Byline: Damaris. Magdalene, Harsha. Bhattacharjee, Saurabh. Deshmukh, Shyamsundar. Mohapatra, Amzad. Ali, Rammohan. Paidi, Prabhjot. Multani
Purpose: The aim of this study was to describe causes of severe visual impairment and blindness (SVI/BL), and assess the mental health and quality of life of children in schools for the blind in North-East India in two phases. Methods: A total of 515 children were examined in 17 schools for the blind in the first phase of study across eight states in North-East India, 6 in Assam, 2 each in Meghalaya, Manipur, Mizoram, and Tripura, 1 each in Arunachal Pradesh, Nagaland, and Sikkim. WHO/PBL eye examination record was used to document findings. In the second phase of study, mental health and quality of life were objectively measured using depression anxiety stress scales (DASS) and low-vision quality of life (LVQOL) questionnaires in 442 children. Results: Approximately 3.1% of children had SVI and 71.84% of children were blind. Anatomical sites of SVI/BL were the whole globe in 44.85%, cornea in 17.66%, and retina in 11.65% of children. The underlying cause of visual loss was undetermined in 55% of children. Hereditary pattern was observed in 1.35% of cases. Approximately 74.94% of children were either blind or severely visually impaired since birth. DASS score revealed that 56.56% of children manifested some levels of anxiety and stress while 85.52% had some reduction in quality of life. Conclusion: A large significant number of these children suffered from potentially preventable and/or treatable cause of SVI/BL. Though nonvisual factors such as physical and mental health were strong predictors of quality of life, this study proves that visual impairment also plays a considerable role in one's quality of life in a population with low vision.
An estimate for global blindness is 37 million, of which 1.5 million are children and almost three-quarters of them live in developing countries. The prevalence of blindness in children ranges from approximately 0.3/1000 children in affluent regions to 1.5/1000 within the poorest communities. World Health Organization (WHO) defines blindness as corrected visual acuity in the better eye of < 10/200 and severe visual impairment as corrected visual acuity in the better eye of <20/200 but equal to or better than 10/200. The Indian definition has recently been modified to be in tune with that of WHO., But despite low prevalence, childhood blindness has been given priority in VISION 2020 program due to its high magnitude particularly prevailing in developing countries and the high number of blind years resulting from the same., The problems faced by the child, the burden on their families, society and the impact on the nation have to be considered as most of the blindness in childhood is avoidable, preventable, and treatable if detected at an early age.
Population-based data on the causes of childhood blindness are difficult to find in developing countries as registers of the blind do not exist, and very large sample sizes would be required for formal cross-sectional surveys. Low vision affects many areas of quality of life including daily functioning...