Clinical profile and error of inclusion and exclusion in schools for the blind in Bangalore and a review of literature.

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From: Indian Journal of Ophthalmology(Vol. 69, Issue 8)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 4,185 words
Lexile Measure: 1380L

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Byline: Vasudha. Kemmanu, Priti. Tayde, Ramesh. Venkatesh, K. Sindhu, B. Keshavardhini, M. Bhanumathi, Naren. Shetty

Purpose: To determine the causes of severe visual impairment and blindness in children in schools for the blind in the city of Bangalore, Karnataka and to determine the error of inclusion and exclusion from these schools. Methods: This was a cross-sectional study. Children in four schools for the blind were subjected to a detailed ophthalmic evaluation. The World Health Organization Program for Prevention of Blindness low-vision form was used to collect data. To know the educational background of children with visual disability of 40% or more (best-corrected visual acuity of [less-than or equal to]6/24 in the better eye), not in schools for the blind, we collected data by telephonic conversation after procuring their phone numbers from our low-vision clinic. Results: One-hundred-seventy-eight children were examined. The major site of anomaly causing blindness in 31% of children was optic nerve, followed by retina (24%), cornea (23%), and whole globe (22%). Avoidable blindness was 35.42%. Thirteen percent of the children with no visual disability were incorrectly enrolled in blind schools. We were able to contact 92 children with a visual disability of [greater-than or equal to]40%. Seventy-eight children (84.78%) attended regular schools; these schools were bereft of a specially trained teacher to look after the needs of the blind. Conclusion: Avoidable blindness is still a cause for concern. Children should undergo eye-examination before being enrolled in schools for the blind to avoid errors of inclusion. Though integrated education for children with vision disability is a good approach, it requires teachers trained in teaching skills particular to blindness. Education for the visually impaired in India needs a major revision.

There is a definite change in the pattern of childhood blindness in India; the shift has been from cornea (preventable) as the main cause of blindness to unavoidable causes like whole globe anomalies and retinal pathologies.[1] This could be because of the vitamin A supplementation program initiated by the Government of India which has led to a decrease in vitamin A deficiency disorders, particularly blindness.[2] Population-based studies are the gold standard for obtaining data on the prevalence, distribution, and determinants of blindness which would help in setting up appropriate health care delivery. Since these studies are time consuming and costly, we make use of data from schools for the blind. The advantage of this data is that a cohort of blind children are easily available. The disadvantages are that children enrolled in schools for the blind, make up only a small proportion of that in the community. It is estimated that in developing countries, only 10% of the blind children attend schools for the blind.[3] Children with multiple disabilities are grossly underrepresented.[4] The first school for the blind was established at Amritsar in 1887.[5] As of 1979, there were 104 schools for the blind[5] and the numbers are increasing since then. During routine screening of schools for the blind in our area, we realized that a substantial number of children...

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Gale Document Number: GALE|A670532693