Ocular Hazards During Birth

Jain, IS; Singh, YP; Grupta, S L; Gupta, Amod

doi:10.3928/0191-3913-19800101-04

Cited by 53 publications

(8 citation statements)

References 4 publications

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“…Retinal hemorrhages are one of the common conditions at birth and seen more commonly in vacuum-assisted births, followed by spontaneous vaginal deliveries, unlike those encountered rarely in cesarean deliveries (6,7) . Most birth-related retinal hemorrhages are intraretinal and typically resorbed within seven to 10 days, but can last up to 30 days (6)(7)(8) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Ocular Abnormalities in Term Infants

Daldal¹,

Turkyilmaz²,

Salış³

et al. 2021

BUCH

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Objective: To exhibit the results of routine ophthalmologic screening in infants between 0-1 years of age referred to the ophthalmology clinic from the departments of pediatrics and family medicine. Method: Referred to the ophthalmology clinic between August 2014 and November 2019, 11196 eyes of 5598 term infants were retrospectively investigated in the study, and all participants were ophthalmologically examined at 1st, 6th, and 12th months of age. Infants’ pupils were dilated with 0.5% tropicamide and 2.5% phenylephrine. On examination, eye and face symmetries were evaluated with inspection, fixation, and ocular tracking. Pupil responses and motility were evaluated with the light source. While the red reflex test was evaluated using a direct ophthalmoscope, fundus was assessed through an indirect ophthalmoscope. Results: Congenital cataract (6), congenital glaucoma (3), strabismus (81), epiphora (426), non-specific retinal hemorrhages (42) and retinal pigmentation changes (10), coloboma (4) (one eyelid, four iris, one optical disc and three chorioretinal), optic disc abnormalities (3), congenital ptosis (13) (unilateral in 12 patients and bilateral in one patient), corneal dysgenesis (2) and microphthalmia (3) were determined in 11196 eyes of 5598 infants (2709 females, 2889 males). Conclusion: Perinatal ophthalmologic screening program is likely to diagnose several diseases earlier, such as congenital cataracts, congenital glaucoma, strabismus, corneal opacities, causing vision losses in infants. Treatment options are available, and some diseases can be treated due to early intervention. Early treatment can also eliminate the problems precluding the development of complex visual ability continuing in perinatal period. Consequently, final visual acuity may be increased.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Ocular Abnormalities in Term Infants

Daldal¹,

Turkyilmaz²,

Salış³

et al. 2021

BUCH

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“…According to Jain et al ,[ 2 ] around 17.3% of neonates born with forceps-assisted deliveries sustain ocular injuries (to eye or adnexa or both). According to McAnena et al ,[ 5 ] around one-third of these injuries are associated with corneal edema at birth, out of which one-fourth can finally culminate in corneal scarring and amblyopia.…”

Section: Epidemiologymentioning

confidence: 99%

“…Avoiding the use of forceps may not be feasible in developing countries and is therefore not recommended considering the low incidence of this complication. [ 2 3 ] Therefore, awareness needs to be created among the consulting obstetricians and health care workers who employ forceps-assisted deliveries to examine the neonatal eyes by themselves or refer them to pediatricians or ophthalmologists for ruling out any such traumatic issues. Early diagnosis followed by accurate refractive correction and masking of the healthy eye within one year of birth may limit the visual morbidity associated with these tears.…”

Section: Preventionmentioning

confidence: 99%

“…[ 1 ] In modern medicine, forceps-induced birth trauma to the eye is a rare clinical event as obstetrical forceps are infrequently employed for delivering neonates owing to the advancements in cesarean section. [ 2 ] However, this complication can still be encountered in developing countries like India where the surgical facilities for cesarean operation are not readily available at every clinic. [ 3 ] The condition can lead to significant visual debilitation in young children and is frequently overlooked due to its low incidence.…”

mentioning

confidence: 99%

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Obstetrical forceps-induced Descemet membrane tears

Agarwal

Singh²,

Sinha³

et al. 2021

Indian Journal of Ophthalmology

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Obstetrical forceps-induced Descemet membrane tears (FIDMT) are usually encountered during complicated forceps-assisted deliveries. The condition may lead to significant visual debilitation in young children and is frequently ignored due to its low incidence. Undue stretch on the Descemet’s membrane during the process of forceps-assisted delivery results in their vertical/oblique tear (s), which usually leads to corneal edema in early neonatal life. On its resolution, these residual tears result in visually disabling astigmatism that can lead to dense and recalcitrant amblyopia. Slit-lamp examination, anterior segment optical coherence tomography, specular microscopy, confocal microscopy, and corneal topography and tomography can be employed for its accurate diagnosis. While these can be prevented by improved perinatal care, once diagnosed, they mandate prompt refractive correction and amblyopia therapy to prevent disabling visual deterioration in affected children. In adulthood, medical and surgical management may be planned for symptomatic patients based on coexistent amblyopia as this is the major factor guiding visual prognosis. There is limited comprehensive literature in this regard, and the present review discusses the pathogenesis, clinical features, and recent developments in investigations, management, and outcomes of FIDMT during the last three decades.

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“…Tears in the Descemet membrane can occur following a complicated forceps-assisted delivery . Corneal folds induce astigmatism and ocular aberrations, resulting in poor image quality and consequent amblyopia . Folds have been described previously but by histopathological examination …”

mentioning

confidence: 99%

Folds in Descemet Membrane Associated With Forceps-Induced Injury

2017

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An adolescent girl presented with low vision in the left eye since birth. Her uncorrected visual acuity was 20/20 OD and 20/200 OS. A history of obstetric forceps-assisted vaginal delivery was elicited. Ocular examination was remarkable for the presence of oblique striae in the cornea of the left eye (Figure, A). Intraocular pressure and posterior segment examination results were normal. Scheimpflug imaging revealed 9 diopters with the rule astigmatism. Anterior segment optical coherence tomography of the cornea showed multiple Descemet folds and scarring (Figure, B). Best corrected visual acuity of 20/63 was achieved with −1.5DS/ +5.50DC × 70.Tears in the Descemet membrane can occur following a complicated forceps-assisted delivery. 1 Corneal folds induce astigmatism and ocular aberrations, resulting in poor image quality and consequent amblyopia. 2 Folds have been described previously but by histopathological examination. 3

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Ocular Hazards During Birth

Cited by 53 publications

References 4 publications

Prevalence of Ocular Abnormalities in Term Infants

Prevalence of Ocular Abnormalities in Term Infants

Obstetrical forceps-induced Descemet membrane tears

Folds in Descemet Membrane Associated With Forceps-Induced Injury

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