title: Ocular motor outcomes after bilateral and unilateral infantile cataracts.
abstract: We wished to study how the severity and duration of early onset visual deprivation affects eye alignment and ocular stability. Thirty-three patients (aged 1 week to 12.8 years) with infantile cataracts (16 bilateral, 17 unilateral) were examined for periods up to 61 months. Twenty-three patients were considered to have cataracts, which were a major obstacle to vision (major form deprivation), 9 of whom underwent surgery within 8 weeks of birth (mean and SD=5.2+/-2.3 weeks) and 10 after 8 weeks (mean and SD=33.9+/-29.7 months). Eye alignment and fixation stability was measured using infrared recording systems and video. Visual acuity was assessed using forced-choice preferential looking techniques in the neonates and infants and with optotypes in the children. Fifteen of the 23 (65%) patients who experienced major form deprivation exhibited a nystagmus, of which 11 (73%) were manifest latent nystagmus (MLN). Nineteen of the 23 (85%) had strabismus. Of the nine patients who underwent early surgery (< or =8 weeks), two displayed a preoperative nystagmus whilst between 10 and 39 months post-operatively 8 (89%) exhibited a nystagmus. Of the group of 10 patients with minor cataracts only 2 (1 late surgery, 1 no surgery) had nystagmus and 2 strabismus. We conclude that following optimal post-operative management of infantile cataracts a sustained nystagmus--typically an MLN--is the most likely ocular motor outcome, even when the period of deprivation is as short as 3 weeks.
authors.affiliation: University of Manchester, Faculty of Life Sciences, P.O. Box 88, Manchester M60 1QD, UK. r.abadi@manchester.ac.uk
authors.forename: Richard V
authors.initials: RV
authors.lastname: Abadi
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Forster
authors.forename: I Christopher
authors.initials: IC
authors.lastname: Lloyd
mesh_terms: D000367:Age Factors; D002386:Cataract / Q000150:complications* / Q000151:congenital / Q000473:pathology; D002387:Cataract Extraction; D002648:Child; D005260:Female; D005403:Fixation, Ocular; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009759:Nystagmus, Pathologic / Q000209:etiology; D015835:Ocular Motility Disorders / Q000209:etiology*; D011379:Prognosis; D012683:Sensory Deprivation; D012720:Severity of Illness Index; D013285:Strabismus / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D015348:Vision, Binocular; D015349:Vision, Monocular; D014792:Visual Acuity