Ocular manifestations in Meningitis in Children

Meningitis is the most common central nervous system disease affecting children leading to focal neurological deficits and various oculovisual anomalies including blindness in children. Commonly seen meningitis in children is of two types - Pyogenic and Tubercular. Meningitis can be associated with cranial neuropathies of II, III, IV, VI and VII cranial nerves due to focal or generalized inflammation. Optic neuritis, optic atrophy and Papilledema are the most important neurological sequelae of meningitis, mainly, tubercular. A Prospective study undertaken for 18 months to evaluate the oculovisual anomalies in Nepalese children showed a high incidence (38.46%) of ocular manifestations in these children. Higher incidence of oculovisual anomalies was seen in Tubercular meningitis as it is a subacute slowly progressive form of meningitis with increased intra-cranial pressure and perivascular fibrosis for more prolonged periods of time. Delayed presentation, hydrocephalous and increased total cell count in CSF were found to be few of the critical determinants, which affected the visual outcome in meningitis patients. Hence, health education and timely intervention are essential.