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. 2000 Sep;84(9):963–967. doi: 10.1136/bjo.84.9.963

Long term follow up of premature infants: detection of strabismus, amblyopia, and refractive errors

N Schalij-Delfos 1, M E L de Graaf 1, W Treffers 1, J Engel 1, B Cats 1
PMCID: PMC1723646  PMID: 10966945

Abstract

AIM—To establish recommendations for long term ophthalmological follow up of prematurely born infants.
METHODS—130 infants with a gestational age (GA) <37 weeks and born between 1 November 1989 and 31 October 1990 were enrolled in a prospective study about the development of strabismus, amblyopia, and refractive errors. Infants were subdivided in three groups according to GA: A <28 weeks (n=32), B ⩾28-⩽32 weeks (n=64), C >32-<37 weeks (n=34). Ophthalmological assessment took place at the postconceptional age of 32 weeks, at term and at 3, 6, 12, and 30 months post term. At the age of 5 years parents received a questionnaire and a majority of the children was examined again (n=99).
RESULTS—At the age of 5 years 46 infants were known to have strabismus (n=29) and/or amblyopia (n=22) and/or refractive errors (n=22). Statistical analysis showed that gestational age, duration of supplementary oxygen, and duration of hospitalisation were important predictive variables for the development of strabismus, amblyopia, or refractive errors (SAR) at the age of 5 years (p<0.05). Infants with a GA ⩽32 weeks had a significantly higher risk of developing SAR than infants with a GA >32 weeks, who developed an incidence comparable with the normal population. Strabismus developed mainly in the first year of life and at the age of 5 years. Most infants with amblyopia were detected at the age of 2-3 years. Refractive errors were found in the first year of life and at the age of 2.5 and 5 years.
CONCLUSION—Infants with a GA <32 weeks should be selected for long term ophthalmological follow up. These infants should be screened at the age of 1 year, in the third year of life (preferably at 30 months), and just before school age (including testing of visual acuity with optotypes).



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Figure 1  .

Figure 1  

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Age at onset of strabismus, amblyopia, and refractive errors of infants who had been classified as having ophthalmological abnormalities at the age of 5 years. The ages at which follow up examinations were originally scheduled are underlined.

Figure 2  .

Figure 2  

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Cumulative distribution of infants with ocular abnormalities (strabismus, amblyopia, and/or refractive errors) at the age of 5 years, according to gestational age at birth. If only infants with a gestational age ⩽31 or ⩽ 32 weeks had been screened, 96% of infants with ophthalmological abnormalities would have been detected.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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