To investigate incidental abnormal ocular findings that may cause visual impairment in neonates.

The medical records of patients requested for screening for retinopathy of prematurity (ROP) at our hospital's pediatrics department between March 2005 and July 2009 were retrospectively reviewed. Patients were classified into premature and mature neonates according to gestational age (under 37 weeks).

A total of 2,090 eyes from 1,045 patients were comprised of 1,514 eyes of 757 premature neonates and 576 eyes of 288 mature neonates. Among 154 eyes of 78 patients (10.17%) who were diagnosed with ROP, 34 eyes of 18 patients had laser treatment. Seven eyes of 5 patients in the premature neonate group (0.46%), and 38 eyes of 23 patients in the mature neonate group (6.57%) were found to have abnormal ocular findings, excluding incidental ROP. Twenty-six eyes of 16 patients were found to have a retinal hemorrhage, and the majority had a birth history of perinatal distress, including birth asphyxia, meconium aspiration, and transient tachypnea of the newborn. Other findings included congenital cataracts, corneal opacity, macular coloboma, persistent hyperplastic primary vitreous, and abnormal fundus.

The incidence of ocular abnormalities in neonates that cause visual impairment is low, but theses may threaten a child's life. Early detection and prompt treatment of ocular disorders in children are important in order to avoid permanent, lifelong visual impairment. Therefore, ophthalmic examinations are essential, even in normal neonates, for early detection of ocular disorders.