Preterm Birth and the Visual System

Abstract

Author Disclosure Drs Madan and Good did not disclose any relationships relevant to this article. After completing this article, readers should be able to: 1. Chart the development of the structures of the eye. 2. Describe the primary visual problems seen in preterm neonates. Despite several interventions, preterm birth remains one of the major causes of poor perinatal outcome. It is estimated that approximately 57,000 preterm infants weighing less than 1,500 g, comprising 1.5% of all live births in the United States, are born each year. (1) Considerable advances in neonatal intensive care in the 1990s, including use of surfactant replacement therapy for preterm infants and antenatal steroid use for women in preterm labor, has led to the increased survival of these infants. However, despite improvements in survival, preterm infants, particularly extremely low-birthweight infants whose birthweights are less than 1,000 g, continue to be at increased risk for abnormal cognitive function, visual-perceptual, visuomotor, and tactile-perceptual skills; cerebral palsy; blindness; and deafness. (2) Many severely handicapped infants have multiple impairments. Cortical visual impairment has emerged as the major cause of visual impairment in the United States. It is well known that appropriate procession of sensory cues is an important requirement for normal motor, mental, and emotional development in infants, and the association between vision problems and neurologic and mental disability is well recognized in several studies. (3) An increased understanding of the impact of extrauterine stimuli on visual development along with improved methods of detecting vision problems can help in prevention, early diagnosis, and rehabilitation of visual impairment in infants. (4) In this article, we review current knowledge of visual development in the preterm infant and the spectrum of visual disturbances seen in preterm infants. Visualization of an image requires refraction of light emanating from the object passing through the lens onto …