Have we stopped looking for a red reflex in newborn screening?

Hdl Handle:
http://hdl.handle.net/10147/209282
Title:
Have we stopped looking for a red reflex in newborn screening?
Authors:
Sotomi, O; Ryan, C A; O'Connor, G; Murphy, B P
Affiliation:
Unified Maternity and Neonatal Services, and Department of Paediatrics & Child, Health, Cork University Hospital.
Citation:
Ir Med J. 2007 Mar;100(3):398-400.
Journal:
Irish medical journal
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209282
PubMed ID:
17491540
Abstract:
Best medical evidence indicates that surgical treatment of significant congenital cataracts is required within the first 3 months of life for optimal visual outcome. The aim of the present study was to review when the diagnosis of congenital cataracts was made in our region, by whom it was made, and the visual outcome at 2 years of age or more. This was a retrospective study in a region with a population of 546,000 and approximately 8500 births per annum, served by a single Regional Ophthalmology centre. All children under 15 years, diagnosed with Congenital Cataract over a 10-year period (1991-2002), were identified using the Hospital In-Patient Enquiry [HIPE] database. Children with cataract(s) from infancy from a congenital cause and those first presenting outside infancy but with salient clinical features indicating early cataract were included in the study. 27 cases of congenital and infantile cataract 15 (56%) males, 12 (44%) females were retrieved. 17 infants (63%) were diagnosed with bilateral disease, while the remainder were unilateral 10 (37%). Most of the cases 17 (63%) were diagnosed following presentation with parental/carer concerns about visual function (usually a squint). However only 2 of these 17 cases presented before 3 months of age. The remaining cases of congenital cataracts were diagnosed by general practitioners 8 (24%), paediatricians 4 (12%), ophthalmologists 3 (9%) or School Medical Officer (1, 3%). No case of congenital cataract was diagnosed by newborn screening examination. Six of 8 infants diagnosed with congenital cataracts before three months of age had a good visual outcome, (visual acuity < 6/24 at 2 years or more). In contrast only 3 of 19 cases who were diagnosed after 3 months of age had good visual outcomes. Despite their relative rarity, it is imperative that congenital cataracts are diagnosed and treated within 3 months of birth. The onus of diagnosis rests with newborn screening examiners at birth and with general practitioners at the 6-8 week checks. Parental concerns about a possible squint should be addressed by performing a red light reflex examination and urgent specialist ophthalmological referral if a flaw is detected.
Language:
eng
MeSH:
Age Factors; Cataract/congenital/*diagnosis; *Cataract Extraction; Child, Preschool; Early Diagnosis; Female; Hospitals, University; Humans; Infant; Infant, Newborn; Ireland; Male; Neonatal Screening/methods/*utilization; Retrospective Studies; Time Factors; Vision Screening/methods/*utilization; Visual Acuity
ISSN:
0332-3102 (Print); 0332-3102 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorSotomi, Oen_GB
dc.contributor.authorRyan, C Aen_GB
dc.contributor.authorO'Connor, Gen_GB
dc.contributor.authorMurphy, B Pen_GB
dc.date.accessioned2012-02-03T15:17:07Z-
dc.date.available2012-02-03T15:17:07Z-
dc.date.issued2012-02-03T15:17:07Z-
dc.identifier.citationIr Med J. 2007 Mar;100(3):398-400.en_GB
dc.identifier.issn0332-3102 (Print)en_GB
dc.identifier.issn0332-3102 (Linking)en_GB
dc.identifier.pmid17491540en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209282-
dc.description.abstractBest medical evidence indicates that surgical treatment of significant congenital cataracts is required within the first 3 months of life for optimal visual outcome. The aim of the present study was to review when the diagnosis of congenital cataracts was made in our region, by whom it was made, and the visual outcome at 2 years of age or more. This was a retrospective study in a region with a population of 546,000 and approximately 8500 births per annum, served by a single Regional Ophthalmology centre. All children under 15 years, diagnosed with Congenital Cataract over a 10-year period (1991-2002), were identified using the Hospital In-Patient Enquiry [HIPE] database. Children with cataract(s) from infancy from a congenital cause and those first presenting outside infancy but with salient clinical features indicating early cataract were included in the study. 27 cases of congenital and infantile cataract 15 (56%) males, 12 (44%) females were retrieved. 17 infants (63%) were diagnosed with bilateral disease, while the remainder were unilateral 10 (37%). Most of the cases 17 (63%) were diagnosed following presentation with parental/carer concerns about visual function (usually a squint). However only 2 of these 17 cases presented before 3 months of age. The remaining cases of congenital cataracts were diagnosed by general practitioners 8 (24%), paediatricians 4 (12%), ophthalmologists 3 (9%) or School Medical Officer (1, 3%). No case of congenital cataract was diagnosed by newborn screening examination. Six of 8 infants diagnosed with congenital cataracts before three months of age had a good visual outcome, (visual acuity < 6/24 at 2 years or more). In contrast only 3 of 19 cases who were diagnosed after 3 months of age had good visual outcomes. Despite their relative rarity, it is imperative that congenital cataracts are diagnosed and treated within 3 months of birth. The onus of diagnosis rests with newborn screening examiners at birth and with general practitioners at the 6-8 week checks. Parental concerns about a possible squint should be addressed by performing a red light reflex examination and urgent specialist ophthalmological referral if a flaw is detected.en_GB
dc.language.isoengen_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshCataract/congenital/*diagnosisen_GB
dc.subject.mesh*Cataract Extractionen_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshEarly Diagnosisen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHospitals, Universityen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMaleen_GB
dc.subject.meshNeonatal Screening/methods/*utilizationen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshTime Factorsen_GB
dc.subject.meshVision Screening/methods/*utilizationen_GB
dc.subject.meshVisual Acuityen_GB
dc.titleHave we stopped looking for a red reflex in newborn screening?en_GB
dc.contributor.departmentUnified Maternity and Neonatal Services, and Department of Paediatrics & Child, Health, Cork University Hospital.en_GB
dc.identifier.journalIrish medical journalen_GB
dc.description.provinceMunster-

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