Strabismus, binocular functions and ocular motility in children with hydrocephalus.
OBJECTIVE
To investigate heterotropia, heterophoria, head posture, nystagmus, stereo acuity, ocular motility and near point of convergence (NPC) in children with hydrocephalus treated surgically before 1 year of age. In addition, the effects of being born with hydrocephalus, the effect of the etiology of hydrocephalus, number of shunt revisions and the size of the ventricles on these variables were studied.


METHODS
A population-based study was performed in 75 children and the results were compared with the results of an age- and sex-matched group (comp group) (n = 140).


RESULTS
Heterotropia 68.9% (comp group 3.6%; p < 0.001), abnormal head posture 41.3% (comp group 0; p < 0.001), nystagmus 44.0% (comp group 0; p < 0.001), stereo acuity < or =60'' 33.8% (comp group 97.1%; p < 0.001) and ocular motility defects 69.7% (comp group 0.7%; p < 0.001) were more common among children with hydrocephalus than in the comparison group. Children with overt hydrocephalus at birth had significantly more heterotropia (p = 0.0006), esotropia (p = 0.002), abnormal head posture (p = 0.02) and motility defects (p = 0.003) compared to those with hydrocephalus developing during the first year of life. The etiology, number of shunt revisions and the size of the ventricles had no significant effect on any of the investigated variables.


CONCLUSIONS
Children with hydrocephalus surgically treated before the age of one year commonly present orthoptic abnormalities. The etiology of hydrocephalus, number of shunt revisions and ventricle size seem to be of minor importance compared with the age of onset of hydrocephalus with regard to the risk for orthoptic abnormalities.
Aring
Eva
E
Department of Ophthalmology, Institute of Clinical Neuroscience, The Sahlgrenska Academy of Göteborg University, Göteborg, Sweden. eva.aring@vgregion.se
Andersson
Susann
S
Hård
Anna-Lena
AL
Hellström
Ann
A
Persson
Eva-Karin
EK
Uvebrant
Paul
P
Ygge
Jan
J
Hellström
Ann
A
D000367:Age Factors; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D003867:Depth Perception; D004948:Esotropia / Q000209:etiology; D005099:Exotropia / Q000209:etiology; D005260:Female; D006257:Head; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D015835:Ocular Motility Disorders / Q000209:etiology*; D011187:Posture; D012086:Reoperation; D013285:Strabismus / Q000209:etiology*; D014786:Vision Disorders / Q000209:etiology; D015348:Vision, Binocular