Low vision and blindness in children with multiple handicaps

Abstract

ObjectiveTo identify causes of visual impairment in children with multiple disabilities (handicaps) evaluated at Laramara, Brazilian Association for Assistance to the Visually Impaired People from March 1998 to November 2003. Method1562 children were evaluated; mean age was 5 years, 49% were females and 51% males; 78% came from the city of São Paulo, Brazil and 20.7% had moderate low vision, 19.2% severe and 9.7% profound low vision. 46.7% were in the near blindness range and 3.7% presented blindness. Data concerning diagnosis, site of the ocular lesion and causes of optic atrophy and cortical visual impairment were analyzed. ResultsThe main causes of visual impairment were: optic atrophy (37%), cortical visual impairment (22%), toxoplasmic macular retinochoroiditis (8.4%), retinopathy of prematurity (7.3%), ocular development abnormalities (6.7%) and congenital cataracts (6%). Optic nerve was the most frequently compromised ocular structure (38.4%). Concerning etiology of the optic atrophy, 47.6% were related to hipoxic–ishemic perinatal episodes and 13.9% to development abnormalities of the central nervous system. Cortical visual impairment was related to perinatal hipoxic–ischemic episodes in 46.9%. ConclusionsNecessity of primary intervention for infectious diseases and better prenatal care is stressed. Secondary prevention measures for detection and treatment of ocular and other problems as well as tertiary intervention and need of rehabilitation units for the multiple impaired are emphasized.