Premature children are at a greater risk than full-term children of having poor distance and near visual acuity, regardless of whether these children have retinopathy of prematurity (ROP) or neurological conditions, says a study in the June Archives of Ophthalmology.

The study, conducted by researchers in Sweden, compared the best-corrected distance and near visual acuities of 216 10-year-old children who were pre-term at birth with those of 217 10-year-old children who were full-term at birth.

Researchers found that poor visual acuity was more likely in children born pre-term than in children born full-term, even after accounting for ROP and neurological conditions. Specifically, 12 of the 216 pre-term children had visual acuity of less than 20/60. None of the full-term children had a visual acuity less than 20/60.


Also, 98% of the full-term group had visual acuity of 20/20 or better compared with 86% of the pre-term children who had 20/20 or above in their better eye. The researchers say this is a surprisingly good overall visual outcome. 

Still, since the visual acuity in the pre-term group was different than that of the full-term groupregardless of the presence of ROP and neurological conditionsprematurity itself appears to affect vision, the researchers say. However, whether the cause of these problems lies with the retina or in the posterior visual pathways is yet to be determined.

Also, children who have neurological conditions were more likely to have significantly lower visual acuity than those without these conditions. A total of 16% of pre-term children had some type of neurological problem.

This is an interesting study in that the researchers found a very small difference in acuity between the pre-term and the full-term group, says Mitchell Scheiman, O.D., director of pediatric and binocular vision programs at the Pennsylvania College of Optometry. But since our mode of practice is to see children at 6 months, 3 years and 6 years of age, what was determined here is not really going to change the way in which we practice. Also, since pediatric O.D.s already know to inquire about premature birth when taking the patients history, this study will not change this aspect of clinical practice either, he says. 

Larsson EK, Rydberg AC, Holmstrom GE. A population-based study on the visual outcome in 10-year-old preterm and full-term children. Arch Ophthalmol 2005 Jun;123(6): 825-32.

Vol. No: 142:7Issue: 7/15/2005