Children with bilateral ONH usually present in infancy with poor vision and nystagmus, whereas unilateral or asymmetric ONH may be detected later due to strabismus. Indirect ophthalmoscopy is usually sufficient to diagnose severe ONH, but in mild to moderate cases, diagnosis is more challenging. Although imaging is usually obtained for known or suspected ONH to evaluate a child for associated central nervous system abnormalities, studies have also investigated the usefulness of MRI as a diagnostic modality for ONH [34]. Orbital Imaging and Vision Loss-Child CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CT Head There is no relevant literature to support the use of CT head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. MRI Head and Orbits MRI of the head and orbits without IV contrast is the most useful modality for evaluation of the developmental abnormalities of the globes, optic nerves, and associated abnormalities in the brain and pituitary gland [2,32-34].
Orbital Imaging and Vision Loss Child. Children with bilateral ONH usually present in infancy with poor vision and nystagmus, whereas unilateral or asymmetric ONH may be detected later due to strabismus. Indirect ophthalmoscopy is usually sufficient to diagnose severe ONH, but in mild to moderate cases, diagnosis is more challenging. Although imaging is usually obtained for known or suspected ONH to evaluate a child for associated central nervous system abnormalities, studies have also investigated the usefulness of MRI as a diagnostic modality for ONH [34]. Orbital Imaging and Vision Loss-Child CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CT Head There is no relevant literature to support the use of CT head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children without leukocoria with decreased visual acuity or vision loss due to congenital or developmental abnormality. MRI Head and Orbits MRI of the head and orbits without IV contrast is the most useful modality for evaluation of the developmental abnormalities of the globes, optic nerves, and associated abnormalities in the brain and pituitary gland [2,32-34].