OCULAR FINDINGS IN CHILDREN WITH CEREBRAL PALSY ATTENDING A TERTIARY HOSPITAL IN NORTH CENTRAL NIGERIA

Abstract

Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria.   We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of Ilorin Teaching Hospital, Nigeria (UITH). A cross sectional survey of children with cerebral palsy presenting at Pediatric neurology clinic of UITH between January and December 2012 was done. Age appropriate visual acuities were checked, ocular examination was done with hand held Slit Lamp and Cycloplegic refraction and fundoscopy done with indirect Ophthalmoscope. Thirty - seven (42.5%) of 87 subjects seen within that period presented for ocular assessment. There were 24 males (64.9%) and 13 females (35.1%) with a male female ratio of 1.8:1. The age ranged between 6-168months with a mean of 50.11+ 46.51months. Thirty- three (89.2%) were delivered full term while 4(10.8%) were preterm. Spastic cerebral palsy accounted for 45.9% of all the cases seen.  Strabismus was found in thirteen subjects (35.1%). This was esotropia in 7(54%) and exotropia in 6 (46%) subjects. Refractive error was found in 32(86.5%) subjects and Cortical Visual Impairment (CVI) in 28(75.7%) subjects    CVI, refractive errors and strabismus are the most common ocular findings in children with Cerebral Palsy in Nigeria. Early detection and early intervention is important to achieve best developmental and educational attainment. Multidisciplinary approach involving Neurologists, Ophthalmologists, and Physiotherapist is paramount in managing these children from the time of diagnosis.