AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

Purpose. To evaluate the correlation between peripapillary retinal nerve fibre layer (RNFL) thickness and both age and refraction error in healthy children using optical coherence tomography (OCT). Patients and Methods. 80 healthy children with a mean age of 9.1 years (range 3.8 to 16.7 years) undergoing routine ocular examination at the orthoptic section of the Ophthalmology Department were recruited for this cross-sectional study. After applying cycloplegia, the peripapillary RNFL thickness was measured in both eyes using the Topcon 3D OCT 2000 device. Results. 138 eyes were included in the analysis. The average refractive error (SE) was +1.7 D (range −5.25 to +7.25 D). The mean total RNFL thickness was 105 μm ± 10.3, the mean superior RNFL thickness was 112.7 μm ± 16.5, and the mean inferior RNFL thickness was 132.6 μm ± 18.3. We found no statistically significant effect of age on RNFL thickness (ANOVA, f = 0.33, p = 0.56). Refraction was proven to have a statistically significant effect (ANOVA, f = 67.1, p < 0.05) in RNFL measurements. Conclusions. Data obtained from this study may assist in establishing a normative database for a paediatric population. Refraction error should be taken into consideration due to its statistically significant correlation with RNFL thickness.

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