Ocular findings in patients with spastic type cerebral palsy.
BACKGROUND
Refractive errors, strabismus, nystagmus, amblyopia, and cortical visual impairment are observed in 50 to 90 % of patients with cerebral palsy. Ocular abnormalities are known to differ according to cerebral palsy type, and spastic type has been reported to be more likely to be associated with ocular defects than the athetoid and ataxic types.


METHODS
A retrospective review of medical records was performed on 105 consecutive children with spastic type of cerebral palsy who underwent ophthalmologic examination between July 2003 and March 2006. The complete ophthalmological examination included measurement of visual acuity, ocular motility, stereoacuity, binocular vision, cycloplegic refraction along with the evaluation of the anterior segment and the posterior segment.


RESULTS
The most common ocular abnormality was strabismus (70.5 %) followed by refractive errors (53.3 %). Exodeviation was more commonly found than esodeviation (46 vs 27 patients), and hyperopia was much more prevalent than myopia. A considerable number of patients with strabismus had abnormal ocular motility wherein 16 patients showed inferior oblique overaction and ten superior oblique overaction. Whereas inferior oblique overaction was accompanied similarly in exotropia and esotropia, superior oblique overaction was accompanied more by exotropia.


CONCLUSIONS
Children with spastic type cerebral palsy have a high prevalence of strabismus and refractive errors. Exotropia and hyperopia are the most common ocular abnormalities. All children with spastic type of cerebral palsy may require a detailed ophthalmologic evaluation.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166, Gumiro, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea.
Myung Jin
MJ
Park
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166, Gumiro, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea.
Yung Ju
YJ
Yoo
Department of Orthopaedic surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166, Gumiro, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea. chin@snubh.org.
Chin Youb
CY
Chung
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166, Gumiro, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea. hjm@snu.ac.kr.
Jeong-Min
JM
Hwang
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005124:Eye Abnormalities / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D012030:Refractive Errors / Q000209:etiology*; D012189:Retrospective Studies; D013285:Strabismus / Q000209:etiology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
Cerebral palsy; Ocular findings; Spastic type; Strabismus