Ophthalmological management in craniosynostosis

In published series, a large proportion of patients with craniosynostosis show impaired vision. A literature review was performed, using the PubMed and Google Scholar databases, to identify original and review articles on the consequences of craniosynostosis on the eyes and visual pathways, and on t...

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Bibliographic Details
Published in:Neuro-chirurgie 2019-11, Vol.65 (5), p.310-317
Main Authors: Touzé, R., Bremond-Gignac, D., Robert, M.P.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Craniosynostoses - complications
Craniosynostoses - pathology
Craniosynostoses - therapy
Craniosynostosis
Eye Diseases, Hereditary - etiology
Eye Diseases, Hereditary - therapy
Humans
Infant
Ophthalmology
Papilledema
Raised intracranial pressure
Strabismus
Vision Disorders - etiology
Vision Disorders - therapy
Visual Pathways - pathology
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Summary:In published series, a large proportion of patients with craniosynostosis show impaired vision. A literature review was performed, using the PubMed and Google Scholar databases, to identify original and review articles on the consequences of craniosynostosis on the eyes and visual pathways, and on the ophthalmological management of craniosynostosis. Many ophthalmic, potentially sight-threatening, complications, can occur in patients with craniosynostosis, especially when syndromic. Optic neuropathy, mostly resulting from the papilledema-optic atrophy sequence, secondary to raised intracranial pressure (ICP), should be diagnosed early, in order to promptly lower the ICP. Cyclovertical and horizontal strabismus and refractive errors are frequent in unicoronal synostosis (anterior plagiocephaly) and syndromic craniosynostosis. Exorbitism, encountered in some cases of syndromic craniofacial synostosis, leads to exposure keratopathy, which requires aggressive management to avoid severe irremediable corneal complications. Amblyopia can result from optic neuropathy, corneal opacities, strabismus, or refractive errors. If undiagnosed and untreated at a young age, it results in permanent visual impairment. Children with craniosynostosis require a multidisciplinary care network including a pediatric ophthalmologist. Systematic ophthalmological follow-up enables papilledema to be diagnosed and amblyopia to be diagnosed and treated, in order to avoid visual impairment.
ISSN:0028-3770
1773-0619
DOI:10.1016/j.neuchi.2019.09.016