Making Blind Children See: Impact of Correcting Moderate and Severe Visual Impairment in Schools for the Blind.

Abstract

PURPOSE:Childhood blindness and visual impairment accounts for enormous burden of blindness. This study aimed to analyze the causes of severe visual impairment and blindness in students attending schools for the blind and to identify those whose vision could be improved by optical aids. On dispensing such aids, the study also aimed to analyze the improvement in their vision function.METHODS:This was a prospective interventional study of 428 certified students from four special schools for blind. All the students underwent a comprehensive ophthalmic examination by a team of four ophthalmologists and four optometrists. The World Health Organization-Prevention of Blindness forms were used to record history and examination details. Spectacles and low-vision aids (LVAs) were dispensed to those whose vision could be improved. The main outcome measure was L V Prasad- Functional Vision Questionnaire (LVP-VFQ), which was used to compare the vision function before and 6 months after the intervention.RESULTS:Two hundred and thirteen (49.5%) students were girls. The causes of blindness in 370 children (<18 years) with vision <6/60 were whole globe involvement in 117 (31.6%) students (this included anophthalmos 47 [12.7%], microphthalmos 61 [16.4%], both 9 [2.4%]), nystagmus 29 (7.8%), optic atrophy 22 (5.9%), retinal causes 42 (11.3%), cataract 18 (4.9%), phthisis bulbi 24 (6.4%), corneal scarring in 40 (10.8%), and retinopathy of prematurity in 4 (1.1%). Fifty-four (12.6%) students were given spectacles and 41 (9.57%) LVA. There was a statistically significant difference in all questions (P < 0.01) of LVP-VFQ for the students dispensed with optical aids 6 months after the intervention. Twenty-four students had their vision improved to 6/60 or better, whereas 26 could now identify letters and print.CONCLUSION:A significant proportion of students in schools for the blind can be helped to improving vision function using optical aids. Students in schools for the blind, nay all visually impaired individuals, need periodic ocular examination and ophthalmic care.