The Status of Childhood Blindness and Functional Low Vision in the Eastern Mediterranean Region in 2012

Abstract

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.

Childhood blindness and visual impairment in an underserved population in South West Nigeria: A clinic-based study

“…Childhood blindness and visual impairment are major disabilities that compromise normal childhood development and usually confer lifelong negative consequences on children. 5,8,9 The mean age of children included in this survey (9.3 + 3.5 years) was similar to a study carried out by Mehari in a rural central hospital in Ethiopia, where the children's ages ranged from 3 months to 15 years, with a mean age of 9.37 + 4.95 years. 10…”

“…Khandekar et al, in their review, found that the aetiology patterns of childhood blindness and visual acuity were divided according to 3 groups of high-, middle-, and low-income nations. 8 Cataract was the main cause of severe visual impairment in our study and is now replacing vitamin A deficiency and measles keratopathy as the main cause of blindness among children in Africa in some populations. 17 However, constraints of inadequate manpower and equipment for management in many parts of Africa 18 including Nigeria, still exists.…”

Vision Screening in Preschool Children: Should a child be admitted to the glaucoma screening?

“…Preporuke u skladu s motom SZO-a "Vision 2020 -Right to the Sight" Khandekar i suradnici daju preporuke za istočno mediteransku regiju u smislu probira na oštećenje vida na razini primarne zdravstvene zaštite. Autori naglašavaju važnost probira na oštećenje vida pri svakom posjetu liječniku radi cijepljenja, organizacije probira vida u predškolskoj dobi i upućivanja na oftalmološku obradu ako dijete nije prošlo testove probira 19 . I Gilbert i Khandekar ističu važnost obrazovanja subspecijalista dječjeg oftalmologa 2,19 .…”

“…Autori naglašavaju važnost probira na oštećenje vida pri svakom posjetu liječniku radi cijepljenja, organizacije probira vida u predškolskoj dobi i upućivanja na oftalmološku obradu ako dijete nije prošlo testove probira 19 . I Gilbert i Khandekar ističu važnost obrazovanja subspecijalista dječjeg oftalmologa 2,19 .…”

Assessment of Oral Health Educational Program on oral health status of visually impaired children in New Delhi

“…Childhood blindness alone accounted for 28.7% of the economic burden of blindness in India . The prevalence of childhood blindness in low‐income countries comprising Asia is estimated to be 0.9/1000 children …”