Background and Purpose The findings of ophthalmic examinations have not been systematically investigated in visual snow syndrome. This study reviewed the abnormal neuroophthalmologic findings in a patient cohort with symptoms of visual snow syndrome. Methods We retrospectively reviewed 28 patients who were referred for symptoms of visual snow to a tertiary referral hospital from November 2016 to October 2019. We defined the findings of best corrected visual acuity (BCVA), visual field testing, pupillary light reflex, contrast sensitivity, full-field and multifocal electroretinography, and optical coherence tomography. Results Twenty patients (71%) were finally diagnosed as visual snow syndrome. Their additional visual symptoms included illusionary palinopsia (61%), enhanced entoptic phenomenon (65%), disturbance of night vision (44%), and photophobia (65%). A history of migraine was identified in ten patients (50%). The mean BCVA was less than 0.1 logarithm of the minimum angle of resolution, and electrophysiology showed normal retinal function in all patients. Contrast sensitivity was decreased in two of the seven patients tested. Medical treatment was applied to five patients which all turned out to be ineffective. Among the eight patients who were excluded, one was diagnosed with rod-cone dystrophy and another with idiopathic intracranial hypertension. Conclusions Neuro-ophthalmologic findings are mostly normal in patients with visual snow syndrome. Retinal or neurological diseases must be excluded as possible causes of visual snow.

AbstractsBackgroundRefractive errors, strabismus, nystagmus, amblyopia, and cortical visual impairment are observed in 50 to 90 % of patients with cerebral palsy. Ocular abnormalities are known to differ according to cerebral palsy type, and spastic type has been reported to be more likely to be associated with ocular defects than the athetoid and ataxic types.MethodsA retrospective review of medical records was performed on 105 consecutive children with spastic type of cerebral palsy who underwent ophthalmologic examination between July 2003 and March 2006. The complete ophthalmological examination included measurement of visual acuity, ocular motility, stereoacuity, binocular vision, cycloplegic refraction along with the evaluation of the anterior segment and the posterior segment.ResultsThe most common ocular abnormality was strabismus (70.5 %) followed by refractive errors (53.3 %). Exodeviation was more commonly found than esodeviation (46 vs 27 patients), and hyperopia was much more prevalent than myopia. A considerable number of patients with strabismus had abnormal ocular motility wherein 16 patients showed inferior oblique overaction and ten superior oblique overaction. Whereas inferior oblique overaction was accompanied similarly in exotropia and esotropia, superior oblique overaction was accompanied more by exotropia.ConclusionsChildren with spastic type cerebral palsy have a high prevalence of strabismus and refractive errors. Exotropia and hyperopia are the most common ocular abnormalities. All children with spastic type of cerebral palsy may require a detailed ophthalmologic evaluation.

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