Outcomes of Eye Examination and Vision Screening in Term Infants Presenting to a Tertiary Hospital in Türkiye

Abstract

Objectives: Ophthalmic screening is an important part of the medical care of children as some eye abnormalities can lead to irreversible vision loss if not treated in the first few months or years of life. The aim of this study is to evaluate the outcomes of the ophthalmic screening program in term infants aged ≤1 year who presented to a tertiary hospital in Türkiye.

Materials and methods: The records of 1,035 infants ≤1 year old who underwent ophthalmic screening between November 2019 and February 2022 were reviewed retrospectively. Demographic and medical details, parental complaints about the infants' eyes, family history of ocular, adnexal, and systemic pathologies, light reactions, red reflex test results, eye movements, blink response to light, fixation and following, noticeable strabismus, conjunctivitis, epiphora, anterior segment and fundus pathologies, and treatments applied were recorded. The referring physician (family physician, pediatrician) and reason for reference were also noted.

Results: Abnormal ophthalmological findings were detected in 136 infants (13.14%). The most common finding was congenital nasolacrimal duct obstruction (72.05%), followed by strabismus (8.82%), ptosis (4,41%), absence of following (3.67%), congenital cataract (2.94%), hemangioma of the adnexa (2.94%), nystagmus (2.94%), albino fundus (1.47%), preretinal hemorrhage (1.47%), and coloboma of the iris and choroid (1.47%). We detected abnormal red reflex in 4 infants who were not referred for red reflex abnormality by the referring physician, while another 4 infants referred for red reflex abnormality had no pathology on ocular examinations including the red reflex test.

Conclusion: The importance of ophthalmic screening in infants is well appreciated but there are inadequacies in performing and interpreting the red reflex test among family physicians and pediatricians. Efforts should be directed at improving vision screening skills, especially red reflex testing.

Keywords: Congenital cataract; national vision screening program; red reflex; retinoblastoma.