Periventricular leukomalacia: An important cause of visual and ocular motility dysfunction in children

The immature visual system in infants born preterm is vulnerable to adverse events during the perinatal period. Periventricular leukomalacia affecting the optic radiation has now become the principal cause of visual impairmen t and dysfunction in children born prematurely. Visual dysfunction is chara cterized by delayed Visual maturation, subnormal visual acuity, crowding, v isual field defects, and visual perceptual-cognitive problems. Magnetic res onance imaging is the method of choice for diagnosing this brain lesion, wh ich is associated with optic disk abnormalities, strabismus, nystagmus, and deficient visually guided eye movements. Children with periventricular leu komalacia may present to the ophthalmologist within a clinical spectrum fro m severe cerebral visual impairment in combination with cerebral palsy and mental retardation to only early-onset esotropia, normal intellectual level , and no cerebral palsy. Optimal educational and habilitational strategies need to be developed to meet the needs of this group of visually impaired c hildren. (Surv Ophthalmo 145:1-13, 2000. (C) 2000 by Elsevier Science Inc. All rights reserved.).