Related Experiment Video
Updated: May 27, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Prevalence of Vision and Eye Movement Abnormalities in Children Referred to the Children's Epilepsy Surgery Service:
Insights
Ophthalmic abnormalities are common in children with epilepsy referred for surgery, with over half undiagnosed. This highlights the need for specialized vision screening in this population.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Epileptology
Background:
- Epilepsy in children can be associated with various comorbidities.
- Ophthalmic issues may impact quality of life and surgical outcomes in pediatric epilepsy patients.
- Early identification of visual problems is crucial for comprehensive care.
Purpose of the Study:
- To determine the prevalence of visual acuity, visual field, and ocular motility problems in children with epilepsy.
- To assess these visual issues in children referred to the Children's Epilepsy Surgery Service (CESS) for surgical evaluation.
Main Methods:
- Retrospective observational study of 221 children referred to CESS (2015-2020).
- Data collected included demographics, epilepsy details, anti-seizure medications, and ophthalmic assessments (visual acuity, visual field, ocular motility, fundus imaging).
Main Results:
- 53% of children had ophthalmic abnormalities, including strabismus (16%), visual field defects (14%), and reduced visual acuity (12%).
- Over half (54%) of those with abnormalities received new diagnoses at the CESS clinic.
- Younger children and those with neurodevelopmental disorders were less likely to complete all vision tests.
Conclusions:
- Ophthalmic abnormalities are highly prevalent in children with epilepsy referred for surgery, with a significant proportion being newly diagnosed.
- The findings support implementing an orthoptic-led vision screening program for children with medically refractory epilepsy, structural etiologies, and focal seizures.
- Improved vision screening can better address the needs of these children within the community.
Purpose:
To report the prevalence of visual acuity, visual field, and ocular motility problems in children with epilepsy referred to the Children's Epilepsy Surgery Service (CESS) for surgery.
Methods:
This was a retrospective observational study of all children referred to the CESS in Bristol between 2015 and 2020. Data extraction included age, age at epilepsy diagnosis, epilepsy etiology (as determined by seizure semiology, neuroimaging, and electroencephalography), anti-seizure drugs, visual acuity, visual field, ocular motility, and fundus imaging.
Results:
A total of 221 children with epilepsy were seen during the study period: 60% (132/221) had structural etiologies, 8% (18/221) were genetic, and in 28% (62/221) the etiology was unknown. Overall, 53% (117/221) were found to have abnormalities, particularly strabismus (16%, 36/221), visual field defects (14%, 27/198), and reduced visual acuity (12%, 26/219). Notably, 54% (63/117) of children with ophthalmic abnormalities were new diagnoses in the CESS clinic. Younger children and those with neurodevelopmental disorders were less likely to complete all vision tests.
Conclusions:
Ophthalmic abnormalities were prevalent among children referred for epilepsy surgery in Bristol and more than half were previously undiag-nosed. The data support the adoption of an orthopticled vision screening service for children with medically refractory epilepsy, structural etiologies, and focal seizures, to better support their needs in the community. [J Pediatr Ophthalmol Strabismus. 2025;62(3):211-219.].
