Tactile corneal reflex development in full-term babies

Objective: To evaluate the development of the tactile corneal reflex in healthy full-term babies. Design: Prospective longitudinal comparative case series. Participants: One hundred and ninety-one babies aged 1 to 3 days examined in the nursery, and 200 babies aged 1 to 12 weeks examined in an orthopedic outpatient clinic. Methods: The tactile corneal reflex was evaluated by three ophthalmologists using the Cochet-Bonnet esthesiometer. Main Outcome Measures: The probability of the presence of the tactile corneal reflex was calculated in relation to gestational age, postpartum age, postconceptional age, and birth weight. Results: The proportion of children with tactile corneal reflex was expressed in a linear logistic model. We found that 10% of the babies had tactile corneal reflex in at least one eye at 2 days of age, 25% at 1 week, 50% at 3.5 weeks, 75% at 6 weeks, and 100% at 12 weeks. The postpartum age had a greater impact on the development of the tactile corneal reflex than the gestational age. The birth weight also had a statistically significant influence (P = 0.005, Wald's test). Conclusions: The tactile corneal reflex is present in only a minority of newborns and develops during the first 3 months of life. These results demonstrate that the tactile corneal reflex has a longitudinal neurologic development and is part of the normal neurologic maturation process.