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Visual impairment in childhood: insights from a community-based survey
N M Flanagan1, A J Jackson, A E Hill
1Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, and South and East Belfast Health and Social Services Trust, Belfast, Northern Ireland, UK. nmflanagan@doctors.org.uk
Background:
The concept of visual impairment (VI) in childhood has changed over the last 30 years. There has been a decrease in the number of children with an isolated visual problem and an increase in the numbers with VI and coexisting neurological disability. This study aimed to produce a profile of VI in childhood with a view to informing future services and to raise awareness of the need for comprehensive assessment including developmental remediation and educational advice.
Methods:
Children with a VI were identified from multiple sources including hospital- and community-based paediatricians and statutory blind registers.
Results:
Seventy-six children with a VI were identified giving a childhood prevalence of 1.61 per 1000. Thirty-two per cent had a normal pattern of development. Global delays/severe learning difficulty were found in 43%. Only 21% of the children had an isolated VI. Additional medical problems were present in 79% of which cerebral palsy, occurring in 33%, was the most common. Nine per cent of the children were classified as totally blind. Cortical visual impairment was diagnosed in 45%. Twenty-two per cent of the children were registered blind or partially sighted.
Conclusions:
Most cases of VI in children did not appear on the statutory blind or partially sighted registers, thus these have limited value for service development. The implications for practice highlight the need for early assessment and advice from a co-ordinated team to optimize visual potential in childhood.