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New insights into visual disturbances accompanying skull deformations

Published on June 1, 2007 at 10:47 PM · No Comments

Most children with a craniofacial deformity known as unicoronal synostosis have the eye-alignment abnormality strabismus, reports a study in the May Journal of Craniofacial Surgery, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

However, contrary to some previous studies, strabismus is no more likely to affect on the same side as the skull deformation compared to the opposite side, conclude Dr. Claire MacIntosh and colleagues of John Radcliffe Hospital, Oxford, U.K.

The researchers reviewed information on 59 children with unicoronal synostosis, focusing on the rates and characteristics of associated visual abnormalities. In infants with unicoronal synostosis, the bones of the developing skull become prematurely fused—one of the joints, or sutures ("soft spots"), joining two skull bones closes before the normal time. The resulting deformity causes a slanted shape of the head. Surgery is needed to restore normal head shape and allow room for the brain to grow.

Another concern for infants with unicoronal synostosis is eye and visual abnormalities, especially strabismus. Sometimes called "lazy eye," strabismus is a condition in which the eyes aren't properly aligned. If the problem isn't treated, vision in the weaker eye will decrease over time—a problem called amblyopia.

In the new study, complete visual assessment detected strabismus in 34 of 59 children with unicoronal synostosis: a rate of 58 percent. However, in contrast to previous research reports, strabismus was no more likely to occur on same side as the prematurely closed suture, compared to the opposite side.

Strabismus was actually more common on the opposite side—56 versus 27 percent—but the difference was not statistically significant. The remaining six patients had "alternating" strabismus.

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