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Aetiology of childhood vision impairment, metropolitan Atlanta, 1991-93
C A Mervis1, M Yeargin-Allsopp, S Winter
1Developmental Disabilities Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. czm4@cdc.gov
Insights
Prenatal factors were the most common cause of vision impairment (VI) in young children, particularly in isolated cases. Perinatal factors were more frequent in children with multiple disabilities, indicating distinct etiological patterns.
Area of Science:
- Pediatric Ophthalmology
- Developmental Disabilities Surveillance
- Public Health Research
Background:
- Vision impairment (VI) affects young children, necessitating understanding of its causes.
- The Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) provides data on developmental disabilities.
Purpose of the Study:
- To describe the underlying causes of vision impairment in young children.
- To categorize etiological factors by developmental time periods (prenatal, perinatal, postnatal).
- To examine associations between etiology, disability type, and vision severity.
Main Methods:
- Utilized data from the MADDSP for children with VI (n=228) in metropolitan Atlanta (1991-93).
- Identified children with VI through record review at medical and educational sources.
- Categorized VI as isolated or with multiple disabilities, and by severity (low vision or blindness).
- Reviewed medical conditions to determine probable etiology and assigned it to prenatal, perinatal, or postnatal periods.
Main Results:
- Prenatal etiologies accounted for 43% of VI cases, with 38% being genetic.
- Perinatal etiologies were identified in 27% of cases; postnatal causes were rare.
- Prenatal causes were more common in isolated VI, while perinatal/postnatal causes were more frequent in multiple disabilities.
- Children with prenatal etiologies generally had less severe vision loss.
Conclusions:
- Prenatal factors are a significant cause of vision impairment in young children.
- Etiological patterns of vision impairment differ based on the presence of multiple disabilities.
- Understanding the timing of etiological factors is crucial for addressing vision impairment in children.
Abstract:
Data from the population-based Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) were used to describe the underlying causes of vision impairment (VI; corrected visual acuity in the better eye of 20/70 or worse) in young children (n = 228) in metropolitan Atlanta in 1991-93. Children with VI were identified through record review at multiple educational and medical sources. Children were categorised as having isolated VI or multiple disabilities (i.e. VI plus one or more of four additional developmental disabilities) and as having low vision (visual acuity 20/70-20/400) or blindness (visual acuity worse than 20/400). Medical conditions abstracted from MADDSP sources were reviewed to determine the probable aetiology of a child's VI. Aetiologies were assigned to one of three developmental time periods: prenatal, perinatal, or postnatal. Prenatal aetiologies were identified in 43% of the children; 38% of the prenatal aetiologies were genetic. Perinatal aetiologies were found in 27% of the children. Postnatal aetiologies were rare. Prenatal aetiologies were more common in children with isolated VI; perinatal and postnatal aetiologies were more common in children with multiple disabilities. Children with prenatal aetiologies tended to have less severe vision loss than did children with perinatal or postnatal aetiologies. The distribution varied by birthweight, but did not differ significantly by sex or race.