main Methods:
- A retrospective cross-sectional study was conducted on 1,878 children with headaches.
- Ophthalmological examinations included sensorimotor, anterior segment, and dilated fundoscopic assessments.
- Cycloplegic refraction was performed in some cases to evaluate refractive errors and asthenopia.
Main Results:
- Over a quarter of children (26.1%) had new ocular findings potentially related to their headaches.
- Common findings included refractive issues (18.2%), strabismus (4.4%), and optic nerve elevation (2.7%).
- While shorter headache duration was linked to ocular findings, other symptoms like nausea or visual changes were not reliable predictors.
Conclusions:
- Ophthalmological examination, including cycloplegic refraction, is recommended for children with headaches.
- Approximately 26% of pediatric headache patients have treatable ocular conditions or signs of intracranial pathology.
- Specific symptoms like visual changes or morning headaches warrant further investigation for optic nerve elevation.
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