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[Ophthalmoscopic evaluation of ocular fixation in children up to 2 years old]
1Abteilung Pleoptik und Orthoptik, Universitäts-Augenklinik Hamburg.
Background:
The examination of fixation on the fundus oculi is one of the main points in the diagnosis of amblyopia. Therefore it is necessary to describe the fixation ability and to clarify at what age children can fixate foveally and at what age this examination can be carried out, considering not only physiological aspects, but also co-operation reasons.
Patient And Methods:
Fixation on the fundus oculi was examined in 111 children aged between 1 and 25 months with the ophthalmoscop-star. This examination was carried out in 64 cases by a second and in 15 cases by a third examiner on the same day.
Results:
During the first 3 months of age children cannot fixate foveally, one can observe instead, a kind of scatter at the posterior pole in a diameter of about 5 degrees. In the course of the 4, and 5, month of age foveal fixation develops. Repeated examinations of the same child on the same day by a 2, and 3, examiner reveal a very high rate of accordance (78%) of their results.
Conclusions:
The examination of fixation on the fundus can be carried out at 4 to 5 months of age. At that age one can differentiate quite reliable between a foveal and eccentric fixation as well as scatter at the posterior pole. The rate of accordance 78% with this fixation examination by several examiners shows that same reliability of this examination carried out in school children and adults. Comparing this result with fixation examination carried out with the Haidinger brushes then one must calculate with a fault rate of about 20% when examining with the ophthalmoscope, considering that the examination with Haidinger brushes as a reference examination.