Childhood sight impairment: a 10-year picture

Abstract

Registering a child as visually impaired is a potentially traumatic, but necessary, milestone in paediatric ophthalmology. Registration enables the provision of services essential to maximise the child's potential. This study was carried out to investigate the changes over a 10-year period in the rates of registration of childhood blindness at a tertiary paediatric ophthalmology department. Particular attention was given to diagnosis, whether the disease was preventable, time to registration, age at registration, and the socioeconomic status of the patient's family. A retrospective analysis of all children registered blind or partially sighted over a 10-year period until December 2006. A total of 256 children were registered blind or partially sighted over the 10 years. All cases were analysed. Of these, 58.2% were male and the average age at registration was 76 months; 52.0% were registered as severely sight-impaired. The most common primary diagnosis was cerebral visual impairment (CVI) in 27% cases, followed by optic atrophy in 16%, and the commonest anatomical site involved was the retina in 30.9%. An average of 25.6 (SD 8.0) registrations were carried out each year. The number of registrations per year is increasing. Seven cases (2.7%) were deemed avoidable and 61 cases (23.8%) were deemed potentially treatable. The mean index of multiple deprivation (IMD) score for the English cases (45.1) was significantly higher than of the surrounding area (P<0.0001). The yearly rates of registration increased slowly over the 10 years. The most common underlying cause for registration remains CVI, with the yearly proportion of registrations because of CVI not altering. The average age of registration was 6.3 years. A significant proportion of the cases of visual impairment, are because of potentially modifiable causes.