Ophthalmic assessment of children before renal transplantation.
OBJECTIVE
To evaluate the usefulness of routine ophthalmic examination before renal transplantation in children.


METHODS
We reviewed the records of ophthalmic assessments of renal transplant recipients at The Hospital for Sick Children, Toronto, Ont., from January 1989 to June 1996. If abnormalities had been found, we determined whether they had previously been documented, were related to the renal disease or other systemic disease, had required intervention or had affected visual function. We calculated the maximum statistical chance of detecting a meaningful eye problem at the pretransplantation assessment. We also estimated the direct cost of the ophthalmic assessment and the effect, if any, of the findings on the patient's medical management.


RESULTS
We included 107 charts. Before the ophthalmic assessment, 32 patients (30%) had known eye problems. The ocular examination detected abnormalities in 46 patients (43%); the abnormalities had not been detected previously in 14 (13%). New, potentially vision-threatening eye disorders were found in 6 (6%) of the patients. No finding affected the short- or long-term management of any patient.


CONCLUSIONS
Children with chronic renal failure had a high prevalence of ocular abnormalities, but most of the abnormalities did not affect visual function. Although ophthalmic assessment before transplantation did not alter the medical management of the renal transplant patients, consultation may be helpful in selected patients, particularly those who are not already under the care of an optometrist or ophthalmologist and those who have a visual complaint.
Behbehani
Abdulmutalib
A
Department of Ophthalmology, The Hospital for Sick Children, University of Toronto, Toronto, Ont.
Kraft
Stephen
S
Buncic
J Raymond
JR
Levin
Alex V
AV
D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000150:complications / Q000175:diagnosis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D009885:Ophthalmology / Q000379:methods; D011300:Preoperative Care; D015351:Vision Screening / Q000191:economics