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Ocular findings in prematurely born children at 5 years of age
K Tuppurainen1, E Herrgård, A Martikainen
1Department of Ophthalmology, University Hospital of Kuopio.
Insights
Premature infants born before 32 weeks show higher rates of significant refractive errors and strabismus by age 5. These visual impairments, including myopia and hyperopia, differ from those in full-term children.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Premature infants face increased risks for various health issues, including visual impairments.
- Understanding long-term ophthalmological outcomes in extremely preterm infants is crucial for early intervention.
Purpose of the Study:
- To assess the prevalence of refractive errors and strabismus in 5-year-old children born prematurely (gestational age ≤ 32 weeks).
- To compare the pattern of eye findings in preterm children with a control group of full-term children.
Main Methods:
- Ophthalmological examinations were conducted as part of a neurodevelopmental evaluation for 58 prematurely born children.
- Refractive errors (hyperopia, myopia, astigmatism, anisometropia), manifest strabismus, and visual impairment were assessed.
- A control group of randomly selected full-term children of the same age was included for comparison.
Main Results:
- Significant hyperopia (≥ +2.0 D) was found in 22.4% of preterm children, myopia (≥ -1.0 D) in 8.6%, astigmatism (≥ 1.0 D) in 12.1%, and anisometropia (≥ 1.0 D) in 12.1%.
- High myopia (-6.0 to -14.0 D) was noted in all myopic cases. Manifest strabismus occurred in 24.2%, and visual impairment/blindness in 6.9%.
- Preterm children exhibited a different pattern of eye findings compared to full-term controls (hyperopia 14.3%, astigmatism 5.4%, strabismus 1.8%).
Conclusions:
- Premature birth, particularly before 32 weeks gestation, is associated with a significantly higher prevalence of various refractive errors and strabismus at age 5.
- Optic atrophy and retinopathy of prematurity are key causes of severe visual defects in this population.
- The distinct ophthalmological profile in preterm children underscores the need for specialized, long-term visual monitoring.
Abstract:
Fifty-eight prematurely born children (gestational age < or = 32 weeks) were studied at the age of 5 years. The ophthalmological examination was part of an extensive neurodevelopmental evaluation. The eye study revealed significant hyperopia (> or = + 2.0) in 22.4%, myopia (> or = -1.0 D) in 8.6%, astigmatism (> or = 1.0 D) in 12.1%, and anisometropia (> or = 1.0 D) in 12.1%. The myopic refractive error was high in all of the cases: from -6.0 to -14.0 D. Manifest strabismus was found in 24.2% and significant visual impairment or blindness in 6.9%. Optic atrophy and cicatricial retinopathy of prematurity were the main causes for severe visual defects. In the randomly selected full-term children of the same age, significant hyperopia was seen in 14.3%, astigmatism in 5.4% and strabismus in 1.8%. The pattern of the eye findings was different in the preterm children compared with those born at term.