Causes of visual impairment in children seen at a university-based hospital low vision service in Brazil
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Published on: November 19, 2020
Cristina Helena Toledo de Paula1, Galton Carvalho Vasconcelos1, Márcio Bittar Nehemy2
1Pediatric Low Vision Division, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Insights
This study on pediatric visual impairment in Brazil found congenital cataract, toxoplasmosis, and glaucoma as leading causes. A high percentage of cases were preventable, with late diagnosis highlighting a critical public health issue.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- Visual impairment significantly impacts child development.
- Early detection and intervention are crucial for managing pediatric visual impairment.
- Understanding the epidemiology of visual impairment in children is essential for targeted public health strategies.
Purpose of the Study:
- To characterize the epidemiologic features of visually impaired children (0-7 years) at a Brazilian university hospital's low vision service.
- To identify the primary causes and affected ocular regions in pediatric visual impairment.
- To assess the proportion of avoidable causes and the age at first appointment.
Main Methods:
- Retrospective review of medical records for 229 visually impaired patients aged 0-7 years.
- Data collection included sociodemographic factors, ocular disorders, affected anatomic regions, etiology, and cause avoidability.
- Analysis utilized World Health Organization classifications for etiologies.
Main Results:
- Congenital cataract (14%), toxoplasmosis (14%), and congenital glaucoma (13%) were the most frequent diagnoses.
- The retina (18%) and lens (15%) were the most affected anatomic regions; 33% had normal-appearing globes.
- Undetermined (43%), perinatal/neonatal (22%), and intrauterine (20%) factors were leading etiologies; 64% of cases had avoidable causes.
Conclusions:
- Congenital cataract, toxoplasmosis, and congenital glaucoma are the primary causes of infant blindness in this cohort.
- The high percentage of avoidable causes and the late mean age at first appointment underscore significant public health concerns.
- Targeted interventions and improved access to care are needed to address preventable pediatric visual impairment.
Purpose:
To evaluate the epidemiologic characteristics of patients 0-7 years of age with visual impairment registered at a university hospital low vision service in Brazil.
Methods:
The medical records of visually impaired patients were retrospectively reviewed for sociodemographic characteristics and ocular and associated deficiencies. In addition to biographical information, the following data were collected: ocular disorders, diagnosis, affected anatomic region, etiology, and avoidable or unavoidable causes.
Results:
A total of 229 patients were included, 65% of whom were referred from rural health centers. The mean age at first appointment was 39.4 months. Associated nonophthalmic disorders were present in 47% of patients. The most prevalent disorders were congenital cataract (14%), toxoplasmosis (14%), and congenital glaucoma (13%). The most commonly affected anatomic regions were the retina (18%) and lens (15%); 33% had a normal-appearing globe. Using World Health Organization classifications, the most prevalent underlying etiologies were undetermined (43%), perinatal/neonatal factors (22%), and intrauterine factors (20%). Avoidable causes were found in 64% of the children.
Conclusions:
The three leading causes of infant blindness in our patient cohort were congenital cataract, toxoplasmosis, and congenital glaucoma. The most commonly affected anatomic regions were retina, lens, and normal-appearing globe. The percentage of avoidable causes of impairment was high and the mean age at first appointment was late.
