Universal Eye Screening Reveals Newborn Ocular Issues

TOPLINE:

Universal eye screening in newborns identifies retinal hemorrhage in 10.64% of babies and other ocular abnormalities in 7.5% of infants, with potential risk factors including premature birth, being born to closely related parents, and systemic abnormalities.

METHODOLOGY:

• The researchers conducted a prospective cohort study at two urban centers in Andhra Pradesh, India, from June 2016 to April 2018, involving 1795 newborns with an average age of 2.67 days at their first eye screening.
• The included newborns did not meet the criteria for screening for retinopathy of prematurity, which typically affects those with a birth weight under 2000 g or a gestational age younger than 34 weeks.
• A questionnaire on universal eye screening was used to collect demographic data, information on neonatal history, and findings on eye examinations within 72 hours of birth.
• A trained retina specialist performed comprehensive examinations of the anterior and posterior segments using an ophthalmoscope with binocular indirect viewing.
• Newborns with ocular abnormalities were referred for further evaluation and management, whereas those without abnormalities were reviewed after 3 months.

TAKEAWAY:

• Retinal hemorrhage was the most prevalent ocular abnormality, observed in 10.64% of newborns (95% CI, 9.25-12.16).
• Other abnormalities were found in 7.5% of newborns (95% CI, 6.34-8.84).
• Newborns with retinal hemorrhage were more likely to be born by normal vaginal delivery than by cesarean or forceps deliveries (odds ratio [OR], 9.91; 95% CI, 6.71-14.64).
• The risk factors for abnormalities other than retinal hemorrhage were premature birth (OR, 4.87; 95% CI, 3.03-7.83), consanguinity (OR, 2.20; 95% CI, 1.28-3.8), and systemic abnormalities (OR, 3.08; 95% CI, 1.94-4.91).

IN PRACTICE:

“Sight-threatening ocular pathology in newborns may be linked to perinatal risk factors such as preterm birth, low birth weight, consanguinity, and systemic abnormalities. Accordingly, it may be prudent to consider specialized ocular screening protocols for neonates within this high-risk cohort,” the authors wrote.

SOURCE:

The study was led by Sameera Nayak of L V Prasad Eye Institute in Vijayawada, India. It was published online on July 6, 2024, in Eye.

LIMITATIONS:

The study was exploratory in nature. The number of elderly parents undergoing assisted vaginal delivery was small and insufficient for risk factor analysis. Some newborns were examined after 72 hours of birth due to logistic issues, potentially altering the birth prevalence and severity of retinal hemorrhage and other pathologies. 

DISCLOSURES:

The study was supported by grants from the US Agency for International Development, Lions Clubs International Foundation, Sun Pharma, and Hyderabad Eye Research Foundation. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.