M. Bharathi Mohan, K. Kavitha, B. Pramila
BACKGROUND Vision plays a significant role in acquisition of skills such as sign language in children with hearing impairment. Auditory training after cochlear implant surgery is given in combination with visual gestures. Thus even subnormal vision will adversely affect their social development. Hence there is a need to do ophthalmic evaluation in children with severe and profound hearing loss. In this study children with severe sensorineural deafness prepared for cochlear implant surgery were evaluated for the presence of ophthalmic manifestation. MATERIALS AND METHODS This is a retrospective hospital-based study from April 2017 to March 2018. Children under the age of 10 years with severe sensorineural hearing loss who were referred to us for ophthalmological evaluation were included in the study. Complete ophthalmic evaluation including anterior segment examination with slitlamp, detailed fundus examination and cycloplegic refraction were done. Syndromic associations were also studied. RESULTS Fourteen children were included in the study period. All the children showed severe sensorineural hearing loss in otoacoustic emission and brainstem evoked response audiometry tests. Maximum number of patients (9 patients) were below 3 years of age (64.7%). There was a female predominance (57.1%). 35.7% of our study population had ocular involvement. Hypermetropia was noticed in two children (14.2%). One patient (7.14%) had salt and pepper appearance of fundus along with other features of congenital rubella syndrome. Waardenburg syndrome with heterochromia iridis in one patient (7.14%) and Usher Syndrome (7.14%) with retinitis pigmentosa in another patient were also noted. Three patients (21.4%) had associated cardiac involvement. CONCLUSION The results of our study indicate that there is a high prevalence of ocular problems in children with severe sensorineural deafness. Coincidence of visual disorders with hearing impairment especially in the early years can negatively impact the development of child. Hence addressing the visual problems helps a lot for them to improve their communication skills.
