Ophthalmologic Evaluation in Pediatric Developmental Delay

Haemin Kang; Hye Young Kim

doi:10.3341/jkos.2010.51.12.1625

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Kang and Kim: Ophthalmologic Evaluation in Pediatric Developmental Delay

Original Article

J Korean Ophthalmol Soc 2010;51(12):1625-1629.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.12.1625

Ophthalmologic Evaluation in Pediatric Developmental Delay

Haemin Kang, MD¹, Hye Young Kim, MD²

¹Department of Ophthalmology, Yonsei University Medical Center, Seoul, Korea

²Department of Ophthalmology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

Address reprint requests to Hye Young Kim, MD Department of Ophthalmology, National Health Insurance Corporation Ilsan Hospital #1232 Baekseok 1-dong, Ilsandong-gu, Goyang 410-719, Korea Tel: 82-31-900-0590, Fax: 82-31-900-0049, E-mail: khyeye@hanmail.net

Received 11 March 2010 Accepted 10 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the ocular results and refractive errors in children with developmental delay and to determine the significance of ophthalmologic screening in children.

Methods

The present study was conducted with children who visited the development delay clinic of National Health Insurance Corporation Ilsan hospital in Goyang, Korea. Primary evaluation included external eye examination, pupil reflex, and ocular movement test with focal light, and secondary evaluation included slit-lamp examination, fundus examination, cycloplegic refraction, and lacrimal drainage test if necessary.

Results

Out of 89 subjects included in the study, 61.8% had ocular abnormalities other than refractive errors, and the two most common results included strabismus and epiblepharon, with occurrence rates of 24.7% and 22.5%, respectively. Among the 60 subjects who underwent cycloplegic refraction, 56.6% had refractive errors, with astigmatism (30%) being the most common. Among the 24 subjects who received treatment, four underwent surgical treatment and 20 started wearing glasses.

Conclusions

The present study revealed a high prevalence of ophthalmologic abnormalities in pediatric developmental delay patients, indicating that systemic and comprehensive ophthalmic examination is necessary for these patients.

Keywords: Global developmental delay, Intellectual disability, Ocular findings, Refractive errors

References

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Table 1.

Diagnosis of 89 pediatric patients

Diagnosis	Number of patients
Intellectual disability	34
Nonsyndromic	23
Syndromic	11
MELAS syndrome	2
Saethre-Chotzen syndrome	1
Respiratory chain disorder	1
Opitz syndrome	1
Parry-Romberg syndrome	1
Congenital myopathy	1
Arnold-Chiari malformation	1
Edward syndrome	1
Jubert syndrome	1
Parry-Romberg syndrome	1
Global developmental delay	24
Nonsyndromic	14
Syndromic	10
Floppy infant syndrome	2
Cornelia de Lange syndrome	2
X chromosome translocation	1
Asperger syndrome	1
Cri-du-chat syndrome	1
Beckwith-Wiedeman syndrome	1
Maple syrup urine disease	1
DeGeorge syndrome	1
Cerebral palsy	10
Borderline IQ	9
Autism	8
Attention deficit hyperactivity disorder	4

Table 2.

Ocular diagnoses excluding refractive errors in 89 developmental delay patients

Ocular diagnosis	Number of patients (%)
Strabismus	22 (24.8)
Epiblepharon	20 (22.5)
Blepharoptosis	4 (4.5)
Nasolacrimal duct stenosis	3 (3.4)
Congenital cataract	2 (2.2)
Nasolacrimal fistula	1 (1.1)
Optic atrophy	1 (1.1)
Optic coloboma	1 (1.1)
Duane retraction syndrome	1 (1.1)

More than one finding can occur in a given subject.

Table 3.

Refractive errors of 60 patients who underwent cycloplegic refraction tests

Refractive errors	Number of patients (%)
Astigmatism	18 (30.0)
Hypermetropia	13 (21.7)
Myopia	12 (20.0)
Anisometropia	2 (3.3)

More than one finding can occur in a given subject.

Table 4.

Treatment after ophthalmologic evaluation

Treatment	Number of patients
Surgical treatment	4
Strabismus surgery	1
Silicone tube intubation	2
Levator resection with silicone tube intubation	1
Non-surgical treatment	20
Spectacles only	17
Spectacles with occlusion for amblyopia	2
Refractive accommodative esotropia	1

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