Risk factors for strabismus in children born before 32 weeks' gestation

doi:10.1136/bjo.83.5.514

British Journal of Ophthalmology 1999;83:514-518; doi:10.1136/bjo.83.5.514

Br J Ophthalmol 1999;83:514-518 ( May )

Risk factors for strabismus in children born before 32 weeks' gestation

Philippa M Pennefather,^a Michael P Clarke,^a Nicholas P Strong,^a David G Cottrell,^b Jonathan Dutton,^c Win Tin^d

^a Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, ^b Department of Ophthalmology, Newcastle General Hospital, Newcastle upon Tyne, ^c Department of Clinical Audit, Southport and Formby District General Hospital, Southport, ^d Regional Maternity Survey Office, Newcastle upon Tyne

Correspondence to: Mrs P M Pennefather, St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP.

Accepted for publication 22 October 1998

AIM $---$ To investigate risk factors associated with strabismus in children bornprematurely.
METHODS $---$ Prospective study of all children born before 32 weeks' gestation between 1 January 1990 and 31 December 1991 in a geographicallydefined population of approximately 3 million in the NorthernRegion of the United Kingdom. All children were examined aged2 years by the same ophthalmologist andpaediatrician.
RESULTS $---$ 558 children (98.6% of study group) were examined. Logistic regression showed an increased risk of strabismus in childrenwith cicatricial retinopathy of prematurity (p=0.02), refractiveerror (p=0.003), family history of strabismus (p<0.0001), andpoor neurodevelopmental outcome (p<0.0001), in particular impairedlocomotor skills (p=0.008) and hand-eye coordination (p=0.001).Gestational age and regressed acute ROP were not independent riskfactors for strabismus (p=0.92 and 0.85respectively).
CONCLUSIONS $---$ This study has identified factors which are independently related to strabismus (although not necessarily causative) and otherswhich are related only indirectly. This may contribute both tothe management of children born prematurely and to future studiesof the aetiology ofstrabismus.

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