BackgroundVernal keratoconjunctivitis (VKC) is a common cause of ocular morbidity in children in warm dry climates such as Sub–Saharan Africa and accounts for about 3 % of serious ophthalmic cases in tropical countries. The purpose of this study was to assess the prevalence and associated factors of vernal keratoconjunctivitis among children living in Gondar City, Ethiopia.MethodsA Cross Sectional Design study was carried out in 737 children under the age of 18 years in Gondar City from April to May 2015. Basic ophthalmic examination was performed using a 3x magnifying loop and torch light and a pretested and structured questionnaire was completed. The association between vernal keratoconjunctivitis and factors such as socio-economic, demographic, and environmental status, and history of allergic disease in affected children and their family members was examined using logistic regression multivariate analysis.ResultsThe prevalence of vernal keratoconjunctivitis was 5.8 % (95 % CI: 4.14, 7.53) (43/737) and mixed type VKC was the most frequent form which was found in 35 out of 43 cases (81.4 %). The following were positively associated with vernal keratoconjunctivitis: use of kerosene/firewood for cooking (AOR = 6.25 (95 % CI: 1.61, 25)), child dust exposure (AOR = 10.0 (95 % CI: 4.16, 20.0)), child history of non-ocular allergic diseases (AOR = 4.0 (95 % CI: 1.92, 8.33)), family history of non-ocular allergic diseases (AOR = 3.57(95 % CI: 1.39, 9.09).ConclusionThere is a high prevalence of vernal keratoconjunctivitis in this region. The use of kerosene/firewood for cooking, child dust exposure, and non-ocular allergic disease in the child or their family were statistically significant risk factors for vernal keratoconjunctivitis.

ObjectivesTo determine the causes of severe visual impairment and blindness (SVI/BL) among students in schools for the blind in Northwest Ethiopia and to identify preventable and treatable causes.MethodStudents attending nine schools for the blind in Northwest Ethiopia were examined and causes assigned using the standard WHO record form for children with blindness and low vision in May and June 2015.Results383 students were examined, 357 (93%) of whom were severely visually impaired or blind (<6/60 in their better eye). 253 (70.9%) were aged 16 years or above and 228 (63.9%) were males. 100 students aged <16 years were blind and four were SVI, total 104. The major anatomical site of visual loss among those 0-15 years was cornea/phthisis (47.1%), usually due to measles and vitamin A deficiency, followed by whole globe (22.1%), lens (9.6%) and uvea (8.7%). Among students aged 16 years and above, corneal/phthisis (76.3%) was the major anatomical cause, followed by lens (6.3%), whole globe (4.7%), uvea (3.6%) and optic nerve (3.2%). The leading underlying aetiology among students aged <16 years was childhood factors (39.4%) (13.5% measles, 10.6% vitamin A deficiency), followed by unknown aetiology (54.8%), perinatal (2.9%) and hereditary factors (2.9%). In the older group, childhood factors (72.3%) (25% measles, 15% vitamin A deficiency) were major causes, followed by unknown aetiology (24.1%), perinatal (2.4%) and hereditary factors (0.8%). Over 80% of the causes were avoidable with majority being potentially preventable (65%).ConclusionCorneal blindness, mainly as the result of measles and vitamin A deficiency, is still a public health problem in Northwest Ethiopia, and this has not changed as observed in other low-income countries. More than three-fourth of causes of SVI/BL in students in schools for the blind are potentially avoidable, with measles/vitamin A deficiency and cataract being the leading causes.

Visual acuity improved significantly after surgery, with better outcomes in bilateral cases. Early detection and surgery by a trained surgeon with good follow-up and postoperative rehabilitation can lead to better visual outcomes.

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Background Bilateral cataract is a significant cause of blindness in children in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children (0–5 years). Results All nine responded. All but one had received either 12- or 3–5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. The surgeons were based in seven health facilities: five in the capital (Addis Ababa) and eight in six public referral hospitals and one private center. Over 12 months (2017–2018) 508 children (592 eyes) aged 0–18 years (most < 15 years) were operated by these surgeons. 84 (17%) had bilateral cataract, and 424 (83%) had unilateral cataract mainly following trauma. A mean of 66 (range 18–145) eyes were operated per surgeon. Seventy-one additional children aged > 5 years were operated by other surgeons. There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country. Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 h. Conclusion Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped pediatric ophthalmology teams are urgently required, with deployment to under-served areas.