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Reduced accommodation in children with cerebral palsy
1School of Optometry, University of Waterloo, Ontario, Canada.
Insights
Many individuals with cerebral palsy exhibit abnormal accommodation patterns and reduced amplitude of accommodation, impacting visual acuity. These visual impairments have significant developmental and educational implications.
Area of Science:
- Ophthalmology
- Neuroscience
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) can affect various physiological systems, including visual function.
- Accommodation, the eye's ability to change focus, is crucial for clear vision, especially at near distances.
- Objective and reliable methods for assessing accommodation are essential in clinical and research settings.
Purpose of the Study:
- To objectively measure and characterize the accommodative response patterns and amplitude in individuals with cerebral palsy.
- To compare the accommodative function in subjects with CP to age-matched normal controls.
- To investigate the associations between accommodative function and other factors like visual acuity, cognitive ability, and age in the CP population.
Main Methods:
- Dynamic retinoscopy, a validated and repeatable technique, was employed to assess accommodation.
- The study included 43 subjects diagnosed with cerebral palsy, aged 3 to 35 years.
- Accommodative response patterns and amplitude were analyzed and compared between the CP group and a normal control group.
Main Results:
- 42% of subjects with CP displayed abnormal accommodative response patterns compared to controls.
- Approximately 29% of the CP group had a reduced amplitude of accommodation (≤4 D).
- Reduced accommodation correlated with lower visual acuity but showed no association with cognitive ability, communication skills, refractive error, or age. A high prevalence of other ocular disorders was also noted.
Conclusions:
- Individuals with cerebral palsy frequently exhibit significant deficits in accommodative function.
- These visual impairments, particularly reduced accommodation, are linked to diminished visual acuity.
- The findings underscore the need for targeted visual assessments and interventions in the developmental and educational management of individuals with cerebral palsy.
Abstract:
Accommodation in 43 subjects with cerebral palsy was measured objectively using a dynamic retinoscopy technique, which has already been shown to be reliable and repeatable. The subject's ages ranged from 3 to 35 years. Of these, 42% were found to have an accommodative response pattern which was different from the normal control group for his/her age. Nearly 29% had an estimated amplitude of accommodation of 4 D or less. The presence of reduced accommodation was found to be associated with reduced visual acuity, but was not associated with cognitive or communication ability, refractive error or age. The prevalence of other ocular disorders in this group is also high. These findings have developmental and educational implications.