Incidence and nature of orthoptic problems found in children previously screened for retinopathy of prematurity: an argument for orthoptic follow-up?

Aim: To determine the incidence and type of visual and/or binocular defects in infants previously screened for and found to have insignificant or no retinopathy of prematurity (ROP). Methods: The case notes of a consecutive cohort of children who had passed screening for ROP were reviewed retrospectively. Details of attendance, orthoptic assessments, related investigations and outcome were documented with particular attention to the incidence and type of ocular defect. Results: One hundred and eight cases were reviewed; 78 cases met the inclusion criteria. Nineteen patients had an ocular defect that required treatment or ongoing orthoptic review. Eleven children had strabismus, of whom 8 had constant esotropia and 3 had intermittent exotropia. Other defects were refractive error (without strabismus), congenital idiopathic nystagmus and a case of an upper lid haemangioma. Conclusions: The review confirmed a higher pre­valence of strabismus and visual/binocular defects in patients who had previously passed screening for ROP compared with the normal population. Constant esotropia was the most common form of strabismus found.