Eye exams are critical for children with PAE and/or FASD to identify potential ocular side effects. Click image to enlarge.

A study recently identified the range and prevalence of reported eye abnormalities among children with prenatal alcohol exposure (PAE) and/or fetal alcohol spectrum disorders (FASD), highlighting the importance of examining children with PAE as well as those suspected of or diagnosed with FASD to ensure early identification and proper management of ocular side effects.

The study conducted reviews of electronic databases as well as manual searches. Articles eligible for inclusion were observational studies in children with PAE and/or FASD, peer reviewed journal articles and studies reporting quantitative or frequency data on functional/structural eye abnormalities. The researchers calculated pooled prevalence, odds ratio and mean difference.

Thirty-six of 1,068 identified articles were eligible for inclusion. These included articles on children with diagnosed fetal alcohol syndrome/FASD (n=31), PAE (n=3) and FASD or PAE without FASD (n=2). Of the structural and functional eye abnormalities identified, the study authors reported that the most prevalent were short palpebral fissure length (66.1%), visual impairment (55.5%), epicanthus (53.5%), subnormal stereoacuity (53.0%), abnormal retinal tortuosity (50.5%), impaired fixation ability (33.3%), telecanthus (31.7%), optic nerve hypoplasia (30.2%) and small optic discs (27.0%).

When compared with non-exposed controls, the data showed that strabismus, subnormal vision, ptosis, short palpebral fissure length, microphthalmos, smaller optic disc area and retinal vessel tortuosity were more prevalent in children with FASD.

“This is the first comprehensive systematic review and meta-analysis to identify the range and prevalence of structural and functional eye abnormalities associated with PAE and FASD in children,” the study authors noted in their paper. “The review identifies the most prevalent eye abnormalities reported in children with FASD and PAE, providing guidance for clinicians who are assessing individuals following PAE. Many conditions identified may impact eye function and hence academic and socio-emotional outcomes, therefore early detection is imperative.”

Tsang TW, Finlay-Jones A, Perry K, et al. Eye abnormalities in children with fetal alcohol spectrum disorders: a systematic review. Ophthalmic Epidemiol. September 14, 2022. [Epub ahead of print].