[Diagnostic electroretinography in the young child].

As soon as visual impairment is suspected in a newborn or an infant by an ophthalmologist or pediatrician, it becomes important to document retinal function. Electroretinography (ERG) in general anesthesia as an outpatient procedure allows to assess the functional state of the retina. In addition, we make use of the anesthesia for ophthalmoscopopy, photography, slit lamp examination and occasionally tonometry. Within the first 10 min of dark adaptation we can electroretinographically distinguish between rod- and cone-mediated b-waves. Anesthesia is performed with Ketamine, occasionally supplemented with Halothane and additional oxygen under noninvasive monitoring of the oxygen saturation. The expenditure of a pediatric check-up and general anesthesia is in our view justified in the light of the opportunity to assess or to exclude a degenerative retinal disease early on. In Leber's congenital amaurosis, a disorder accounting for about 3.5% of blindness in infants, the ERG result is essential, particularly when ophthalmoscopic changes are missing. The prevailing diagnoses in our cases include, in decreasing frequency, congenital cataract, ROP, tapetoretinal degenerations, pediatric-neurologic syndromes, and microphthalmus.