Evidence-Based Overview of Ophthalmic Disorders in Deaf Children: A Literature Update

Abstract

The main conclusions of this project are: a) the overall quality of evidence in the literature concerning deaf children and their ophthalmic problems is very low, b) the prevalence of ophthalmic problems in deaf children is very high (approximately 40% to 60%) and these problems may remain undetected for years although they may have a serious impact on children's acquisition of communication skills, c) screening for ophthalmic problems in deaf children should be encouraged and specialist ophthalmic examination should be carried out as soon as the diagnosis of deafness is confirmed irrespective of age, and may need to be repeated at intervals following diagnosis, d) families should be informed about the nature of the screening process in discussion with the relevant professionals and appropriate information should be available in a range of formats and in different community languages, e) professionals administering the tests should be familiar with the needs of deaf children with ophthalmic problems and should be sensitive to the communication needs of the child, especially undertaking behavioural testing where their collaboration is needed, f) while orthoptists can perform the majority of psychophysical tests (visual and stereo acuity tests, ocular motility tests, etc.) a comprehensive opthalmologic assessment by slit lamp biomicroscopy, streak retinoscopy, direct and indirect ophthalmoscopy, intraocular pressure measurement etc is required. Electrophysiologic testing to help identification of Usher syndrome may also be required, and finally g) serial hearing assessments of children with dual sensory deficits are needed to monitor hearing thresholds, to optimise hearing aid use and to ensure timely referral for cochlear implantation for those who need it.

Ophthalmological screening of a paediatric cochlear implant population: a retrospective analysis and 12-year follow-up

“…These higher rates of ocular abnormality have been attributed to the retina and cochlea maturing during the same embryological period (fourth embryonic week) from the same embryonic layer (ectoderm), which may be susceptible to genetic and/or environmental factors. 8 The most frequent ophthalmic finding is refractive errors (26.4%), similar to the earlier studies. Fourteen of our patients with refractive errors were fitted with corrective spectacles.…”

“…Some disorders may be correctable (eg, refractive) or treatable (eg, cataracts). 8 It is crucial to establish normal visual acuity, as hearing-impaired children are extremely dependent on vision to compensate for the loss of auditory input. 4 Those children with non-correctable and non-treatable visual disorders, such as retinitis pigmentosa in Usher's syndrome, are especially good candidates for early cochlear implants, which will improve listening and spoken language skills.…”

Cross-modal plasticity in cuban visually-impaired child cochlear implant candidates: topography of somatosensory evoked potentials

“…However, during analysis and interpretation of the results, we realized that the limitations of considering deaf-blindness as a disability involving the loss of both senses without taking into account that vision loss is not necessarily total. [35] When dealing with children who have profound bilateral sensorineural deafness in common, there is absolutely no possibility of exploring cortical activation via this route. In contrast, given that these children presented differences in vision loss severity, we have still to explore their cortical response in terms of CMP if given visual in addition to tactile stimuli.…”

“…[37] Finally, although this study did not examine neural and synaptic mechanisms that could provide supporting evidence of SEP N20 topography changes in CI candidates, we could hypothesize about the phenomena involved by referring to basic experimental fi ndings regarding neuroplastic changes in sensory systems as an effect of single sensory deprivation (auditory or visual) discussed in review articles on the topic. [35,38] In summary, neuroplasticity in deaf-blind children requires further study. Post-CI assessment of deaf-blind children using electrophysiological techniques, in this case SEP N20, will be useful to describe changes or lack thereof in cortical reorganization during auditory rehabilitation.…”

Ophthalmologic Screening in A School for the Hearing Impaired in Turkey

“…1 For this pa ti ent gro up, edu ca ti o nal mo di fi ca ti ons and ca re er plan ning are im por tant, be ca u se so me of the se pa ti ents will ad di ti o nally ha ve vi su al im pa ir ment be yond early adult hood. [4][5][6] Anot her con cern for the se pa ti ents is the need for pro fes si o nal sup port to the fa mily and chil dren for adap ting to this chal len ging si tu a tion.…”