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Visual acuity in unilateral cataract

D A Thompson1, H Møller, I Russell-Eggitt

  • 1Department of Ophthalmology, Great Ormond Street, Hospital for Children, NHS Trust, London.

The British Journal of Ophthalmology
|September 1, 1996
PubMed
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Patching the fellow eye after congenital cataract surgery may reduce vision in that eye. This visual acuity loss, detected by logMAR charts, may be an iatrogenic effect of patching.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Visual Neuroscience

Background:

  • Unilateral congenital cataract treatment involves patching the fellow eye to promote visual development in the operated eye.
  • The potential for iatrogenic visual deficits in the patched fellow eye is a concern.

Purpose of the Study:

  • To investigate whether patching the fellow eye in children treated for unilateral congenital cataract leads to iatrogenic visual deficits.
  • To compare the visual acuity of the fellow eye in treated patients with controls.

Main Methods:

  • Sweep visual evoked potentials (VEPs) were used to objectively estimate grating acuity in 12 children (4-16 years) post-cataract surgery.
  • Recognition linear acuities were measured using a Bailey-Lovie logMAR chart.
  • Acuities were compared between the aphakic eye, fellow phakic eye, binocularly normal controls, and untreated uniocularly impaired children.

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Main Results:

  • A statistically significant reduction in recognition acuity was found in the fellow phakic eye of the patient group compared to controls (p < 0.01).
  • This acuity loss was not observed in children with untreated uniocular visual impairment.
  • The acuity loss was not detected using sweep VEP estimates, although VEPs are useful for infants and non-communicative individuals.

Conclusions:

  • Patching the fellow eye in treated unilateral congenital cataract cases can lead to a measurable loss of recognition acuity.
  • This loss may be an iatrogenic effect of occlusion therapy.
  • Sweep VEPs are valuable for objective acuity assessment in specific populations, but slower VEP recordings may be better for higher acuities.