Stabismus, Amblyopia and Refractive Errors in Patients with Cerebral Palsy

Park, S J; Chang, B L

Abstract

Many reports have said that patients with cerebral palsy have high prevalence of strabismus and amblyopia and may expect to see satisfactory results with classical treatment i.e. strabismus surgery or occlusion therapy. This study is to investigate the clinical aspects of strabismus, amblyopia and refractive errors in patients with cerebral palsy. We sorted the data of those who had visited our pediatric clinic for strabismus in a retrospective way to find the types of cerebral palsy, results of brain MRI or CT,types of strabismus, prevalence of refractive errors and amblyopia and treatment results: we defined refractive error as spherical equivalent +1.5 diopter or more, -1.5 diopter or less, astigmatism 1.5 diopter or more. Of 38 patients whose type of cerebral palsy could be identified, 37 had spastic type and 1 patient athetoid. Of 20 patients who had underwent brain imaging, 9 had periventricular leukomalacia. Six out of 9 with PVL had amblyopia while 3 out of 11 without amblyopia had amblyopia. Strabismus was detected in 52 patients: 15 [29%] with exodeviation, 13 [25%] with esodeviation, 7 [13%] with exodeviation and dissociated vertical deviation. Twenty seven patients had refractive error. Amblyopia was detected in 25 patients. Twelve patients had been followed up till 2 years after surgery for strabismus and all the twelve patients had cosmetic success. Among those, 9 patients had undergone operation only once, 2 patients twice and 1 patient three times. Occlusion therapy was applied to 19 patients and 4 of them had successful results. In conclusion, ophthalmologists need to be encouraged to diagnose and treat strabismus and amblyopia in patients with cerebral palsy.