Article Text

PDF
Perceptual visual dysfunction, physical impairment and quality of life in Bangladeshi children with cerebral palsy
  1. D Mitry1,
  2. C Williams2,3,
  3. K Northstone2,
  4. A Akter4,
  5. J Jewel4,
  6. N Khan5,
  7. M Muhit4,
  8. C E Gilbert6,
  9. R Bowman1,6,7
  1. 1Research Centre for Ophthalmology, NIHR Biomedical Research Centre at Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, UK
  2. 2School of Social and Community Medicine, University of Bristol, Bristol, UK
  3. 3Department of Paediatric Ophthalmology, Bristol Eye Hospital, Bristol, UK
  4. 4Child Sight Foundation, Dhaka, Bangladesh
  5. 5Child Neurology and Development, Bangladesh Institute of Child Health, Dhaka Shishu Hospital Dhaka, Bangladesh
  6. 6Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
  7. 7Department of Clinical Research, Institute of Child Health, London, UK
  1. Correspondence to Dr Danny Mitry, Clinical research fellow, Moorfields Eye Hospital, London EC1V 2PD, UK; mitryd{at}gmail.com

Abstract

Background Cerebral palsy (CP) is the most common cause of motor disability in children and is often accompanied by sensory and/or cognitive impairment. The aim of this study was to characterise visual acuity impairment, perceptual visual dysfunction (PVD) and physical disability in a community-based sample of Bangladeshi children with CP and to assess the impact of these factors on the quality of life of the children.

Methods A key informant study was used to recruit children with CP from Sirajganj district. Gross Motor Function Classification System (GMFCS) levels and visual impairment were assessed by a physiotherapist and an optometrist, respectively. Assessments of visual perception were performed and standardised questionnaires were administered to each child's main carer to elicit indicators of PVD and parent-reported health-related quality of life. A generalised linear regression analysis was conducted to assess the determinants of the quality of life scores.

Results 180 children were recruited. The median age was 8 years (IQR: 6–11 years); 112 (62%) were male; 57 (32%) had visual acuity impairment and 95 (53%) had some parent-reported PVD. In analyses adjusted for age, sex, GMFCS and acuity impairment, visual attention (p<0.001) and recognition/navigation (p<0.001) were associated with total health-related quality of life, and there were similar trends for total PVD score (p=0.006) and visual search (p=0.020).

Conclusions PVD is an important contributor in reducing quality of life in children with CP, independent of motor disability and acuity impairment. Better characterisation of PVD is important to help design interventions for affected children, which may improve their quality of life.

  • Public health
  • Visual pathway
  • Visual perception
  • Vision
  • Child health (paediatrics)

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas