Neuro-ophthalmological disorders in cerebral palsy and cortical visual impairment patients.

Javaria Mustafa, Ajmal Chaudhary


OBJECTIVE: To find the types & proportion of various Neuro ophthalmological disorders in cerebral palsy patients. To find the proportion of nystagmus, fundus findings, refractive error and type of deviations.

STUDY DESIGN AND METHOD: It is descriptive cross sectional study. Data were collected by clinical examination and by self-designed Proforma. Visual acuity on Log Mar chart for distance Vision. For Fundoscopy use ophthalmoscope, refractive error by Retinoscope, and strabismus by cover test.

RESULTS: Study included total 113 patients were involved. Out of 113 patients, 33 (29.20%) were males and 80 (70.80%) were females. Ocular history of the patients. 39 (34.51%) have visual inattention, 54 (47.79%) have no eye contact and 20 (17.70%) have searching eyes. Visual response: 33 (29.20%) have good visual response and 80 (70.80%) have poor visual response. 90 (79.65%) have nystagmus and 23 (20.35%) have no nystagmus. Type of deviation: 44 (38.94%) have esotropia, 35 (30.97%) have exotropia and 34 (30.09%) were orthotropic.

CONCLUSION: It is concluded that patients of cerebral palsies have a significant chance of having strabismus, refractive error, nystagmus and squint; all related with poor visual response. Hence, these patients must have complete ophthalmic examination.

KEY WORDS: Cerebral palsy, Cortical visual impairment, Strabismus.

Full Text:



• Neil RM., Walsh FB, and Hoyt WF,eds. Walsh and Hoyt's clinical neuro-ophthalmology. Lippincott Williams & Wilkins, 2005(2).

• Peter R. A report: the definition and classification of cerebral palsy. DevMed Child NeurolSupl 109 .2006April;109 (2007): 8-14.

• Susan CM, William V. Cortical visual impairment. Handbook of pediatric neuro-ophthalmology. Springer New York, 2006. 247-254.

• Jonathan TD. Walsh and Hoyt's Clinical Neuro-Ophthalmology: The Essentials. Journal of Neuro-Ophthalmology2015; 35(4): 29.

• Gilbert A. Neuro-Ophthalmology: Non-Organic Visual Loss in Children. Neuro-Ophthalmology .2015.

• Schenk-Rootlieb AJ, van Nieuwenhuizen O, van WaesPF,van der Graaf Y. Cerebral visual impairment in cerebralpalsy: relation to structural abnormalities of the cerebrum. Neuropediatrics 1994; 25(2): 68–72. DOI: 10.1055/s-2008-1071588.

• Frohman LP .The human resource crisis in neuro-ophthalmology. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.2008Sep; 28 (3): 231–4.

• Newman SA. Interventional neuro-ophthalmology: not an oxymoron. .Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.2012 Jun;32 (2): 177–84.

• Centers for Disease Control and Prevention. (2013). Data & statistics for cerebral palsy.Retrieved August 10, 2013, from

• Rethlefsen SA, Ryan DD, Kay, RM. Classification systems in cerebral palsy. OrthopClin North Am.2010 Oct ; 41 (4): 457–67.

• Wittebol-Post D, Willemse J. The prevalence of cerebral visual disturbance in children with cerebral palsy. Dev Med Child Neurol.1992 Jun;34(6):473-80.

• Bertone C, Misefari W, Galli J, Balottin U, Bianchi PE. Neuro ophthalmological disorders in cerebral palsy : ophthalmological, oculomotor, and visual aspects. 2012 Aug;54(8):730-6. doi: 10.1111/j.1469-8749.2012.04324.x. Epub 2012 Jun 19.

• Armour BS, Courtney-long EA, Fox HM, Fredine H, Cahill A. Prevalence and Causes of Paralysis-United States. Am J Public Health. 2016 Oct;106(10):1855-7.