Ocular Evaluation in Cerebral Palsy Patients at Children’s and Eye Hospitals at the University Teaching Hospitals, Lusaka, Zambia

Abstract

Background: Cerebral palsy is a group of non-progressive disorders of movement or posture. Visual handicap in Cerebral Palsy patients can have a direct impact on psychosocial status. Refractive errors, strabismus, nystagmus, amblyopia and cortical visual impairment are observed in 50 to 90 % of patients with cerebral palsy. Objective: To evaluate for visual impairment in CP patients at Children’s Hospital at UTHs. Methods: A cross section study was performed on 100 Cerebral palsy patients attending the neurological clinic at the University Teaching Hospitals-Children’s Hospital from February to April 2021. The patients were sampled systematically from the register at neurology clinic and ophthalmological examination was conducted at Eye hospital which included measurement of visual acuity, ocular motility, refraction along with the evaluation of the anterior and posterior segments. Results: Fourty nine percent (49%) of the patients seen had ocular abnormalities of which the most common abnormality was refractive error (32.5%) followed by strabismus (21.5%). Esodeviation was more commonly found than exodeviation (65.0% vs 35.0%), and hyperopia was slightly more prevalent than myopia. Astigmatism was the most common refractive error at 40.0%. Conclusions: Children with cerebral palsy at the University Teaching Hospitals-Children’s Hospital have a high prevalence of strabismus and refractive errors. Esotropia and hyperopia are the most common ocular abnormalities. All children with cerebral palsy may require a detailed ophthalmologic evaluation.