Eye Malformations in Children with Heavy Alcohol Exposure in Utero

Objective

To determine whether children who do not develop fetal alcohol syndrome (FAS) despite heavy alcohol exposure are at risk for eye abnormalities.

Study design

We screened 9628 pregnant women and identified 101 women who were drinking ≥ 2 oz of absolute alcohol per day and 101 nondrinking control women. We followed 43 exposed and 55 control offspring between age 4 and 9 years, performing masked standardized ophthalomologic examinations.

Results

The groups did not differ in their rates of impaired visual acuity, refractory errors, ptosis, epicanthal folds, or short palpebral fissures. Biomicroscopy examination was normal in all exposed subjects; cataracts were detected in 2 control subjects (4%) but in no exposed subjects. Arterial tortuosity was seen in 7 exposed subjects (16%) and in 8 control subjects (15%). Optic nerve hypoplasia was not detected in any subject.

Conclusions

Previous research has found that children with FAS have a high incidence of serious ophthalmologic defects; our data indicate that the risk is limited to children with FAS and does not extend to children exposed to high levels of alcohol prenatally who do not develop FAS. Eye examinations are unlikely to clarify the diagnosis in children suspected of having alcohol-related damage.

Abbreviations: BCVA, Best-corrected visual acuity, CI, Confidence interval, FAS, Fetal alcohol syndrome, FASD, Fetal alcohol spectrum disorders, NICHD, National Institute of Child Health and Human Development, SD, Standard deviation