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Congenital ocular blindness in children, 1945 to 1984
G C Robinson1, J E Jan, C Kinnis
1Department of Pediatrics, Faculty of Medicine, B.C. Children's Hospital, Vancouver, Canada.
Insights
Congenital blindness rates in British Columbia have decreased significantly, with genetic disorders now leading causes. Improvements in care have reduced severe vision loss and associated handicaps in affected children.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Congenital ocular blindness presents a significant public health challenge in pediatric populations.
- Historical data on the prevalence and causes of congenital blindness are crucial for understanding trends and informing interventions.
Purpose of the Study:
- To analyze trends in the birth prevalence and causes of congenital ocular blindness in British Columbia from 1945 to 1984.
- To identify shifts in the leading causes of congenital blindness and assess changes in associated handicaps.
Main Methods:
- Retrospective population-based study of 676 children born in British Columbia with congenital ocular blindness between 1945 and 1984.
- Analysis of birth prevalence rates and etiological factors over four decades.
Main Results:
- The birth prevalence rate of congenital blindness decreased from 8 to 3 per 10,000 live births.
- Genetic ocular disorders replaced retinopathy of prematurity as the primary cause, though retinopathy of prematurity is reemerging.
- Optic nerve lesions increased, while lens lesions decreased, correlating with rubella infection rates.
- Fewer children presented with no light perception and fewer associated handicaps.
Conclusions:
- Significant progress has been made in reducing congenital blindness and its severity over the study period.
- Changes in leading causes reflect advancements in disease prevention (e.g., rubella vaccination) and medical care.
- Ongoing surveillance is necessary to monitor reemerging causes like retinopathy of prematurity and address new trends.
Abstract:
A total of 676 children born in British Columbia with congenital ocular blindness during the years 1945 through 1984 were studied. The birth prevalence rate of congenital blindness has decreased from eight per 10,000 live births in the late 1940s to three per 10,000 live births. Retinopathy of prematurity was replaced by genetic ocular disorders as the leading cause of congenital blindness, although the former is reemerging. The rate of congenital rubella infection also declined. There has been a significant increase in the rate of births with optic nerve lesions during the past 15 years, while the rate of births with lesions of the lens fell, reflecting the decline in the rate of maternal rubella infection. There are fewer children with congenital ocular legal blindness who have no light perception today, and they also have fewer associated handicaps.