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Changing pattern of childhood blindness in Maharashtra, India
P Gogate1, M Deshpande, S Sudrik
1H.V., Desai Eye Hospital,Survey number 93, Tarawade Vasti, Mohammadwadi, Hadapsar, Pune 411028, India. parikshitgogate@hotmail.com
Insights
Congenital anomalies are the leading cause of childhood blindness in Maharashtra, India. Many cases are preventable or treatable, highlighting the need for improved low vision and optical services.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Childhood blindness remains a significant public health issue in India.
- Understanding the etiological factors is crucial for targeted interventions.
Purpose of the Study:
- To identify the primary causes of severe visual impairment and blindness among children in schools for the blind in Maharashtra.
- To assess the proportion of preventable or treatable causes of blindness.
Main Methods:
- A cross-sectional study involving 1778 children aged under 16 years in 35 schools for the blind.
- Ophthalmic examinations and classification of visual loss causes using the World Health Organization's system.
Main Results:
- Congenital anomalies (41.3%) were the leading cause, followed by corneal conditions (22.2%) and retinal disorders (11.2%).
- Over one-third (34.5%) of visual impairment was due to preventable or treatable conditions.
- Low vision devices and refraction provided some benefit to a small percentage of children.
Conclusions:
- Congenital anomalies represent a substantial and increasing proportion of childhood blindness.
- There is a need to enhance low vision and optical services, and further research into congenital anomaly etiology is warranted.
- Corneal scarring appears to be a decreasing cause of blindness.
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.
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