Purpose: To describe refractive status in children/young adults with CP and relate refractive error to standardised measures of type/severity of CP impairment and to ocular dimensions.Methods: A population-based sample of 118 participants aged 4-23 years with CP (mean 11.64±4.06) and an age appropriate control group (n=128, age 4-16 years, mean 9.33±3.52) were recruited. Motor impairment was described using the Gross Motor Function Classification Scale (GMFCS) and subtype allocated using the Surveillance of Cerebral Palsy in Europe (SCPE). Measures of refractive error were obtained from all participants and ocular biometry from a subgroup with CP.Results: (1) A significantly higher prevalence and magnitude of refractive error was found in the CP group compared to controls. (2) Axial length and spherical refractive error were strongly related. This relation did not improve with inclusion of corneal data. (3) There was no relation between the presence or magnitude of spherical refractive errors in CP and the level of motor impairment, intellectual impairment or the presence of communication difficulties. Higher spherical refractive errors were significantly associated with the non-spastic CP subtype. (4) The presence and magnitude of astigmatism was greater when intellectual impairment was more severe and astigmatic errors were explained by corneal dimensions.Conclusions: High refractive errors are common in CP pointing to impairment of the emmetropisation process. Biometric data support this possibility. In contrast to other functional vision measures, spherical refractive error is unrelated to CP severity but those with non-spastic CP tend to demonstrate the most extreme errors of refraction.
Bibliographical noteelectronic publication ahead of print
- Cerebral Palsy • refractive error • motor impairment • ocular biometry • population based