Ocular manifestations in children with developmental delay in an eye hospital of northern Bangladesh

Abstract

Background: The aim of this study was to identify common ocular manifestations in children with developmental delay in an eye hospital of northern part of Bangladesh.Methods: It was a retrospective medical record review of children with developmental delay who attended the pediatric ophthalmology department in an eye hospital from January 2019 to December 2019. Data were collected for their age, gender, past medical history, ophthalmic examination findings and systemic problems. Ophthalmic examination included examination of lid and adnexa, anterior and posterior segment examination and assessment of squint and refraction.Results: Medical records of 102 with developmental delay were identified and studied (59 boys and 43 girls, mean age 1.57 years, 53.9% aged <1 year). Of these children, 44 (43.1%) were referred by the pediatricians. The most common past medical histories were perinatal asphyxia (42.2%), history of convulsion (30.4%), neonatal seizures (9.8%) and history of speech delay (1%). On ophthalmic examination, 30 (29.5%) had poor vision, 20 (19.6%) had refractive error, 23 (22.5%) had Strabismus and 11 (10.8%) had nystagmus. Optic atrophy was also observed among 11 children (10.8%).Conclusions: Ocular manifestations are commonly seen in children with developmental delay which can be cause of severe visual impairment and overall disability in later life. Hence an early ophthalmologic screening and intervention in these children by developing good referral network between ophthalmologist and pediatricians can help to substantially improve the developmental and academic achievement.

Frequency of Ocular Manifestations in Developmentally Delayed Children

“…Sixty three children (15.5%) presented with strabismus, esotropia being the predominant entity. Afroze R, 13 reported the prevalence of strabismus to be 22.5%, with esotropia (12.7%) being more common than exotropia (9.8%) which is in accordance with the study of Nielsen et al 17 Nystagmus was seen in 225 (55.4%) children. These children performed goal-directed hand movements slowly and with difficulty.…”

“…This was in accordance with studies conducted by Smitha et al 12 Similarly, Afroze R, in a study conducted in Bangladesh found a preponderance of boys. 13 Very few studies are available for ocular manifestations under 5 years of age. Our study found maximum patients in the age group of 1 -2 years (42%), which follows similar studies conducted in Karnataka and Mumbai.…”

“…The same was evident in the study by Smitha et al (83.6%) 12 , Akinci et al, (77%), 14 Chandrakishore and Sujata (86%) 15 and Afroze R (65.7%). 13 Taking into consideration the above statistics, not enough stress can be paid to the importance of early eye examination by a pediatric ophthalmologist.…”

Prevalence of visual dysfunction and ocular motility disorders in developmentally delayed patients

“…We evaluated the distribution and percentage of reduced VA, RE, strabismus and reduced contrast sensitivity in 257 DD children having IQ ≤ 80 by WISC, between the age ranges of 06-16 years, mean age was 8.88 ± 2.70 years. In our study, male children were more 160 (62.3%) than female 97 (37.7%), similar to the studies conducted by Smitha KS et al 15 and Afroze R et al 16 …”

“…14 We evaluated the distribution and percentage of reduced VA, RE, strabismus and reduced contrast sensitivity in 257 DD children having IQ ≤ 80 by WISC, between the age ranges of 06-16 years, mean age was 8.88 ± 2.70 years. In our study, male children were more 160 (62.3%) than female 97 (37.7%), similar to the studies conducted by Smitha KS et al 15 and Afroze R et al 16 Vora et al conducted a study on DD children and reported the prevalence of RE as 58.5%. The prevalence rates were 18.6%, 24.3% and 27.1% for hyperopia, myopia, and astigmatism respectively.…”