Changing pattern of childhood blindness in Maharashtra, India

Abstract

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 severe visual impairment in Malaysia: a nationwide study

“…That the critical period of surgery for unilateral congenital cataract is 6 weeks of age is a well-known fact, and permanent sensory deprivation can occur if surgery is delayed beyond 4 months of age in bilateral dense cataract. 19 In our study, the lensrelated disorders accounted for 17.2%, being nearly similar to Thailand (16.9%) 10 and Indonesia (16.4%).…”

“…Similarly affected family members were seen in 21% of the children almost similar to a study from India. 10 The majority of them (n ¼ 323, 68.9%) were blind (best corrected visual acuity (BCVA) in the better eye of o3/60). No statistical difference in visual impairment categories was observed between the two education systems (P ¼ 0.06, 2 d.f.…”

A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India

“…This finding is relatively less in magnitude when compared to the recent finding from Maharashtra. 8 No child in our study was found to be blind due to retinopathy of prematurity (ROP). Though, this finding concurs with a recently published report from Maharashtra, 8 however, ROP is found to be reaching epidemic proportions and becoming a public Visual impairment among children in schools for the blind S Krishnaiah et al health problem not only in India but also in many middle income countries.…”

“…The finding of higher rates of microphthalmos and anophthalmos has been found to be a common finding in many studies conducted earlier on blind children in India. 3,4,7,8,14,15 Congenital ocular anomalies were responsible for major causes of blindness in 41.3% and 27.4% of children in Maharashtra and Delhi, respectively. Retinal blindness was the second most common cause of SVI/BL (18.9%; n ¼ 21) identified in this population.…”

“…7 Another survey conducted in Maharashtra in which children o16 years of age from 35 residential schools for the blind were examined reported that 95.4% of children were blind (presenting VA in better eye o3/60). 8 In order to set priorities for control programmes related to childhood blindness in India, epidemiological data of the prevalence and major causes of childhood blindness is required from different sections of the population. Reliable population-based data on the causes of blindness in children is difficult to obtain.…”