Ocular findings in children attending occupational therapy clinic at Kenyatta National Hospital, Nairobi, Kenya

Abstract

Objectives: To describe the pattern of ocular abnormalities, their correlation with the physical disorders and describe associated risk factors in children attending the Occupational therapy clinic at Kenyatta National Hospital. Design: Cross sectional hospital based. Subjects: A hundred and eighty seven children, aged between three months and 13 years with cerebral palsy and sensory integration deficits. Results: Majority of the patients had cerebral palsy(CP), 160(85.6%), while in those with sensory integration deficit(SID), attention- deficit / hyperactive disorder and autism had almost equal proportions, 20(10.7%) and 18(9.6%) respectively. Among all the children, 62% had ocular anomalies. Children with CP had a much higher prevalence (58.3%) compared to SID group (3.7%). The common ocular abnormalities included cortical visual impairment (48.7%), refractive errors (39%) and squints (34.2%). Association between physical disability and ocular anomalies was noted more in patients with CP compared with SID. Strabismus, cortical visual impairment and myopia were more likely to occur in patients with CP. Significant hyperopia was noted only in CP patients. Strabismus and cortical visual impairment were more likely to occur in patient with neonatal jaundice, while refractive errors in patients with congenital causes and optic atrophy in patients with meningitis. Conclusion: Visual disabilities in children with physical disabilities were common. Cortical visual impairment, refractive errors and squints were more common. Children with CP had a much higher prevalence compared to the SID group. Recommendation: All Children with CP and SID should be referred to ophthalmologist and low vision specialist for assessment.