Ocular manifestations in fetal alcohol syndrome

Eight children with the fetal alcohol syndrome are described with ocular anomalies. They all had a strong history of maternal alcohol abuse throughout pregnancy, especially in the first trimester. All the children had eye abnormalities. These included external eye lesions, Peters' anomaly, lens opacification, ocular motility disorders, and optic nerve hypoplasia. Fetal alcohol syndrome is characterised by at least three of the following findings: (1) marked preand postnatal growth deficiency with generalised dystrophy (weight, length, and/or head circumference below the 10th percentile when corrected for gestational age); (2) involvement of central nervous sytem (signs of neurological abnormality,' intellectual impairment, or developmental delay); (3) typical facies with at least two of the following signs: microcephaly (head circumference below the third percentile), microphthalmia and/or short palpebral fissures, long philtrum, thin upper lip, and flattening of the maxillary area.' Supplementary findings such as skeletal, cardiac, or genitourinary anomalies are also common. A wide variety of abnormalities during embryogenesis may result in a spectrum of change from minor alteration to the full blown syndrome. We describe eight children, four males and four females, presenting at age 1 month to 6 years. All had a strong maternal history of alcohol abuse during pregnancy.