Byline: Sonia. Huang, Michelle. Sun, Ashwin. Mallipatna, Cesar. Carrillo, Yi. Tang, Khine. Nweni, Tin. Win, Than. Aung, Naing. Lin, Ye. Win, Andy. Griffiths, Martin. Holmes, Naw. Thapaw, Soe. Hlaing, Robert. Casson, James. Muecke
Purpose: To determine the causes of visual impairment (VI) and blindness among children in schools for the blind in Myanmar; to identify the avoidable causes of VI and blindness; to provide spectacles, low-vision aids, and ophthalmic treatment where indicated; to provide an update of the 2007 survey performed and identify any major epidemiological changes. Methods: Two hundred and ninety children under 16 years of age from all eight schools for the blind in Myanmar were examined and the data entered into the World Health Organization Prevention of Blindness Examination Record for Childhood Blindness. Results: In total, 271 children (93.4%) were blind (visual acuity [VA] <3/60 in the better eye) and 15 (5.17%) had severe visual impairment (SVI = VA <6/60 to 3/60 in the better eye). Most children had whole globe as the major anatomical site of SVI or blindness (105, 36.6%). The cause was unknown in the majority of these (155, 54.0%). One hundred and twelve children had avoidable causes of blindness and SVI (39.0%). Forty children (13.9%) required an optical device and 10.1% required surgical or medical attention, with a potential for visual improvement through intervention in 3.48%. Conclusion: In all, 39.0% of children had potentially avoidable causes of SVI and blindness with cataracts and measles being the commonest causes. This follow-up survey performed after the first one completed in Myanmar in 2007 demonstrates a change in the major site of abnormality from the cornea to whole globe and a reduction in avoidable blindness but highlights the ongoing burden of measles.
Myanmar is a country in mainland South-East Asia with a population of approximately 53 million people, of which 70% live in rural areas. An estimated 19 million of the world's children are visually impaired, with 1.4 million of these children irreversibly blind., Over a decade ago, the first survey of childhood blindness in Myanmar performed by our research team found that nearly half of all children in schools for the blind had potentially avoidable visual impairment (VI) and blindness, including refractive error and congenital cataract. In addition, corneal opacification secondary to measles and vitamin A deficiency (VAD) was identified as the leading cause. This study prompted several strategies aimed at addressing the lack of specialized pediatric eye services. In particular, the nongovernment organization Sight For All trained the country's first pediatric ophthalmologist and established pediatric eye units at the three major ophthalmic teaching institutes in the country. These measures combined with Myanmar's measles immunization program initiated in 2007 were expected to significantly reduce the burden of childhood blindness in Myanmar. We conducted a school-based survey to determine if there have been any significant changes in patterns of childhood VI and blindness in Myanmar over the last decade.
Over a 2-week period in 2018, all eight schools for the blind in Myanmar were visited...