Tags

Type your tag names separated by a space and hit enter

Clinical judgement of near pupil responses provides a useful indicator of focusing ability in children with cerebral palsy.
Dev Med Child Neurol. 2008 Jan; 50(1):33-7.DM

Abstract

Accommodation is often reduced in cerebral palsy (CP). Knowledge about accommodative facility is valuable when investigating a child's visual needs and developing strategies for education. With normal accommodation, changing focus from distance to near results in pupil constriction. We compared quality of near pupil responses (NPR) with objective measures of accommodative function obtained with dynamic retinoscopy (DR) to investigate the utility of NPR in indicating accommodative facility. NPR and accommodative function of 90 children with CP (56 males, 34 females; median age 11y, range 4-18y) were assessed. A total of 93% of participants had spastic CP (71.3% bilateral involvement, 28.7% hemiplegia). The severity of motor impairment ranged from very mild (n=7) to severe (no independent walking, n=28). NPR was classified subjectively as normal, reduced, or absent and compared with DR measures of accommodative response. A total of 9.8% of pupil responses were judged absent, 25.6% reduced, and 64.6% normal. Participants with reduced or absent pupil responses demonstrated significantly poorer levels of accommodation with DR (one-way analysis of variance p<0.01). Sensitivity and specificity of NPR in identifying participants with reduced accommodation were 83% (95% confidence interval [CI] 65.5-92.4%) and 72% (95% CI 58.4-82.0%) respectively. NPR provides a rapid, useful indicator of accommodative function in children with CP.

Authors+Show Affiliations

Vision Science Research Group, School of Biomedical Sciences, University of Ulster, Co. Londonderry, Northern Ireland. kj.saunders@ulster.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18173628

Citation

Saunders, Kathryn J., et al. "Clinical Judgement of Near Pupil Responses Provides a Useful Indicator of Focusing Ability in Children With Cerebral Palsy." Developmental Medicine and Child Neurology, vol. 50, no. 1, 2008, pp. 33-7.
Saunders KJ, McClelland JF, Richardson PM, et al. Clinical judgement of near pupil responses provides a useful indicator of focusing ability in children with cerebral palsy. Dev Med Child Neurol. 2008;50(1):33-7.
Saunders, K. J., McClelland, J. F., Richardson, P. M., & Stevenson, M. (2008). Clinical judgement of near pupil responses provides a useful indicator of focusing ability in children with cerebral palsy. Developmental Medicine and Child Neurology, 50(1), 33-7. https://doi.org/10.1111/j.1469-8749.2007.02012.x
Saunders KJ, et al. Clinical Judgement of Near Pupil Responses Provides a Useful Indicator of Focusing Ability in Children With Cerebral Palsy. Dev Med Child Neurol. 2008;50(1):33-7. PubMed PMID: 18173628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical judgement of near pupil responses provides a useful indicator of focusing ability in children with cerebral palsy. AU - Saunders,Kathryn J, AU - McClelland,Julie F, AU - Richardson,Patrick M, AU - Stevenson,Mike, PY - 2008/1/5/pubmed PY - 2008/3/28/medline PY - 2008/1/5/entrez SP - 33 EP - 7 JF - Developmental medicine and child neurology JO - Dev Med Child Neurol VL - 50 IS - 1 N2 - Accommodation is often reduced in cerebral palsy (CP). Knowledge about accommodative facility is valuable when investigating a child's visual needs and developing strategies for education. With normal accommodation, changing focus from distance to near results in pupil constriction. We compared quality of near pupil responses (NPR) with objective measures of accommodative function obtained with dynamic retinoscopy (DR) to investigate the utility of NPR in indicating accommodative facility. NPR and accommodative function of 90 children with CP (56 males, 34 females; median age 11y, range 4-18y) were assessed. A total of 93% of participants had spastic CP (71.3% bilateral involvement, 28.7% hemiplegia). The severity of motor impairment ranged from very mild (n=7) to severe (no independent walking, n=28). NPR was classified subjectively as normal, reduced, or absent and compared with DR measures of accommodative response. A total of 9.8% of pupil responses were judged absent, 25.6% reduced, and 64.6% normal. Participants with reduced or absent pupil responses demonstrated significantly poorer levels of accommodation with DR (one-way analysis of variance p<0.01). Sensitivity and specificity of NPR in identifying participants with reduced accommodation were 83% (95% confidence interval [CI] 65.5-92.4%) and 72% (95% CI 58.4-82.0%) respectively. NPR provides a rapid, useful indicator of accommodative function in children with CP. SN - 0012-1622 UR - https://www.unboundmedicine.com/medline/citation/18173628/Clinical_judgement_of_near_pupil_responses_provides_a_useful_indicator_of_focusing_ability_in_children_with_cerebral_palsy_ L2 - https://doi.org/10.1111/j.1469-8749.2007.02012.x DB - PRIME DP - Unbound Medicine ER -