A population-based study on the prevalence and causes of childhood blindness and visual impairment in North India.

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From: Indian Journal of Ophthalmology(Vol. 69, Issue 6)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 4,540 words
Lexile Measure: 1800L

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Byline: Meenakshi. Wadhwani, Praveen. Vashist, Suraj. Senjam, Vivek. Gupta, Rohit. Saxena, Radhika. Tandon

Purpose: This was a population-based study to determine the prevalence and causes of visual impairment in children less than 16 years in Urban North India. Methods: This cross-sectional study was conducted in 40 clusters of urban Delhi. 20,955 children aged less than 16 years underwent visual acuity screening using age-appropriate visual acuity charts. Unaided visual acuity of enumerated children aged over 2 years was assessed by using Lea symbols chart in 3-5 years age group and logMAR tumbling E charts for the 6-15 years age group. For children aged 0-2 years, fixation and following to torch light was assessed. All the children with unaided visual acuity of <6/12 in any eye in age group 3-15 years and inability to follow the light in age <3 years were referred for detailed ophthalmic examination. Results: Amongst 20,955 children examined for visual acuity a total of 789 children were referred to the central clinic for detailed ophthalmic examination. Of these referred children, a total of 124 had presenting visual acuity <6/18 in the better eye. The prevalence of visual impairment (VI) was 5.92 per thousand (95% CI: 4.96-7.05). The prevalence of moderate to severe visual impairment was maximum in the age group of 11 to 15 years. The main cause of avoidable VI in these children was a refractive error (75.7%). The prevalence of blindness was 0.42 per thousand. Conclusion: Optic nerve abnormalities were the most important cause of blindness in children. Refractive error is the most important cause of visual impairment amongst children and needs to be addressed.

Visual impairment (VI) has profound implications in terms of reduced educational, recreational, and social opportunities in children. Globally, around 1.4 million blind children less than 16 years of age are blind, of this approximately 75% of them are from developing countries. The prevalence of blindness in children varies from 0.3 per thousand children in developed countries to 1.5 per thousand in developing countries.[1],[2]

In India, there are numerous gaps in knowledge about epidemiology of childhood blindness with very few community-based studies available in northern part of India compared to southern part of the country.[3],[4],[5],[6],[7],[8],[9] There is a consistent lack of evidence on the epidemiology and varied cause of childhood blindness in the north. To deal with the problems, several interventions have been introduced to address childhood blindness in the past few decades under NPCB (National Program for control of blindness) in India. Due to these interventions implemented across the country by World Health Organisation (WHO) and NPCB, a paradigm shift in the causes of childhood blindness has been reported especially in south India.[3],[5],[7],[9],[10],[11] While there are numerous community-based surveys from southern India,[3],[5],[6],[7] similar studies from the north are not available. As there are numerous differences in the availability and accessibility of health care services and cultural practices, these regional studies may not be reflective of the whole of India. Region-wise data is essential to plan and augment available resources and provide...

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Gale Document Number: GALE|A663757993