Impaired fine motor skills in children following extraction of a dense congenital or infantile unilateral cataract

Abstract

Purpose: To evaluate fine motor ability in children treated for unilateral congenital or infantile cataract.

Methods: Twenty-three children 3-13 years of age who were treated for unilateral congenital or infantile cataract and 38 age-similar control children were enrolled. Children completed five fine motor skills tasks (unimanual dexterity, bimanual dexterity, drawing trail, aiming, catching) from the Movement Assessment Battery for Children-2. Raw scores were converted into standardized scores, with higher scores indicating better performance.

Results: Compared with controls, children treated for unilateral cataract scored lower on drawing trail (P = 0.009), aiming (P = 0.009), and catching (P < 0.001) but not on unimanual (P = 0.77) or bimanual dexterity (P = 0.31). Poorer affected eye visual acuity was moderately related to poorer performance for unimanual dexterity (r = -0.47; P = 0.025), bimanual dexterity (r = -0.50; P = 0.014), and catching (r = -0.41; P = 0.051). Those with a poor visual outcome (>0.6 logMAR) had worse performance than those with a good visual outcome (≤0.6 logMAR) for all tasks (all P values, 0.008-0.09) except aiming. Cataract type (congenital, 9; infantile, 14) and sensory fusion by Worth 4-Dot testing at 33 cm (pass, 10; fail, 13) had no effect on fine motor performance (all P values, 0.12-0.98).

Conclusions: In our study cohort, fine motor deficits were found in children treated for congenital or infantile unilateral cataract.

FIG 1.

Fine motor performance. Mean standard scores per task for unimanual dexterity, bimanual dexterity, drawing trail, aiming, and catching tasks (A) and per subscale for manual dexterity and aiming and catching (B) for children treated for unilateral cataract (white bars) compared with control children (dark gray bars). The dotted line represents the 50th percentile. Errors bars represent standard error of the mean (SEM). *Group differences are significant after Bonferonni-correction.

FIG 2.

Factors affecting fine motor performance. A, Mean standard scores for children treated for unilateral cataract who have a poor visual outcome of >0.6 logMAR (horizontal line bars) compared with those who have a good visual outcome of ≤0.6 logMAR (checkerboard bars) for unimanual dexterity, bimanual dexterity drawing trail, aiming, and catching tasks. The dotted line represents the 50th percentile. Error bars represent SEM. *Group differences are significant after Bonferonni-correction. B, Scatterplots showing correlations of affected-eye visual acuity (logMAR) with mean standard scores for unimanual dexterity, bimanual dexterity, and catching tasks. Poorer affected eye visual acuity was related to poorer performance on these tasks. Dotted line indicates the trend. Overlapping points have been slightly jittered horizontally for clarity.