Prevalence and Pattern of Cerebral Visual Impairment Amongst Children Attending Kenyatta National Hospital Eye Clinic
Abstract
Background: In the absence of injury to the anterior afferent visual pathways or the ocular
structures, cerebral visual impairment (CVI) is characterized by vision loss caused by damage to
the retro-geniculate pathway or by vision loss that is more than anticipated given the severity of
ocular pathology. Ocular pathologies such as refractive errors may coexist but insufficient to
cause severe vision impairment. Common causes of CVI include birth asphyxia, meningitis and
hydrocephalus. Studies on CVI in Sub Sahara Africa are limited as it is listed under other causes
of visual impairment or blindness and not as an individual entity. Several patients had been
diagnosed with cerebral visual impairment at Kenyatta National Hospital eye clinic however, no
audit of the condition had been done.
Objective: To describe the prevalence and pattern of cerebral visual impairment in children
attending Kenyatta National Hospital eye clinic.
Design: It was a retrospective, hospital-based study.
Study location: The study was done at Kenyatta National hospital eye clinic.
Methods: The study included all children with CVI seen at Kenyatta National hospital eye clinic
from 1st January 2019 to 28th February 2021. A standardized questionnaire was used to obtain
patient data. The variables of interest included known causes of cerebral visual impairment, age
at diagnosis, age at presentation, associated non-ocular co-morbidities, ocular examination
findings and refractive status. Prevalence of CVI was calculated from this study population.
Data was analyzed using SPSS Version 24 software. Descriptive statistical analysis and
inferential analysis was used.
Results were presented in text, tables, graphs and charts.
Results: A total of 674 children were reviewed and 53 children met the study inclusion criteria.
The prevalence of CVI was 7.9%.The male to female ratio was 1.4:1with the mean age at
presentation of 25.9 months. The main presenting complaint was poor vision (100%). The main
known cause of CVI was meningitis/encephalitis (41.4%) followed by birth asphyxia (31%).
Half of the children were not fixing or following light. The main ocular examination finding was
optic atrophy (39.6%). The main refractive error was simple hyperopia (41.7%). The commonest
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non-ocular co-morbidity was delayed milestones/motor impairment (61.5%). Some children had
more than one non-ocular co-morbidity.
Conclusion: All children presented with poor vision. The commonest known cause was
meningitis/encephalitis. More than half of the patients had severe visual impairment. The main
ocular finding was optic atrophy. Simple hyperopia was the commonest refractive error. The
commonest non-ocular co-morbidity was developmental delay/motor impairment
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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