Uncorrected amteropia among children hospitalized for headache evaluation: a clinical descriptive study.

Gad Dotan,Shlomi Cohen,Anat Kesler,Elad Moisseiev,Chaim Stolovitch

doi:10.1186/1471-2431-14-241

Gad Dotan, Shlomi Cohen + Show 3 more

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https://doi.org/10.1186/1471-2431-14-241

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Abstract

BackgroundHeadache is a common complaint in children occasionally requiring hospital admission. The purposes of the present study were to analyze the prevalence of uncorrected ametropia in children with headache admitted to the hospital, and evaluate the importance of refraction assessment as part of their evaluation.MethodsA retrospective review of children admitted to the Tel Aviv Medical Center for headache evaluation from December 2008 to March 2013, in whom the only abnormality found was an uncorrected refractive error.ResultsDuring the study period 917 children with headache were hospitalized for evaluation and 16 (1.7%) of them (9 boys, mean age 12 years, range 8–18 years) were found to have an uncorrected ametropia. Average headache duration was 4 months (range, 1 week to 1 year) and mean follow-up was 15 months (range, 1 month to 3 years). Twelve (75%) children had brain imaging and 4 children (25%) had a lumbar puncture before their refractive abnormality was identified. Anisometropia and myopia were the most common refractive errors encountered (n = 10 each), followed by hyperopia (n = 6) and astigmatism (n = 3). Despite having uncorrected refractive errors most children (n = 10) did not complain of any visual difficulty. All children were given proper refractive correction and 14 of them reported complete headache resolution on re-examination one month later.ConclusionsUncorrected ametropia is a possible cause of headache among hospitalized children. Therefore, complete ophthalmic evaluation, which includes proper refraction assessment, is important as it can identify a treatable headache etiology. Children without visual difficulty should be equally evaluated, as many children with headache and uncorrected amteropia do not have vision complaints.

Highlights

Headache is a common complaint in children occasionally requiring hospital admission
It is well recognized that certain eye conditions such as acute glaucoma, posterior scleritis or optic neuritis may be associated with eye pain and/or headache [1]; there is much less certainty that uncorrected refractive errors are a possible source of headache
During the study period 917 children with headache were hospitalized to the Tel Aviv medical center and in 16 (1.7%) of them (9 boys, mean age 12 years; range 8 to 18 years) the only abnormality found was an uncorrected ametropia

Summary

Introduction

Headache is a common complaint in children occasionally requiring hospital admission. It is well recognized that certain eye conditions such as acute glaucoma, posterior scleritis or optic neuritis may be associated with eye pain and/or headache [1]; there is much less certainty that uncorrected refractive errors are a possible source of headache. The purposes of the present study were to analyze the prevalence of uncorrected ametropia in children with headache admitted to the hospital, and evaluate the importance of refraction assessment as part of their evaluation Pain absent on awakening and Several authors [3-7] reported on possible association between refractive errors and headache in both children and adults; whereas others [8-11] reported on the contrary believing that the finding of an abnormal refractive error in an individual with headache is purely coincidental, based on the high prevalence of both conditions in the general population, which does not imply a causal relationship between them.

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