Aim: To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India. Methods: Children aged ,16 years with a visual acuity of ,6/60 in the better eye, attending 35 schools for the blind were examined between 2002 and 2005, and causes were classified using the World Health Organization's system. Results: 1985 students were examined, 1778 of whom fulfilled the eligibility criteria. The major causes of visual loss were congenital anomalies (microphthalmos or anophthalmos; 735, 41.3%), corneal conditions (mainly scarring; 395, 22.2%), cataract or aphakia (n = 107, 6%), and retinal disorders (mainly dystrophies; n = 199, 11.2%). More than one third of children (34.5%) were blind from conditions which could have been prevented or treated, 139 of whom were referred for surgery. Low vision devices improved near-acuity in 79 (4.4%) children, and 72 (4%) benefited from refraction. No variation in causes by sex or region was observed. Conclusions: Congenital anomalies accounted for 41% of blindness, which is higher than in a similar study conducted 10 years ago. Corneal scarring seems to be declining in importance, low vision and optical services need to be improved, and research is needed to determine the aetiology of congenital anomalies.

Childhood blindness and visual impairment (CBVI) are major disabilities that compromise the normal development of children. Health resources and practices to prevent CBVI are suboptimal in most countries in the Eastern Mediterranean Region (EMR). We reviewed the magnitude and the etiologies of childhood visual disabilities based on the estimates using socioeconomic proxy indicators such as gross domestic product (GDP) per capita and <5-year mortality rates. The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region. The current study determined the rates of bilateral blindness (defined as  Best corrected visual acuity(BCVA)) less than 3/60 in the better eye or a visual field of 10° surrounding central fixation) and functional low vision (FLV) (visual impairment for which no treatment or refractive correction can improve the vision up to >6/18 in a better eye) in children <15 years old. We used the 2011 population projections, <5-year mortality rates and GDP per capita of 23 countries (collectively grouped as EMR). Based on the GDP, we divided the countries into three groups; high, middle- and low-income nations. By applying the bilateral blindness and FLV rates to high, middle- and low-income countries from the global literature to the population of children <15 years, we estimated that there could be 238,500 children with bilateral blindness (rate 1.2/1,000) in the region. In addition, there could be approximately 417,725 children with FLV (rate of 2.1/1,000) in the region. The causes of visual disability in the three groups are also discussed based on the available data. As our estimates are based on hospital and blind school studies in the past, they could have serious limitations for projecting the present magnitude and causes of visual disabilities in children of EMR. An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed. The objectives, strategies, and operating procedures for child eye-care are presented. Variables impacting proper screening are discussed. To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

Purpose:To report the outcome of surgically managed primary angle-closure glaucoma (PACG) cases in 84 eyes at a tertiary eye hospital in South India.Materials and Methods:Retrospective analysis of medical records of 84 eyes of 81 patients with PACG, who were surgically managed over 4 years at tertiary eye hospital in South India. Data were obtained from medical and surgical records of the patients identified from October 2010 to October 2014. The patients were operated by two surgeons in the Glaucoma Department of the institute.Results:The patients’ mean age at surgery was 56.21 years. Twenty-four eyes with a mean intraocular pressure (IOP) of 45.8 mmHg underwent trabeculectomy, and 60 eyes with a mean IOP of 29.9 mmHg underwent trabeculectomy with cataract extraction with or without intraocular lens implantation with good postoperative IOP control. A statistically significant greater reduction in IOP was noted in 14 patients who underwent augmentation with Mitomycin C (P = 0.0060, Student's t-test).Conclusion:Knowing the risk factors, the diagnostic methods and treatment options for PAC disease is vital to every ophthalmologist as it is potentially treatable yet visually debilitating if untreated. Trabeculectomy or trabeculectomy with cataract extraction preferably with antifibrotics is an excellent treatment modality for PACG, which also effectively halts the disease progression.