Long-Term Visual Outcomes in Prematurely Born Children

Abstract

Purpose: Prematurely born children are at risk of numerous complications that affect the visual system. Retinopathy of prematurity (ROP) and cerebral visual impairment (CVI) are among two major causes of childhood blindness and visual impairment in industrialized nations, and large countries with emerging economies are seeing increasing childhood blindness from ROP alone, adding to the burden of disease worldwide. The purpose of this paper is to review the long-term impacts of prematurity, ROP and CVI on vision in children who were born preterm.

Method: The topics in this review of the literature include the burden of vision loss in prematurely born children world-wide, a description of ROP and CVI, effects on visual acuity, refractive errors, strabismus and binocularity, visual fields and contrast sensitivity, and risk factors for visual complications.

Results: Children who are most at risk of visual complications are those with the smallest gestational age at birth and birth weight in general. Although ROP severity and the presence of neurological impairments including CVI play a large role in the development of poor visual outcomes, premature birth alone without CVI or severe ROP increases the risk of future visual complications. Awareness of signs and symptoms of CVI are important in the management of affected children.

Conclusion: Children born preterm are at increased risk of reduced visual acuity, refractive errors, strabismus and amblyopia, complications of ROP, CVI, visual field abnormalities and reduced contrast sensitivity. Awareness of risk factors warranting close monitoring and signs and symptoms of CVI are critical to optimize the visual outcomes and overall development.

Keywords: Prematurity; cerebral visual impairment; contrast sensitivity; long-term outcomes; refractive errors; retinopathy of prematurity; strabismus; visual acuity; visual fields.