Abstract
The eye is one of the most important senses for the overall development of a person, personality and self-esteem. We reviewed records of all patients referred from various centers across the city with visual impairment due to various non-ocular causes from March 2016-December 2017. The demographics, disease and treatment protocols, ophthalmic evaluation comprising of Visual Function Questionnaire 25(VFQ25) NEVI version 2000, functional visual assessment, perimetry, visually evoked potential(VEP), contrast sensitivity test(CST), retinal nerve fibre layer(RNFL) and Macula ocular computed tomography(OCT) were reviewed at baseline and at 6 months’ post-intervention. Of total fifty patients, 32 (64%) were with the brain tumor (commonest Optic pathway glioma: 62%). Twenty four(75%) were <21years at diagnosis. Mean age of presentation to us being 10.7 (1.5-22) years. Of these, 21 were students. Visual impairment ranged from bilateral no perception of light (blindness) to 20/20 (none). Average best-corrected visual acuity(BCVA) of the better eye:20/80 (moderate impairment) and of the worst eye: 20/175(severe impairment). Twenty patients (83%) underwent visual rehabilitation. Eight patients were prescribed optical enhancement devices and 11 visual stimulation exercises. Surgical intervention was done for 4 patients of which two were orneo-protective and two restorative procedures for unsightly appearance of the blind eye. Average VFQ score improved from 92.9 at presentation to 76.5 at 6 months.
CONCLUSION
This review provides important insight into the baseline spectrum of visual morbidity in brain tumors and supports the benefit of routine integration of such services in the management of these patients.