An Assessment of Ocular Morbidities of Children Born Prematurely in Early Childhood

Purpose: To assess the ocular morbidities of premature children in early childhood. Methods: One hundred seventeen children with a history of gestational age of less than 37 weeks at birth underwent ophthalmic examination including visual acuity testing with Lea symbols, anterior and posterior segment examination, refraction, orthoptic examination for strabismus, and ocular biometry. They were subdivided into three groups according to gestational age (28 or less, 29 to 32, and 33 to 36 weeks). The prevalence of ocular morbidities and mean value of refractive errors were studied. Results: The mean age of the subjects at examination was 37.6 +/- 1.1 months (range: 20 to 65 months). Only 62.4% of the eyes had visual acuity better than 20/32. The prevalence of high myopia (above -5.0 diopters [D]), myopia (below -5.0 D), and strabismus was 12.5%, 22.5% and 33.3% in the 28 weeks or less group and 3.6%, 18.9%, and 24.1% in the 29 to 32 weeks group, respectively, whereas 7.9% of the 33 to 36 weeks group had myopia and 13.2% had strabismus. Spherical equivalent in eyes that received cryotherapy and with macular heterotopia was -2.7 +/- 3.9 and -4.4 +/- 3.4 D, respectively. Biometric measurements showed that high myopic eyes had statistically significantly thicker lenses compared to myopic and hyperopic eyes (P = .01). Conclusion: This study confirms that children born prematurely are at increased risk of ocular morbidities such as defective visual acuity, myopia, and strabismus. High myopic eyes have thicker lenses compared to myopic and hyperopic eyes, and eyes with macular heterotropia and treated with cryotherapy are more prone to development of high myopia.