Korean J Ophthalmol.  2014 Jun;28(3):241-245. 10.3341/kjo.2014.28.3.241.

Symptom Based Diagnosis of Infant under One Year in Outpatient Clinic

• Han S
• Kim US

• KMID: 2133323
• DOI: http://doi.org/10.3341/kjo.2014.28.3.241

Abstract

PURPOSE
We investigated chief complaints and ocular disorders in infants under one year of age and analyzed the association between complaints and disorders.
METHODS
The medical records of 815 infants were reviewed. Chief complaints were grouped into the following 11 categories: eyelid drooping, epiphora (tearing), ocular discharge, lid swelling, eyelashes touching the eyeball, abnormalities of the anterior segment, abnormal eyeball movement (e.g., squint or nystagmus), red eye, trauma, poor eye contact, and miscellaneous. We performed ophthalmologic examinations at the doctors' discretion and analyzed the relationship between chief complaint and final diagnosis.
RESULTS
Mean age of visiting the outpatient clinic was 6.09 +/- 3.07 months. The most common complaint was ocular discharge, followed by abnormal eyeball movement, epiphora, and eye redness. Among infants with ocular discharge, most were attributed to congenital nasolacrimal duct obstruction (155 infants) and conjunctivitis (75 infants). A total of 160 guardians complained of abnormal eyeball movement and 86 of 160 infants (51.9%) suffered from pseudoesotropia. Additionally, exodeviation and esodeviation was found in 17.9% and 16.4% of infants, respectively. Eight guardian complained of poor eye contact in their infants and these infants were diagnosed with retinal disorders (3), congenital optic nerve disorders (2), cataract (1), glaucoma (1), and high hyperopia (1).
CONCLUSIONS
The most common ocular symptoms in infants under one year of age included ocular discharge, epiphora, and eye redness. However, infants with poor eye contact or suspected abnormal eye movement should undergo a full ophthalmologic examination.

Keyword

Diagnosis; Infant

MeSH Terms

*Ambulatory Care Facilities
Eye Diseases/*diagnosis
Female
Follow-Up Studies
Humans
Infant
Male
*Patient Compliance
Retrospective Studies

Figure

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  Fig. 1 (A) The final diagnosis of infants who presented with guardian complaints of abnormal eyeball movement. (B) The type of strabismus in the 48 infants with true eyeball deviation.

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  Fig. 2 Characteristics of the two most common symptoms (ocular discharge and epiphora). CNLDO = congenital nasolacrimal duct obstruction.

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