Abstract
BackgroundCurrently, about 2 per 1000 children in the industrialised world are severely visually impaired or blind (SVI/BL) due to diverse uncommon conditions that are usually present from early infancy. The impact of SVI/BL is lifelong and life-changing. Thus, children are a priority in the WHO-led global initiative against avoidable blindness. The aim of this scoping review is to assess the current evidence base on interventions to prevent or treat the major causes of childhood SVI/BL, specifically the degree of alignment between robust interventional research (RCTs) and the burden (relative frequency) of the key causative disorders, identifying gaps in the evidence base for tackling childhood blindness.Methods/designWe will perform a scoping review of the published literature of randomised controlled trials (RCTs) for clinical interventions that prevent or treat eye and vision diseases in children (<18 years old). Major electronic databases MEDLINE (PUBMED), EMBASE and the Cochrane CENTRAL will be searched to identify published trials using a comprehensive paediatric specific strategy informed by previous searches. The outcome of our study, randomised clinical trial activity, will be measured by the total number of RCTs and total paediatric participants randomised. The quantity and distribution of activity across diseases will be classified in the broad categories of anatomical site affected (per WHO taxonomy). The degree of alignment between paediatric trial activity and burden of SVI/BL disease (relative proportion) will be measured using a test of association (Spearman’s correlation coefficient).DiscussionDespite the global public health importance of childhood blindness, there has been no assessment of the completeness of the evidence base regarding clinical interventions to prevent or treat the causative disorders. This scoping review will measure the degree of alignment between the published evidence and the burden of disease to identify gaps in current knowledge and consider the underlying reasons, informing clinicians, policy makers and funders about research priorities.
Highlights
About 2 per 1000 children in the industrialised world are severely visually impaired or blind (SVI/Severe visual impairment or blindness (BL)) due to diverse uncommon conditions that are usually present from early infancy
Despite the global public health importance of childhood blindness, there has been no assessment of the completeness of the evidence base regarding clinical interventions to prevent or treat the causative disorders
The global burden of disease is conventionally measured using Disability-adjusted life years (DALYs), but the lack of data on children, reflecting a paucity of national epidemiological studies of visual impairment [11], means the burden of childhood blindness has to be inferred from the YLD component of DALYs, which is higher compared to adults, because it occurs so much earlier in the life course
Summary
The intensity and focus of randomised trial research should ideally align with the global burden of disease Measuring this association is important, as clinicians, funding bodies and policy makers should be aware of the areas where evidence is lacking in order to actively adjust research priorities. We will use the findings of this review to highlight any mismatch between the burden of childhood eye diseases and the evidence, focusing on the blinding disorders that confer the highest impact. In identifying these gaps in our knowledge with regards to interventions, we will discuss the potential barriers that have led to this disparity.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
