PT  - JOURNAL ARTICLE
AU  - Roseline Ekanem Duke
AU  - Justin Nwachukuw
AU  - Chima Torty
AU  - Uche Okorie
AU  - Min J Kim
AU  - Kathryn Burton
AU  - Clare Gilbert
AU  - Richard Bowman
TI  - Visual impairment and perceptual visual disorders in children with cerebral palsy in Nigeria
AID  - 10.1136/bjophthalmol-2020-317768
DP  - 2022 Mar 01
TA  - British Journal of Ophthalmology
PG  - 427--434
VI  - 106
IP  - 3
4099  - http://bjo.bmj.com/content/106/3/427.short
4100  - http://bjo.bmj.com/content/106/3/427.full
SO  - Br J Ophthalmol2022 Mar 01; 106
AB  - Cerebral palsy (CP) is the most common cause of childhood physical disability globally. This study describes the spectrum of ocular morbidity and visual impairment in a community-based (recruited by key informants) sample of children with CP in Cross River State, Nigeria.Methods A paediatric neurologist clinically confirmed CP and assessed systemic comorbidity. Ophthalmological assessment included developmental age appropriate acuity tests, objective refraction and objective and subjective tests of perceptual visual dysfunction (PVD).Results 388 children aged 4–15 years with CP were identified. Visual problems were reported by carers in only 55 (14%) cases. Binocular visual acuity impairment was seen in 20/201 by Lea symbols test (10%) and 213/388 (55%) by the mirror test. Abnormal visual fields were seen in 58/388 (14.9%); strabismus in 183 (47%) abnormal contrast sensitivity in 178 (46%) and abnormal saccades in 84 (22%), spherical refractive errors in 223 (58%), significant astigmatism in 36 (12%), accommodative dysfunction in 41 (10.6%), optic atrophy in 198 (51%). Perceptual visual disorders were present in 22 (6%) subjectively and 177 (46%) objectively. The estimated frequency of cerebral visual impairment (CVI) in children ranged from 61 (16%) to 191 (49%) if children with optic atrophy were included.Conclusion Children with CP have a wide spectrum of ocular morbidity and visual impairment, underestimated by carers. Children with CP require visual acuity assessments with a range of tests which account for associated comorbidities and oculomotor dysfunction. Functional vision assessments for PVD is important. CVI is common.Data are available on reasonable request. Deidentified participant data may be requested from the Investigator using their publishable contact and orchid identifier.