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News
Eye problems are rare in CMV-positive newborns, especially those without symptoms, according to a new Canadian study. Of 347 infants who screened positive for congenital cytomegalovirus (cCMV), 93.4% had normal eye exams — and zero asymptomatic infants had CMV-related eye findings. Experts say a positive screen should kick off a full evaluation, not an automatic ophthalmology referral.
A new population-based study out of Canada is prompting a rethink of how clinicians handle eye referrals for newborns who test positive for congenital cytomegalovirus (cCMV) — the most common congenital infection and a leading cause of non-genetic hearing loss. Researchers reviewed eye exam results for 347 cCMV-positive infants and found that the vast majority (93.4%) had completely normal exams. Crucially, not a single asymptomatic infant had CMV-related eye findings, and urgent ophthalmology referrals didn't change clinical management.
That said, experts urge caution before abandoning baseline eye exams altogether. Classifying an infant as "asymptomatic" is tricky — subtle signs like brain imaging abnormalities or low birth weight can be missed, and some eye problems only emerge later in childhood. The American Academy of Pediatrics (AAP) recommends ophthalmologic evaluation for infants with signs of CMV disease, while a positive screen alone doesn't automatically warrant an urgent referral.
Key Takeaways:
Why it matters: As universal newborn cCMV screening expands, clinicians need clear, evidence-based guidance on which infants truly need specialist follow-up — especially where access to pediatric ophthalmology is limited. A positive screen should be the start of a thorough evaluation, not a one-size-fits-all referral trigger.
