[Change in the course of blindness in childhood]

In the course of the 20th century there have been major changes in the causes of blindness in childhood. This is illustrated by the example of the 1271 children born between 1885 and 1976 who attended the Bavarian State School for the Blind. The following developments became apparent: Until 1940 the most common cause of blindness, accounting for 25% of the cases, was corneal disease, almost exclusively of infectious origin. This cause has been reduced most, to 2%. There has also been a clear reduction in blindness due to anterior uveitis (mainly due to infection) and chorioretinitis. There were fewer such cases -5% and 3%, respectively. Since the 1960s there have been no further cases of blindness due to ocular injury in children, and no case of sympathetic ophthalmia has occurred since 1950. While the incidence of congenital cataract and buphthalmos has remained constant, they now only lead to blindness in a small proportion of those affected, thanks to improvements in therapy. The incidence of blindness caused by retinal detachment, usually associated with myopia, is also unchanged, though rare (2-3%). The same applies to bilateral retinoblastoma, while the frequency of optic nerve atrophy (20%) and tapetoretinal degeneration (16-19%) has remained both constant and high. There has been a drastic increase in ocular malformations and developmental anomalies. These include retrolental fibroplasia, which was responsible for blindness in 38% of the children born between 1967 and 1976. Overall, there has been a major reduction in the number of blind children in the population since the 1960s and especially since the 1970s.