Risk factors for strabismus in children born before 32 weeks' gestation

Aim-To investigate risk factors associated with strabismus in children born prematurely. Methods-Prospective study of all children born before 32 weeks' gestation b etween 1 January 1990 and 31 December 1991 in a geographically defined popu lation of approximately 3 million in the Northern Region of the United King dom. All children were examined aged 2 years by the same ophthalmologist an d paediatrician. Results-558 children (98.6% of study group) were examined. Logistic regress ion showed an increased risk of strabismus in children with cicatricial ret inopathy of prematurity (p=0.02), reactive error (p=0.003), family history of strabismus (p<0.0001), and poor neurodevelopmental outcome (p<0.0001), i n particular impaired locomotor skills (p=0.008) and hand-eye coordination (p=0.001). Gestational age and regressed acute ROP were not independent ris k factors for strabismus (p=0.92 and 0.85 respectively). Conclusions-This study has identified factors which are independently relat ed to strabismus (although not necessarily causative) and others which are related only indirectly. This may contribute both to the management of chil dren born prematurely and to future studies of the aetiology of strabismus.