Delayed Visual Maturation

In view of the fact that there may be delay in maturation in any of several fields of development (Illingworth, 1961) it would not be surprising if some children showed delay in visual maturation. Having studied the visual development in two such children I searched the literature for information on the matter. The search included all volumes of the Quarterly Cumulative Index Medicus and standard textbooks on ophthalmology. I found very few references to the subject. Doyne (1930), writing from his experience at The Hospital for Sick Children, Great Ormond Street, London, wrote that 'In some cases the development of sight is only delayed'. He described a child of 3 months of age who showed no sign of vision. Ophthalmoscopic examination showed pigmentary deficiency of the retina and choroid. Sight began to develop from the seventh month, and was normal by 18 months. He referred to the frequency with which mentally subnormal children showed no apparent evidence of vision for some months, and wrote that the commonest cause of delayed sight development was albinism. Doggart (1957) mentioned the problem of infants who showed no sign of vision in the early weeks, and who subsequently saw normally. He suggested that this might be due to delayed myelination of the optic nerve, described by several French authors as 'La pseudoatrophie grise du nerf optique'. Doggart also referred to the frequency with which optic atrophy and other lesions were wrongly diagnosed.