Visual impairment in children with acute nontraumatic coma

Purpose: To determine the incidence and severity of visual impairment in ch ildren following acute nontraumatic coma. Methods: An 18-month prospective epidemiologic study of acute nontraumatic coma was undertaken in the former Northern NHS Region of England. Children aged >1 month and <16 years were included in the study if they had a Glasgo w Coma Score of <less than or equal to>12 for >6 hours or if they died with in 6 hours of the onset of decreased levels of consciousness. For survivors , ophthalmologic assessments were performed 6 weeks and 12 months after pre sentation. Results: Two hundred eighty-seven children were included in the study, of w hom 127 died. Of the 137 examined survivors, 35 had visual abnormalities su spected by the examining neurologist during the ophthalmic assessment. Of t hese, visual impairment was confirmed in 10 children at the 6-week assessme nt by the pediatric ophthalmologist. At the 12-month assessment, visual imp airment remained stable in 9 children and improved in 1. Conclusion: In this study, 6.6% of children surviving acute nontraumatic co ma had visual impairment that persisted at the 12-month follow-up examinati on. Incidence of visual impairment in acute nontraumatic coma is 0.97 per 1 00,000 children per year.