Visual Deficiency and Scoliosis

Abstract

STUDY DESIGN: A transversal study involving group comparison was performed. OBJECTIVE: To investigate whether children who are visually impaired have a higher rate of spinal deformity. SUMMARY OF BACKGROUND DATA: Evidence has accumulated pointing to an association between idiopathic scoliosis and postural control in which vision is involved. An association between scoliosis and ocular troubles is present in many diseases, but no study on a large blind population has yet been undertaken. METHODS: Data was obtained from an official school screening campaign involving two consecutive classes in a regional school for the visually handicapped and from two consecutive classes in three public vocational schools. This study included 75 children who were visually handicapped (mean age, 11 years and 7 months) and 728 healthy control participants (mean age, 10 years 2 months). Trunk deformity was assessed by Moire topography and measurement of any trunk hump by the forward bending test. The children with visual impairment who had evidence of trunk deformity underwent radiographs of the spine a few months after the back surface assessment, then again 12 to 24 months later. RESULTS: Occurrences of trunk deformity were significantly different in the two groups (P < 0.0001), with five times more back surface abnormalities in the blind population. Of the 26 children with both visual impairment and trunk deformity, 18 had a structural scoliosis on radiographs, with an average Cobb Meyer angle of 14.1 degrees (range, 10-28 degrees ), but there was evidence of an evolving condition in only three cases. CONCLUSIONS: These findings are compatible with a postural etiology of scoliosis in the visually impaired population.