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Ophthalmic Findings in Aboriginal Children with High Rates of Prenatal Alcohol Exposure and Fetal Alcohol Spectrum
Tracey W Tsang1,2, Tiffany Allen3, Angus Turner4,5
1Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.
Insights
Ophthalmic abnormalities like astigmatism and blepharoptosis are more common in Indigenous children with prenatal alcohol exposure (PAE) or fetal alcohol spectrum disorder (FASD). Early eye assessments are crucial for effective treatment in these vulnerable children.
Area of Science:
- Ophthalmology
- Paediatric Medicine
- Public Health
Background:
- Indigenous children in remote areas face unique health challenges.
- Prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorder (FASD) can lead to developmental issues.
- Ophthalmic conditions require timely diagnosis and intervention.
Purpose of the Study:
- To document eye conditions in an Indigenous Australian paediatric population.
- To investigate the link between FASD, PAE, and specific eye anomalies.
- To inform targeted eye care strategies for at-risk children.
Main Methods:
- Retrospective review of medical records for eye problems.
- Ophthalmic assessments conducted by specialists in a defined cohort.
- Prevalence of abnormalities analyzed and stratified by PAE and FASD status.
Main Results:
- 19% of children had FASD, and 55% had PAE.
- Common findings included astigmatism (15.6%), strabismus (22.3%), and short palpebral fissure length (21.3%).
- Higher rates of short palpebral fissure length and blepharoptosis were observed in children with FASD compared to controls.
Conclusions:
- Certain eye abnormalities are more prevalent in Indigenous children with PAE or FASD.
- Early detection and management of vision and structural eye anomalies are vital.
- Enhanced access to eye care services is essential for this population.
Purpose:
To describe ophthalmic findings in an Indigenous paediatric population and the associations between fetal alcohol spectrum disorder (FASD), prenatal alcohol exposure (PAE), and eye anomalies.
Methods:
Medical records were reviewed for eye problems, and eye assessments were conducted by an orthoptist or ophthalmologist in the Lililwan Project cohort, which comprised 108 (81%) of all children born between 2002 and 2003, and residing in the remote Fitzroy Valley, Western Australia in 2010. Values from ophthalmic assessments and prevalence of abnormalities were presented for the total cohort and stratified by group: FASD; PAE (no FASD); and No PAE.
Results:
Of children, 55% had PAE and 19% FASD. Most (98%) had normal vision; 15.6% had keratometry cylinder values indicating astigmatism and potential for improved vision with glasses. Strabismus (22.3%), short palpebral fissure length (PFL; 21.3%), upslanting palpebral fissures (12.0%), follicular trachomatous inflammation (6.9%), abnormal slit lamp assessments (6.7%), retinal tortuosity (6.7%), and blepharoptosis (5.6%) were identified. Strabismus and trachoma rates were higher than in the general child population. Ophthalmic findings were similar between groups except for prevalence of short PFL (FASD > No PAE; p = 0.003); abnormal keratometry cylinder values (FASD [29.4%] and PAE (no FASD) [20.0%] > No PAE [5.3%]; p = 0.031) and blepharoptosis (FASD [9.5%] > other groups [0%]; p = 0.040).
Conclusion:
Despite the small sample, some eye abnormalities were higher in children with PAE and/or FASD. Access to eye services or assessment of vision and structural eye anomalies is essential for Indigenous children, particularly those with PAE or FASD to allow early effective treatment.
