Outpatient evaluation of vision and ocular motricity in 123 children with cerebral palsy

Purpose: Children with cerebral palsy (CP) may present varied ophthalmological problems. Paradoxically, however, investigation of visual function and possible related disorders is not routinely conducted in this population during medical consultations. Method: This paper proposes a simple, practical guide for assessing vision and ocular motricity in children with CP. One-hundred and twenty-three patients (mean age: 8.4 years +/- 2.3) from the Sarah Network of Rehabilitation Hospitals (Brasilia, Rio de Janeiro and Sao Luis units) were studied. Various parameters were investigated (smooth pursuit movements, strabismus, visual acuity, visual field, visuospatial neglect and nystagmus) using the following assessment tools: adapted smooth pursuit test for ocular motricity; Snellen test for visual acuity; confrontation method for visual field; cancellation test (star test) for visual neglect; and cover test for strabismus. Nystagmus was assessed based on patient observation. Results: Eighty-one children completed all the evaluations. Among these, 38 (47%) had no visual problems (hemiplegia 60.5%; diplegia 41.4%; triplegia 12.5%; mixed tetraplegic 33.3%); 23 had difficulties in one of the tested items; and 20 had problems in two or more areas of vision. Conclusions: Visual and oculomotor tests are of significant importance in children with CP and provide relevant information for creating a rehabilitation programme aimed at the individual as a whole.