My baby three-month old baby has
straight eyes but is not attentive to colourful toys. Does he have a visual
maturation delay?
At
birth, visual acuity is very poor and newborns show only sporadic fixation.
Smooth pursuit eye movements develop by two months of age. Visual acuity will
have improved significantly by then. Two month old infants should show some
visual attentiveness, and by 4-6 months of age, an infant should be able to
follow his mother’s face. Lack of visual attentiveness by 2-4 months of age
requires an ophthalmology consultation.
On of
the most common causes of poor visual attentiveness in infancy is delayed visual
maturation. Patients with this condition may belong to any of these three
groups:
Group
1: Isolated delayed visual maturation
Infants
with isolated delayed maturation of vision usually present with visual
inattentiveness by 3-4 months of age, and it is very unusual for improvement to
occur beyond 6 months of age. In these patients, general and neurological
development is normal, and the only problem is that they appear to see less well
than expected for their chronologic age. They have normal ocular examination
and no systemic abnormalities. They generally have an excellent visual
prognosis and show normal fixation and visual attentiveness by approximately
6-12 months of age, without specific treatment. However, several studies have
emphasized that upon follow-up examination, these children frequently have
delays in achieving developmental milestones speaking, sitting and walking,
compared to unaffected siblings.
Group
2: DVM with systemic disease or mental retardation
Children
who were born premature, with severe intercurrent illness early in life
(hydrocephalus, brain malformations, infantile spasm, seizure disorders,
hypoglycemia, hypocalcemia, Aicardi syndrome, tuberous sclerosis), mental
retardation with or without seizures, belong to this group. Their vision
usually improves in the same way as in group 1, with residual defects related to
their illness such as residual visual defects, problems with visual perception,
or hand-eye coordination. Those patients who have DVM in association with
neurologic defects and/or seizures show slower visual development and less
complete visual recovery.
Group
3: DVM with ocular disease
The
children belonging to this category have ocular disease that occurred early in
life and frequently have nystagmus. Children with albinism, bilateral
cataracts and optic nerve hypoplasia belong to this group. Their vision is much
worse than would be expected from the primary disease alone. Therefore, there
is DVM in addition to their structural eye defect. Their vision improves to
their final level more slowly and less fully than group 1, but faster and more
completely than group 2.
Cortical vision impairment
or cortical blindness is another consideration for a baby with poor vision, with
no apparent nystagmus and no gross ocular or systemic disorder. In most cases
the child with significant cortical visual impairment either will have a history
of significant perinatal hypoxia or other precipitant causes of this disorder or
will present with other associated neurologic signs. Occasionally, however,
only a magnetic resonance image or computed tomography will be able to discern
between cortical blindness and DVM.
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
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EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
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(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
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(632) 407-3883
Mobile: (63917) 855-2020
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CLINIC HOURS
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Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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DELAYED VISUAL MATURATION information
compiled by Dr.
Barbara L. Roque and initially uploaded on May 1, 2005.
Last updated on
September 13, 2007. |
