Purpose:

To evaluate the common ocular abnormalities in children with cerebral palsy (CP) and to correlate them with gestational age, birth weight, clinical subtype of CP and neuroradiological findings.

Material and Method:

104 patients with CP were enrolled in this study. Detailed ophthalmic examinations including visual acuity, ocular motility, nistagmus and orthoptic assessments, cycloplegic refraction and fundoscopic examinations were performed. The relationship between gestational age, birth weight, clinical subtype of CP, neuroradiological assessments and the results of ocular examinations was evaluated.

Results:

The mean age was 53.0±41.9 months at the first visit. Etiologic factor was asphyxia in 56.7% of patients. 84.6% of patients had abnormal ocular findings. Eighteen children (17.3%) had nystagmus and 61 children (58.7%) had squint. Lower gestational age and birth weight were observed in patients with esotropia compared to those with exotropia and orthophoria (p=0.003 and p=0.006, respectively). Abnormal morphology of the optic disc was present in 96 eyes (46.2%). 41.4% of patients had spastic diplegia and 40.4% had spastic tetraplegia. Among all spastic subtypes of CP, poor vision was detected to be statistically significant in the tetraplegia group (p=0.039). Anisometropia and significant refractive error were found in 18.3% and 41.3% of patients, respectively. Severe periventricular leukomalacia (PVL) was found in 32 patients and poor vision was detected to be statistically significant in the presence of PVL (p=0.041).

Results: Discussion:

Early ophthalmic assessment of CP cases is important in providing best visual rehabilitation. Especially spastic diplegic or tetraplegic CP patients with positive neuroradiological findings, younger gestational age and lower birth weight should undergo detailed ophthalmic examinations.

Keywords: Cerebral palsy, ocular disorders, periventricular leukomalacia, squint