Relation between neurological status, refractive error, and visual acuity in children: a clinical study

The aims of the present study were: (1) to determine the refractive status and visual acuity of a group of 75 neurologically impaired children (5 to 192 months of age); and (2) to investigate the relation between the visual and neurological status of these children. Refractive error was determined using non-cycloplegic near retinoscopy and visual acuity was estimated using acuity cards (Keeler or Cardiff) and pattern-onset visual evoked potentials (VEP). Subjects demonstrated a markedly different distribution of refractive error from that of a neurologically normal age-matched population. Refractive error anomalies were more prevalent in children older than 5 years, suggesting abnormal refractive development. A wide range of visual acuity was found with both tests (acuity cards, 0.07 to 2.08 logMAR; VEP, O.78 to 2.68 logMAR). Visual acuity and refractive status varied with level and type of physical impairment. Level of intellectual impairment exhibited a weak relation with visual status.