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Epidemiology of blindness in children
Ameenat Lola Solebo1,2,3,4, Lucinda Teoh1, Jugnoo Rahi1,4,2,3
1Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK.
Insights
Globally, 1.4 million children experience severe visual impairment and blindness (SVI/BL). Emerging therapies offer hope, but research is needed to understand causes and develop treatments for childhood visual disorders.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Childhood blindness affects 1.4 million children globally, with significant socioeconomic and mortality implications.
- Severe visual impairment and blindness (SVI/BL) in children presents distinct etiological patterns in high-income versus low-income countries.
- While avoidable causes like retinopathy of prematurity (ROP) and cataract are increasing, cerebral visual impairment and optic nerve anomalies remain prevalent.
Purpose of the Study:
- To review emerging therapies for severe visual disability in children.
- To analyze the changing landscape of childhood blindness causes globally.
- To identify research needs for developing novel treatments for currently untreatable childhood visual disorders.
Main Methods:
- Literature review focusing on emerging therapies for childhood SVI/BL.
- Analysis of epidemiological data on the causes of childhood blindness.
- Synthesis of current understanding of risk factors and treatment gaps.
Main Results:
- Cerebral visual impairment and optic nerve anomalies are leading causes of SVI/BL in high-income nations.
- ROP and cataract are increasingly common avoidable causes of childhood blindness.
- In low-income settings, causes are shifting towards patterns seen in high-income countries, emphasizing the role of improved maternal/neonatal health and ophthalmic infrastructure.
Conclusions:
- Improving maternal/neonatal health and ophthalmic care infrastructure is crucial for reducing avoidable childhood blindness.
- Novel therapies for conditions like ROP and retinal dystrophies require further investigation into safety and efficacy.
- Population-based research on cerebral visual impairment and optic nerve hypoplasia is essential for understanding risk factors and developing treatments.
Abstract:
An estimated 1.4 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during childhood and to die in childhood than a child not living with blindness. This update of a previous review on childhood visual impairment focuses on emerging therapies for children with severe visual disability (severe visual impairment and blindness or SVI/BL).For children in higher income countries, cerebral visual impairment and optic nerve anomalies remain the most common causes of SVI/BL, while retinopathy of prematurity (ROP) and cataract are now the most common avoidable causes. The constellation of causes of childhood blindness in lower income settings is shifting from infective and nutritional corneal opacities and congenital anomalies to more resemble the patterns seen in higher income settings. Improvements in maternal and neonatal health and investment in and maintenance of national ophthalmic care infrastructure are the key to reducing the burden of avoidable blindness. New therapeutic targets are emerging for childhood visual disorders, although the safety and efficacy of novel therapies for diseases such as ROP or retinal dystrophies are not yet clear. Population-based epidemiological research, particularly on cerebral visual impairment and optic nerve hypoplasia, is needed in order to improve understanding of risk factors and to inform and support the development of novel therapies for disorders currently considered 'untreatable'.
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