Red Reflex Examination in Neonates for 2 Years Screening

Document Type : Original Article

Authors

1 Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Red reflex is a simple test that can detect potentially life-threatening ocular abnormalities. In 2012, a red reflex screening campaign started in Umbria, central Italy. In the present study, we report the results of eye examination in the routine first visit of newborns in a private hospital within 2014-2016.
Methods: The red reflex test was carried out as a part of the first health visit of newborns in a private hospital for 2 years. The eyes of all newborns were examined on the first day of life by a handheld ophthalmoscope. The suspected cases with cataract were referred to the Ophthalmologic Department of Mashhad University of Medical Sciences, Mashhad, Iran, for the confirmation of the diagnosis.
Results: During the 2 years of the study, a total of 10,484 neonates were delivered in this hospital 10 of whom were referred for ophthalmology consultation due to suspected abnormal red reflex. In 2 cases (0.019%), the diagnosis of congenital cataract was confirmed by an ophthalmologist.
Conclusion: The results of the current study are consistent with the findings of previous studies, although the reports on red reflex screening are sporadic in the literature. Due to low cost and easy performance and in spite of high false-positive red reflex test, it appears to be useful for the early diagnosis of congenital low-vision disease for the prevention of vision impairment. In addition, the present study confirmed that the red reflex test should become a part of the first newborn examination immediately after birth.

Keywords

References

1. American Academy of pediatrics: section on Ophthalmology; American Association for pediatric ophthalmology and strabismus; American Academy of ophltalmology; American association of Certified Orthoptist. Red reflex examination in neonates, infants, and children. Pediatrics. 2008; 122(6): 1401-4.
2. Lambert SR, Drack AV. Infantile cataract. Surv ophtalmol. 1996; 40(6):427-58.
3. World health organization. Global Initiative for the elimination of avoidance blindness. Geneva: World health organization; 1977.
4. Magnusson G, Bizjajeca S, Haargaard B, Lundsrom M, Nystrom A, Tronqvist K. Congenital cataract screening in maternity ward is effective: evaluation of the pediatric cataract register of Sweden. Acta Paediatr. 2013; 102(3):263-7.
5. Evantov–Froedman S, Leiba H, Fildel–Rimon O, Juster-Richard A, Shinwel ES. The red reflex examination ion neonates an efficient tool for early diagnosis of congenital ocular diseases. Isr Med Assoc J. 2010; 12(2):259-61.
6. Murray McGavin DD. Global initiative for the elimination of avoidable blindness. Community Eye Health. 1998; 11(25):3.
7. Ruttum MS, Nelson DB, Wamser MJ, Balliff M. Detection of congenital cataracts and other ocular media opacities. Pediatrics. 1987; 79(5):814-7.
8. Cagini C, Tosi G, Stracci F, Rinaldi VR, Verrotti A. Red reflex examination in neonates: evaluation of 3 years of screening. Int ophtalmol. 2017; 37(5):1199-204.
9. Royal College of Ophtalmologists. Ophtalmic services for children: report of a joint working party. London: Royal College of Ophtalmologists and the British Pediatric Association; 1994.
10. Haargaard B, Nystrom N, Rosensvard A, Tornqvist K, Magnusson G. The paediatric cataract registers (PECARE): analysis of age at detection of congenital cataract. ACTA Ophtalmol. 2015; 93(1):24-6.
11. Sheeladevi S, Lawrenson JG, Fielder AR, Suttle CM. Global prevalence of childhood cataract: a systematic review. Eye Lond. 2016; 30(9):1160-9.
12. Tomairek RH, Amin M, Raafat K, Abdel Hady S, Elkotoury H. Prevalence of congenital ocular anomalies among children with genetic disorders: an Egyptian study. Semin Ophthalmol. 2018; 33(5):613-9.
13. The Israel Neonatology Association guidelines for routine red reflex examination in newborns. Hebrew. Available at: URL: http://www.isneonet. org.il/upload/infocenter; 2009.
14. Litmanovitz I, Dolfin T. Red reflex examination in neonates: the need for early screening. Isr Med Assoc J. 2010; 12(5):301.
15. Rahi JS, Dezteux C, The British Congenital Cataract Interest Group. Measuring and interpreting the incidence of congenital ocular anomalies: lessons from a national study of congenital cataract in the UK. Invest Ophtalmol Vis Sci. 2001; 42(7):1444-8.
16. Rahi JS, Dezateux C. National cross sectional study of
Congenital Cataract Mohammadzadeh A et al
49 Iranian Journal of Neonatology 2020; 11(4)
detection of congenital and infantile cataract in the United Kingdom: role of childhood screening and surveillance. BMJ. 1999; 318(7180):362-5.
17. Bhatti TR, Dott M, Yoon PW, Moor CA, Gambrell D, Rasmussen SA. Descriptive epidemiology of infantile cataracts in metropolitan Atlanta, GA. 1968-1998. Arch Pedaiter Adoless Med. 2003; 157(4):341-7.
18. Sotomi O, Ryan CA, O'Connor G, Murphy BP. Have we stopped looking for a red reflex in newborn screening? Ir Med J. 2007; 100(3):398-400.
19. Li J, Xia CH, Wang E, Yao K, Gong X. Screening, genetics, risk factors, and treatment of neonatal cataracts. Birth Defects Res. 2017; 109(10):734-43.
20.Saeidi R, Izanloo A, Habibnejad R. P435 Retinopathy of prematurity prevalence and risk factors in developing countries. Archives of Disease in
Childhood. 2019 Jun 1;104(Suppl 3):A326.
21. Saeidi R, Hashemzadeh A, Ahmadi S, RAHMANI S. Prevalence and predisposing factors of retinopathy
of prematurity in very low-birth-weight infants discharged from NICU.
Iranian Journal of Neonatology
Volume 11, Issue 4
October 2020
Pages 46-49

Files

Share

How to cite

Statistics