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Evaluation of the Apparently Blind Child

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Pediatric Ophthalmology

Abstract

• Children with apparently poor vision can usually be divided into three categories: (1) those with abnormal ocular examination; (2) non-existent retinal findings but abnormal ERG; or (3) those with normal ocular examination.

• Common causes of non-ocular visual impairment include congenital ocular motor apraxia (saccade initiation failure), cortical visual impairment, and delayed visual maturation.

• Understanding the clinical presentation, assessment, and prognosis for each entity is essential for proper diagnoses and counseling.

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References

  1. Aldosari M (2003) Delayed visual maturation associated with auditory neuropathy/dyssynchrony. J Child Neurol 18:358−361

    Article  PubMed  Google Scholar 

  2. Beauvieux J (1947) La cecite apparente chez le nouveau-ne la pseudo-atrophie grise du nerf optique. Arch Ophtalmol (Paris) 7:241−249

    Google Scholar 

  3. Birch EE, Bane MC (1991) Forced choice preferential looking acuity of children with cortical visual impairment. Dev Med Child Neurol 33:722−729

    Article  PubMed  CAS  Google Scholar 

  4. Brodsky MC (1996) Apparently blind infant. In: Brodsky MC, Baker RS, Hamed LM (eds) Pediatric neuro-ophthalmology. Springer, Berlin Heidelberg New York, pp 11−41

    Google Scholar 

  5. Cassidy L, Taylor D, Harris C (2000) Abnormal supranuclear eye movements in the child: a practical guide to examination and interpretation. Surv Ophthalmol 44(6):479−506

    Article  Google Scholar 

  6. Casteels I (2005) Clinical investigation of bilateral poor vision from birth. In: Taylor D, Hoyt CS (eds) Pediatric ophthalmology and strabismus. Elsevier Saunders, Philadelphia

    Google Scholar 

  7. Cocker KD, Moseley MJ, Stirling HF, Filder AR (1998) Delayed visual maturation: pupillary responses implicate subcortical and cortical visual systems. Dev Med Child Neurol 40:160−162

    PubMed  CAS  Google Scholar 

  8. Cogan DG (1952) A type of congential ocular motor apraxia presenting jerky head movements. Trans Am Acad Ophthalmol Otol 56(6):853−862

    CAS  Google Scholar 

  9. Cogan DG (1972) Heredity of congenital ocular motor apraxia. Trans Am Acad Ophthalmol Otol 76(1):60−63

    Google Scholar 

  10. Eviatar L, Miranda S, Eviatar A, Freeman K, Borkowski M (1979) Development of nystagmus in response to vestibular stimulation in infants. Ann Neurol 5:508−514

    Article  PubMed  CAS  Google Scholar 

  11. Fielder AR, Evans NM (1988) Is the geniculostriate system a pre-requisite for nystagmus? Eye 2:380−382

    Google Scholar 

  12. Fielder AR, Mayer DL (1991) Delayed visual maturation. Sem Opthalmol 6(4):182−193

    Article  Google Scholar 

  13. Fielder AR, Russell-Eggitt IR, Dodd KL, Mellor DH (1985) Delayed visual maturation. Trans Ophtalmol Soc UK 104:653−661

    Google Scholar 

  14. Fielder AR, Gresty MA, Dodd KL, Mellor DH, Levene MI (1986) Congenital ocular motor apraxia. Trans Ophthalmol Soc UK 105:589−598

    PubMed  Google Scholar 

  15. Gilbert C, Foster A (2001) Childhood blindness in the context of VISION 2020−the right to sight. Bull WHO 79(3):227−232

    Google Scholar 

  16. Foster GC (2001) Blindness in children: control priorities and research opportunities. Br J Ophthalmol 85:1025−1027

    Article  PubMed  Google Scholar 

  17. Good WV (2001) Development of a quantitative method to measure vision in children with chronic cortical visual impairment. Trans Am Ophthalmol Soc 99:253−269

    PubMed  CAS  Google Scholar 

  18. Good WV, Hou C (2004) Normal vernier acuity in infants with delayed visual maturation. Am J Ophthalmol 138:140−142

    Article  PubMed  Google Scholar 

  19. Good WV, Hou C (2006) Sweep visual evoked potential grating acuity thresholds paradoxically improve in low-luminance conditions in children with cortical visual impairment. Invest Ophthalmol Vis Sci 47(7):3220−3224

    Article  Google Scholar 

  20. Good WV, Jan JE, DeSa L, Barkovich JA, Groenveld M, Hoyt CS (1994) Cortical visual impairment in children. Surv Ophthalmol 38(4):351−364

    Article  Google Scholar 

  21. Granet DB, Hertle RW, Quin GE, Breton ME (1993) The visual-evoked response in infants with central visual impairment. Am J Ophthalmol 116:437−443

    PubMed  CAS  Google Scholar 

  22. Harris CM, Shawkat F, Russell-Eggitt I, Wilson J, Taylor D (1996) Intermittent horizontal saccade failure (ocular motor apraxia) in children. Br J Opthalmol 80:151−158

    Article  CAS  Google Scholar 

  23. Hoyt CS (2004) Delayed visual maturation: the apparently blind infant. J AAPOS 8(3):215−219

    Google Scholar 

  24. Hoyt CS, Nickel BL, Billson FA (1982) Ophthalmological examination of the infant. Dev Aspects Surv Ophthalmol 26(4):177−189

    Article  CAS  Google Scholar 

  25. Hoyt CS, Jastrzebski G, Marg E (1983) Delayed visual maturation in infancy. Br J Opthalmol 67:127−130

    Article  CAS  Google Scholar 

  26. Huo R, Burden SK, Hoyt CS, Good WV (1999) Chronic cortical visual impairment in children: aetiology, prognosis, and associated neurological deficits. Br J Ophthalmol 83:670−675

    PubMed  CAS  Google Scholar 

  27. Illingsworth RS (1961) Delayed visual maturation. Arch Dis Child 36:407−409

    Article  Google Scholar 

  28. Jacobsen LK, Dutton GN (2000) Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. Surv Ophthalmol 45(1):1−13

    Article  Google Scholar 

  29. Jan JE, Goenveld M, Sykanda AM, Hoyt CS (1987) Behavioural characteristics of children with permanent cortical visual impairment. Dev Med Child Neurol 29:571−576

    PubMed  CAS  Google Scholar 

  30. Jan JE, Goenveld M, Sykanda AM (1990) Light-gazing by visually impaired children. Dev Med Child Neurol 32:755−759

    PubMed  CAS  Google Scholar 

  31. Jan JE, Groenveld M, Anderson DP (1993) Photophobia and cortical visual impairment. Dev Med Child Neurol 35:473−477

    PubMed  CAS  Google Scholar 

  32. Jan JE, Kearney S, Groenveld M, Sargent MA Poskitt KJ (1998) Speech, cognition and imaging studies in congenital ocular motor apraxia. Dev Med Child Neurol 40:95−99

    PubMed  CAS  Google Scholar 

  33. Lambert SR, Kriss A, Taylor D (1989) A longitudinal clinical and electrophysiological assessment. Ophthalmol 96(4):524−527

    CAS  Google Scholar 

  34. Marr JE, Green SH, Willshaw HE (2005) Neurodevelopmental implications of ocular motor apraxia. Dev Med Child Neurol 47:815−819

    Article  PubMed  CAS  Google Scholar 

  35. Phillips PH, Brodsky MC, Henry PM (2000) Congenital ocular motor apraxia with autosomal dominant inheritance. Am J Ophthalmol 129(6):820−822

    Article  Google Scholar 

  36. Roland EH, Jan JE, Hill A, Wong PK (1986) Cortical visual impairment following birth asphyxia. Pediatr Neurol 2:133−137

    Article  PubMed  CAS  Google Scholar 

  37. Russell-Eggit I, Harris CM, Kriss A (1998) Delayed visual maturation: an update. Dev Med Child Neurol 40:130−136

    Google Scholar 

  38. Sargent MA, Poskitt KJ, Jan JE (1997) Congenital ocular motor apraxia: imaging findings. Am J Neuroradiol 18:1915−1922

    PubMed  CAS  Google Scholar 

  39. Shahar E, Hwang PA (2001) Prolonged epileptic blindness in an infant associated with cortical dysplasia. Dev Med Child Neurol 43:127−129

    Article  PubMed  CAS  Google Scholar 

  40. Tresidder J, Fielder AR, Nicholson J (1990) Delayed visual maturation: ophthalmic and neurodevelopmental aspects. Dev Med Child Neuro 32:872−881

    Article  CAS  Google Scholar 

  41. Uemura Y, Agucci Y, Katsumi O (1981) Visual developmental delayed. Ophthalmic Paediatr Genet 1:4−11

    Article  Google Scholar 

  42. van Genderen M, Riemslag F, Jorritsma F, Hoeben F, Meire F, Stilma J (2006) The key role of electrophysiology in the diagnosis of visually impaired children. Acta Ophthalmol Scand 84:799−806

    Article  PubMed  Google Scholar 

  43. Weiss A, Kelly JP, Phillips JO (2001) The infant who is visually unresponsive on a cortical basis. Ophthalmology 108:2076−2087

    Article  PubMed  CAS  Google Scholar 

  44. Winges KM, Zarpellon U, Hou C, Good WV (2005) Delayed visual attention caused by high myopic refractive error. Strabismus 13:75−77

    Article  PubMed  Google Scholar 

  45. Yavuz Gurer YK, Kukner S, Kunak B, Yilmaz S (1995) Congential ocular motor apraxia in two siblings. Pediatr Neurol 13:261−262

    Article  Google Scholar 

  46. Saidkasimova S et al. (2007) Cognitive visual impairment with good visual acuity in children with posterior ventricular white matter injury: a series of 7 cases. J AAPOS 11(5):426−430

    Google Scholar 

  47. Chao CP et al. (2006) Neonatal hypoxic−ischemic encephalopathy: multimodality imaging findings. Radiographics 26:S159−S172

    Article  PubMed  Google Scholar 

  48. Clifford-Donaldson CE et al. (2006) Teller acuity card norms with and without use of a testing stage. J AAPOS 10(6):547−551

    Google Scholar 

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Good, W., Martin, T. (2009). Evaluation of the Apparently Blind Child. In: Wilson, M., Trivedi, R., Saunders, R. (eds) Pediatric Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68632-3_7

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  • DOI: https://doi.org/10.1007/978-3-540-68632-3_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-68630-9

  • Online ISBN: 978-3-540-68632-3

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