Ocular manifestations of congenital insensitivity to pain, f
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A Study was conducted to describe ocular manifestations in children with congenital insensitivity to pain with and without anhidrosis (CIPA and CIP) that inferred that they are more likely to develop corneal scarring.

Researchers reviewed records of eye examinations of 39 children diagnosed with CIPA or CIP. Clinical data was collected with particular attention to ocular surface findings. Corneal sensitivity was tested by presence of a blink reflex upon touching the cornea. Statistical analysis assessed differences in manifestations between the two conditions, and relationships among corneal sensitivity, presence of corneal opacities and visual acuity (VA). CIPA was diagnosed in 32 children and CIP in 7. The median follow-up periods were 50 months (CIPA group) and 94 months (CIP group).

Results:
--Corneal opacities were present in 23% of CIPA eyes and in 57% of CIP eyes.

--A blink reflex was positive in 52% of CIPA eyes and in 33% of CIP eyes.

--Researchers recorded VA more than 20/25 in 36% of CIPA eyes, whereas all patients with CIP had VA less than 20/30.

--For the whole cohort, a negative correlation was found between a preserved blink reflex and the presence of corneal opacities, and a positive correlation between a preserved blink reflex and VA more than 20/25.

To summarize, children who are born with a congenital sensitivity to pain are more likely to develop corneal scarring. Patients with CIP have more serious ocular surface disease than patients with CIPA, which is likely due to a higher prevalence of corneal sensation loss. A retained blink reflex was associated with good vision in both classes. Affected children should be closely monitored to ensure that ocular surface disease is treated promptly and vision loss is avoided.

Source: https://bjo.bmj.com/content/early/2021/03/21/bjophthalmol-2020-317464?rss=1
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