Campos E C, Gualdi G
Pediatr Med Chir. 1985 Jan-Feb;7(1):57-62.
Pathological changes in the visual system are often present in children with neurological handicaps. Strabismus, refractive errors, amblyopia, optic atrophy are the more frequent findings. The ophthalmological evaluation in these children includes: eliciting of pupillary light reflex; occlusion test; cover-test; observation of symmetry of corneal light reflexes; retinoscopy and ophthalmoscopy. Strabismus is the most frequent alteration. The so-called "caotic" strabismus, with very variable angle of squint and abnormalities of the vertical movements, is peculiar in children with neurological handicaps. Sensorial adaptation to strabismus can lead to: suppression, lack of fusion power, anomalous retinal correspondence, amblyopia; these sequelae are the same as those found in strabismic patients without neurological lesions. The basic aims of therapy are an energetic treatment of sensorial anomalies of strabismus, and the development of the best possible visual acuity in each eye. Surgical treatment has mainly cosmetic purposes. It tends to be delayed in time because the results are rather impredictable, owing to the variations of the angle of squint. It is stressed that surgical and non-surgical treatment of strabismus in children with neurological handicaps has no influence on their psycho-motor performances.
神经系统障碍儿童的视觉系统常出现病理变化。斜视、屈光不正、弱视、视神经萎缩是较为常见的症状。对这些儿童的眼科评估包括：检查瞳孔对光反射；遮盖试验；交替遮盖试验；观察角膜光反射的对称性；检影验光和眼底检查。斜视是最常见的病变。所谓的“紊乱性”斜视，斜视角度变化很大且垂直运动异常，在神经系统障碍儿童中较为特殊。对斜视的感觉适应可导致：抑制、融合力缺失、异常视网膜对应、弱视；这些后遗症与无神经病变的斜视患者相同。治疗的基本目标是积极治疗斜视的感觉异常，并使每只眼睛尽可能发育出最佳视力。手术治疗主要是出于美容目的。由于斜视角度的变化导致结果难以预测，手术往往会推迟进行。需要强调的是，对神经系统障碍儿童的斜视进行手术和非手术治疗对其心理运动表现没有影响。
