Meera Suresh Joshi1, Omkar Jagdish Telang2, Vrunda Gangadhar Morepatil3

In India, an estimated 1.5-2.5% children below 2 years of age are developmentally delayed. A higher incidence of ocular disability is seen in these children, refractive errors and strabismus being most common. These can add to the overall burden of health as most of them have developmental comorbidities. The aim of the study is to study the ocular disorders in children with developmental delay.
We studied 112 children between the 2-12 years of age diagnosed to have developmental delay. All the subjects underwent a detailed ophthalmic evaluation including visual acuity testing using Snellen’s charts (3m and 6m) and Log MAR charts (recorded as per Snellen’s vision testing to maintain uniformity), cycloplegic refraction, torchlight and slit-lamp evaluation and dilated fundus examination. The data was tabulated and represented using bar diagrams, Pie charts and graphs. The results were expressed as percentages. Design-Cross-sectional, observational study.
66 boys and 46 girls (total 112) were evaluated. The mean age of the study population was 7.8 years ± 2.4 SD. The aetiology of developmental delay was cerebral palsy (64%), Down syndrome (22%), autism (7%), intellectual disability (4.5%) and 1 case each of congenital hypothyroidism and ataxia telangiectasia. The prevalence of ocular disorders was found to be 84.8%, which was slightly higher in girls (87%) as compared to boys (83%). Refractive error (79.5%) was the commonest ocular disorder followed by strabismus (46.4%). Astigmatism (44.6%) was the commonest refractive error, which was divided into myopic astigmatism (19.6%), hyperopic astigmatism (13.8%) and mixed astigmatism (11.2%). Simple hyperopia was seen in 21.9% subjects and simple myopia in 12.1%. Exotropia (52%) was commoner than esotropia (48%). Other ocular abnormalities included optic atrophy, nystagmus, epicanthal folds, cataract, mongoloid slant, ptosis, telecanthus, conjunctival telangiectasia and blepharitis. Almost, 10% children with cerebral palsy had optic atrophy and 25% of those with Down syndrome had cataracts.
Ocular disorders are commonly seen in children with developmental delay. Refractive errors and strabismus are commonest and can easily be treated. Early diagnosis, prompt intervention and a close follow up are essential in order to prevent amblyopia.