Article Text

Change of refractive state and eye size in children of birth weight less than 1701 g
  1. A R O’Connor1,
  2. T J Stephenson1,
  3. A Johnson2,
  4. M J Tobin3,
  5. S Ratib4,
  6. A R Fielder5
  1. 1Division of Child Health, University of Nottingham, Nottingham, UK
  2. 2National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
  3. 3Department of Special Education, University of Birmingham, Birmingham, UK
  4. 4Trent Institute for Health Services Research, University of Nottingham, Nottingham, UK
  5. 5Department of Optometry and Visual Science, City University, London, UK
  1. Correspondence to: Dr Anna O’Connor Division of Orthoptics, Thompson Yates Building, Quadrangle, University of Liverpool, Liverpool L69 3GB, UK; annaoc{at}


Aims: To determine the refractive status and ocular dimensions of a cohort of children at age 10–12 years with birth weight below 1701 g, and also the relation between the neonatal ophthalmic findings and subsequent refractive state.

Methods: 293 low birthweight children who had been examined in the neonatal period were assessed at 10–12 years of age. The examination consisted of autorefraction, keratometry, and A-scan. Results of right eyes were compared with published normative data.

Results: 293 of the birth cohort of 572 children consented to participate. The average mean spherical equivalent (MSE) in the low birthweight cohort was +0.691 dioptre, significantly higher than the control data (+0.30D, p = 0.02). The average change in MSE over the 10–12 year period was −1.00 dioptre (n = 256), but only 62.1% of cases showed a shift in refractive error of the appropriate magnitude and direction. The presence of any retinopathy of prematurity (ROP) increases the risk of developing anisometropia sixfold.

Conclusions: Low birth weight and ROP both significantly impact the refractive state in the long term. At age 10–12 years children born preterm have an increased prevalence of all refractive errors. In low birthweight children refractive state is relatively stable over the first decade of life with a shift towards myopia of 1 dioptre.

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  • Permission for this study was obtained from Nottingham University Hospital Ethics Committee and informed consent was obtained from all parents.

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