Pediatric ocular changes in hydrocepalus: review

Hydrocephalus is a condition in which abnormal accumulation of cerebro spinal fluid within the ventricles or subarachnoid space of the brain. It develops when there is an imbalance between the amount of CSF production and the rate at which it is absorbed. This can be caused by a blockage in the pathways through which the fluid travels or from an overproduction of fluid. This disturbance then causes the ventricles to enlarge (i.e. ventriculomegaly) or subarachnoid space and intra cranial pressure to increase, resulting in an enlarged head along with other symptoms i.e. headache, irritability, lethargy, fever, vomiting, visual changes like setting sun sign, visual field defect, strabismus, papilledema etc.. Cranial Ultra Sound, CT and MRI play an important role in the diagnosis of Hydrocephalus. CT can assess size of ventricles and other structures. MRI can find malformation, tumors and other causes. Patients who progress to more severe forms will have to either undergo a shunt placement or endoscopic third ventriculostomy. Thorough eye examination is important to detect ocular changes and it will be useful to stop further vision loss. Further research is required in order to early diagnosis which helps in reducing severity of disease.