Eye Findings in Hydrocephalus

By Joseph Alfano, M.D

In the greatest majority of cases of vision and eyes of the hydrocephalic patient are normal in all respects, except for a refractive error which may require glasses. In some patients with hydrocephalus, one or both eyes will turn in, a condition known as strabismus of the esotropic variety.

In some patients, one or both eyes may turn out, a condition known as divergent strabismus. Most patients with hydrocephalus will have pupils of normal size which contract normally to light. In some patients however, the pupils are larger than normal and do not react to light or react poorly to light.

While most patients with hydrocephalus are able to move their eyes up and down quite well, in some cases these patients cannot raise their eyes to look up, and in doing so they develop a retraction of the upper eyelids. This syndrome is referred to as Parinaud's Oculogranular Syndrome.

Most hydrocephalic patients have normal vision, some patients develop poor vision due to a weakness of the optic nerve or nerves know as optic-atrophy. This condition is the result of dilatation in the third ventricle and the vision cannot be improved with eyeglasses, although decompression of the third ventricle may sometimes result in a spontaneous improvement of vision.

Many hydrocephalic patients merely require glasses or corrective surgery to straighten an eye that turns in or out.