Ophthalmological findings in children with encephalitis

Acta Ophthalmol. 2017 Feb;95(1):66-73. doi: 10.1111/aos.13305. Epub 2016 Dec 14.


Purpose: To evaluate ophthalmological abnormalities in children with acute encephalitis.

Methods: Thirty-six children included in a hospital-based prospectively and consecutively collected cohort of children with acute encephalitis were investigated for ophthalmological abnormalities. The investigation included clinical ophthalmological examination, fundus photography, neuro-ophthalmological examinations as well as visual and stereo acuity. Results on laboratory examinations, clinical findings, neuroimaging and electroencephalography registrations were recorded for all children.

Results: The median age was 4.0 years (Interquartile Range 1.9-9.8). The aetiology was identified in 74% of cases. Three of 36 patients were found to have abnormal ophthalmological findings related to the encephalitis. Transient sixth nerve palsy was seen in a 15-year-old child and transient visual impairment was seen in a 3.5-year-old child. Bilateral miosis and ptosis, i.e. autonomic nerve system symptoms, were seen in an 11-month-old child, with herpes simplex 1 and N-methyl-d-aspartate receptor antibody encephalitis. All three children recovered and improved their ophthalmological function with time.

Conclusion: Only 3 of 36 children were found to have ophthalmological abnormalities due to encephalitis and they all improved with time. Thus, ophthalmological consultation does not seem to fit in a screening programme for childhood encephalitis but should be considered in selected cases.

Keywords: central nervous system; infection; neurological; ophthalmological outcome; paediatric.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Child
  • Child, Preschool
  • Electroencephalography
  • Encephalitis, Viral / complications*
  • Encephalitis, Viral / diagnosis
  • Encephalitis, Viral / physiopathology
  • Eye Diseases / diagnosis
  • Eye Diseases / etiology*
  • Eye Diseases / physiopathology
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Neuroimaging
  • Prospective Studies
  • Tomography, X-Ray Computed
  • Visual Acuity / physiology