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Original research
Prospective observational study of universal newborn eye screening in a hospital and community setting in New Zealand
  1. Samantha Kaye Simkin1,
  2. Stuti L Misra1,
  3. Malcolm Battin2,
  4. Charles N J McGhee1,2,
  5. Shuan Dai1,2
  1. 1 Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  2. 2 Auckland District Health Board, Auckland, New Zealand
  1. Correspondence to Dr Shuan Dai; shuandai{at}


Objective Early detection of ocular abnormalities in newborn infants is essential for timely diagnosis and treatment. This study aimed to assess wide-field digital imaging for universal newborn eye screening (UNES) to determine the prevalence of ocular abnormalities, including retinal haemorrhages, in newborn infants in New Zealand.

Design Prospective ocular screening study of infants.

Setting A public hospital maternity ward and a community birth centre in Auckland, New Zealand.

Patients A total of 350 infants were enrolled in UNES, those with birth weight <1250 g or gestational age <30 weeks were excluded.

Methods Wide-field digital images of the external eye and retina were captured by RetCam (Natus Medical, San Carlos, California, USA) and reviewed by an ophthalmologist via an established telemedicine methodology.

Main outcome measures Detection of ocular abnormalities, including retinal haemorrhages. Correlation between haemorrhages and maternal, obstetric and neonatal factors.

Results A total of 346 infants completed screening (median age 2 days). Retinal haemorrhages were present in 50 cases (14.5%), two cases exhibited persistent retinal haemorrhages at 6-week follow-up. A significant increase in the odds of retinal haemorrhages was present for vaginal delivery compared with caesarean section. Other ocular abnormalities, including congenital cataract and optic nerve hypoplasia, were present in 1.4% of infants.

Conclusions Ocular abnormalities were detected by UNES including congenital cataract and optic nerve hypoplasia. However, retinal haemorrhages, significantly associated with delivery modality, were the most common abnormality detected. The majority of retinal haemorrhages resolved spontaneously.

  • screening
  • ophthalmology
  • neonatology

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  • Patient consent for publication Not required.

  • Contributors All authors listed made substantial contributions to the conception and design of the research project. SS: acquired the data and performed the initial analysis and drafted the work. SLM, MB, CNJM, SD: all revised the work critically for intellectual content. All authors have given final approval of the version published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The Save Sight Society, University of Auckland Faculty of Medical and Health Sciences Performance Based Research Fund, University of Auckland Doctoral Scholarship and the New Zealand Association of Optometrist’s Education and Research Fund.

  • Competing interests None declared.

  • Ethics approval This study was approved by the National Health and Disability Ethics Committee (14/NTA/183).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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