Visual Impairment In Children Research Articles

Impact of Refractive Errors on the Academic Performance of High School Children of Lahore.

IntroductionThe process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development.ObjectiveThis research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore.MethodologyA total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma.ResultsThe prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at p-value < 0.05.ConclusionA significant impact was observed in the average academic scores of the results after refractive corrections.

The role of screening and surveillance in the detection of childhood vision impairment and blindness in the UK

ObjectiveUnderstanding pathways to detection for childhood visual impairment (VI) is critical for planning services. We aimed to describe patterns of detection for childhood VI.Design and settingCross-sectional study using data from...

EVALUATION OF VARIOUS CAUSES OF CEREBRAL VISUAL IMPAIRMENT IN CHILDREN AT TERTIARY CARE CENTRE

Purpose: The purpose of this study is to evaluate the etiology, associated ophthalmological and neurological ndings of cerebral visual impairment (CVI) in children at a tertiary care center. Methods: A retrospective study was conducted on 71 patients visiting between February 2020 to August 2021 at a tertiary care hospital, J.L.N. medical college and hospital, Ajmer, Rajasthan. Diagnosis of CVI was based on ocular examination found poor visual function that could not be accounted by age, ocular ndings and neuroimaging.Results: The records of 44 boys and 27 girls were analysed. Majority of them were &lt;3yrs (40.8%) . The most common etiology was perinatal hypoxia (29%), followed by prematurity (22.5%). Moreover, 9(12.7%) showed mixed aetiology, 8(11.3%) had hydrocephalus and 7(9.9%) had hypoglycemia . Amongst the ocular associations, refractive error was the most common, seen in 32 (45%) children, while strabismus in 31 (44%), nystagmus in 22(31%). Thirty two (45%) children had associated developmental delay, while 38(53%) had seizures. The most common ndings were ischemic encephalopathy (31%), periventricular leukomalacia (23%), cortical and subcortical atrophy and structural malformations (24%). Conclusion: CVI is of increasing importance as a cause of vision impairment in children. The major causes for CVI tend to be perinatal hypoxia followed by prematurity. Establishing the etiology for these children at early age may aid in early rehabilitation of these children.

Identification of a New Mutation p.P88L in Connexin 50 Associated with Dominant Congenital Cataract.

Congenital hereditary cataract is genetically heterogeneous and the leading cause of visual impairment in children. Identification of hereditary causes is critical to genetic counselling and family planning. Here, we examined a four-generation Chinese pedigree with congenital dominant cataract and identified a new mutation in GJA8 via targeted exome sequencing. A heterozygous missense mutation c.263C > T, leading to a proline-to-Leucine conversion at the conserved residue 88 in the second transmembrane domain of human connexin 50 (Cx50), was identified in all patients but not in unaffected family members. Functional analyses of the mutation revealed that it disrupted the stability of Cx50 and had a deleterious effect on protein function. Indeed, the mutation compromised normal membrane permeability and gating of ions, and impeded cell migration when overexpressed. Together, our results expand the pathogenic mutation spectrum of Cx50 underlying congenital cataract and lend more support to clinical diagnosis and genetic counseling.

Modern Methods for the Diagnosis of Morphological and Functional Features of the Retina in Dysbinocular and Anisometropic Amblyopia

Child health is a global health priority. Anomalies of refraction, complicated by amblyopia and squint, occupy one of the leading places in the pathology of the visual system of children. According to data obtained from 26 regions of Russia, the leading place in the ocular morbidity of children and adolescents is occupied by ametropia and strabismus with amblyopia. They account for up to 90 % of all cases of visual impairment in childhood. The term amblyopia is understood to mean a decrease in the maximum corrected visual acuity that occurred at an early age, which is caused by disorders of the functions of the visual analyzer, without changes in the fundus and organic lesions of the visual pathways and centers. Despite the outstanding achievements of 21st century medicine, today the questions of the pathophysiological essence of this condition remain open, which is the subject of discussions among pediatric ophthalmologists around the world. In this regard, the literature review presents the results of domestic and foreign authors who studied the morphological (optical coherence tomography) and functional (electroretinography, microperimetry) features of the retina in dysbinocular and anisometropic amblyopia. Some authors have demonstrated the presence of differences in the thickness of the central region and the layer of nerve fibers in patients with amblyopia compared with paired and healthy eyes, their correlation with functional parameters, as well as changes in the thickness of the choroid and microvasculature of the retina. Recently, there have been works devoted to the study of the photosensitivity of the retina in patients with amblyopia and visual rehabilitation using this equipment. A number of authors have shown that with amblyopia, the retinal photosensitivity parameters in the central region are reduced, and there is a correlation between these changes and morphological changes in the posterior pole. The microperimeter also makes it possible to carry out visual rehabilitation, in particular in pediatric patients, and isolated results have been published on the use of this method in patients with amblyopia. The literature data are quite contradictory, and more research remains to be done to determine whether these changes in the retina are primary in relation to this disease, or whether they can be the result of retrograde changes that are obscured by defocusing of visual images from birth.

Profiling children with cerebral visual impairment in a tertiary eye care center

Background: Cerebral visual impairment (CVI) is a bilateral visual impairment that affects children in all industrialized countries. It has become more common in low-income countries as a result of the increased survival rates of children who suffer from severe neurological conditions during the perinatal period. The purpose of this study was to determine the characteristics of children with CVI in a tertiary children’s eye care center population. Methods: From October 2020 to September 2021, a cross-sectional study was conducted to select all consecutive patients with a diagnosis of cerebral visual impairment aged 6 months to 16 years. On the neurological deficit, information was gathered from the patient’s referral: parental interviews, observations, and direct assessment were used for functional vision characteristics, and an ophthalmic examination was performed for eye findings. The interviewees’ responses were matched to the ten specific behavioral characteristics shared by children with CVI. Cortical visual impairment was diagnosed using three criteria: [the vision loss is not explained by abnormalities found on the eye examination, a neurological medical diagnosis, and the child exhibits one of the unique visual and behavioral characteristics described by Roman Lantz]. A descriptive statistical analysis (frequency, mean, and range) was calculated. Results: Forty children with CVI (1.96% of total children) were seen. The mean age was 2.56 ( 1.98) years. There were 24 (60%) males. On a referral paper of 28, hypoxic-ischemic encephalopathy was the commonest cause mentioned (70.0%). Seizures were the most frequent neurological deficit at presentation. Ophthalmic and neurologic impairments were found in 42.5% of children with CVI. Based on Roman-Lantzy’s three phases of the CVI Range, 90% of children with CVI at the test time had Phase I or Phase II vision. Conclusion: According to the findings of this study, visual impairment is critical in the diagnosis of CVI. The prevalence of CVI as a cause of childhood vision impairment is significant. Hypoxic-ischemic encephalopathy is the most common cause of CVI. All children with CVI have serious neurological issues, and the majority have associated ophthalmic abnormalities.

Long-term visual outcomes of children screened for retinopathy of prematurity with telemedicine in New Zealand

ABSTRACT Clinical Relevance Children with a history of regressed retinopathy of prematurity (ROP) are at increased risk of peripheral avascular retina. Wide-field digital retinal imaging and telemedicine is an effective tool for ROP screening. Ophthalmologists and Optometrists should have a high level of clinical suspicion for peripheral retinal changes in children screened for ROP. Background Retinopathy of prematurity, a vaso-proliferative disorder of the pre-term retina, is a preventable cause of childhood visual impairment. The Auckland Regional Telemedicine ROP (ART-ROP) network, established in 2006, utilises wide-field digital imaging and telemedicine to screen at-risk infants for ROP. This prospective observational study reports the long-term ocular outcomes of ART-ROP network infants. Methods A comprehensive paediatric eye examination including cycloplegic autorefraction and wide-field retinal imaging was completed on all participants. Participants had been screened for ROP by the ART-ROP network between May 2008 and October 2011. Results A total of 69 children, with a mean age of 5 to 8 years old were assessed and divided into two groups: those with or without a history of ROP, 44 and 25 children, respectively. Infants with a history of ROP had significantly lower gestational age (26.6 ± 1.9 vs. 29.1 ± 1.6 weeks, p < 0.001) and birth weight (937 ± 237 vs. 1177 ± 311 grams, p = 0.001). No significant differences were detected between the two groups for visual acuity (p = 0.596), stereopsis (p = 0.219), refractive error (p = 0.472), or strabismus. Clinically significant refractive error was noted in 10 participants; none with moderate or high myopia. Retinal imaging exposed asymptomatic, persistent, peripheral avascular retina in four children, all of whom had a history of regressed ROP. Conclusion Visual and ocular outcomes did not vary based on history of ROP, with no participant having reduced vision as a result of undetected or untreated ROP. Further research is required into the long-term implication of persistent avascular retina in regressed ROP.

Risks of Visual Impairment and Its Progression in Children and Adolescents under Modern Conditions of Education and Upbringing: A Scientific Review

Introduction: Intensive introduction of digital technologies and educational tools poses risks of visual impairment in children and adolescents as the most active users of the digital space. Objective: To assess risks of visual impairment in children and adolescents in the context of active dissemination of digital technologies in education and everyday life based on a literature review in order to choose directions for pediatric prevention of eye diseases. Materials and methods: We did a review of Russian and English language scientific literature published in 2007–2021, found on eLIBRARY.RU, PUBMED, Web of Science, and Scopus information portals and platforms. We selected 48 articles containing an evidence-based assessment of risks of eye diseases related to e-learning and long screen time in children and adolescents, especially during the COVID-19 pandemic and associated lockdown. Results: We observed combined risks of visual impairment and musculoskeletal disorders due to violation of hygienic requirements for illumination, working posture, distance to the screen, and screen time when using various gadgets. Concomitant risk factors for eye diseases related to vitamin D deficiency were evaluated. Conclusions: We identified groups at risk of visual impairment based on health indicators and the intensity of using the digital environment. We also specified basic methodological and regulatory documents, the compliance with which could reduce the risks of visual impairment in children, adolescents, and students, and proposed up-to-date directions of research on the topic of the review for maintenance of eye health.

Visual impairment in children with multiple disabilities in schools for children with special needs in South India.

Purpose:To understand/assess ocular and functional vision impairment in children with multiple disabilities with a functional vision assessment battery in addition to standard ophthalmic examinations in an outreach setting.Methods:Seven schools for children with special needs, 243 children in total, were screened for ocular disorders and functional vision impairment through school camps.Results:Among them, 37% had refractive errors needing spectacle correction. With standard ocular testing methods, the visual impairment was around 32%, but when functional vision was assessed, the functional vision impairment amounted to 70% in these children. The presence of functional vision impairment was found to be independent of the associated disability. Assessment of visual capacities such as visual closure, saccade pursuits, optic ataxia, and developmental milestones early on can help in suspecting the presence of CVIConclusion:Children with multiple disabilities are more at risk of functional vision impairment, which significantly impairs their ability to function in daily life. A complete functional vision assessment becomes essential to plan early intervention for these children. The significant proportion of vision impairment and functional vision loss in our study indicates the need for coordinated structured programs to address vision-related problems in children with multiple disabilities.

A Comparison of Long-Term Treatment Outcomes Between Giant and Nongiant Craniopharyngiomas

There is limited literature on outcomes after surgical treatment of giant craniopharyngiomas in adult and pediatric patients. A retrospective review of 159 patients undergoing surgery for craniopharyngiomas at a single institution was performed. Patients with giant craniopharyngiomas (maximum dimension ≥4.5 cm) were compared with nongiant tumors in terms of various clinical and radiological parameters and long-term surgical outcomes. Extent of resection was determined by postoperative magnetic resonance imaging. Factors associated with post-treatment obesity were also analyzed. Giant craniopharyngiomas (n= 66) were characterized by higher rates of childhood presentation, visual impairment, neurological deficits, multicompartmental involvement, and hydrocephalus as compared with nongiant tumors (n= 139). Giant tumors also were less likely to undergo transsphenoidal resection and were associated with a higher rate of postoperative neurological morbidity. There were no significant differences between the 2 groups in terms of extent of resection, use of postoperative radiation therapy, and long-term endocrinological outcomes. Overall recurrence rates over a mean follow-up period of 4.1 years were similar between giant and nongiant tumors; however, recurrences after presumed gross total resection/near total resection were significantly higher in the former subgroup versus the latter (39.4% vs. 18.4%; P= 0.044). Risk factors for post-treatment obesity in giant craniopharyngiomas included adult age (P= 0.001), preoperative obesity (P= 0.003), and hypothalamic involvement (P= 0.012). Gross total resection/near total resection of giant craniopharyngiomas can be achieved at rates comparable to nongiant tumors. However, there remains a greater risk of postoperative neurological morbidity. Radiation therapy mitigates the risk of recurrence on long-term follow-up.

Global Tendency and Frontiers of Research on Myopia From 1900 to 2020: A Bibliometrics Analysis

Background:Myopia is one of the most common causes of vision impairment in children and adults and has become a public health priority with its growing prevalence worldwide. This study aims to identify and evaluate the global trends in myopia research of the past century and visualize the frontiers using bibliometric analysis.MethodsThe literature search was conducted on the Web of Science for myopia studies published between 1900 and 2020. Retrieved publications were analyzed in-depth by the annual publication number, prolific countries and institutions, core author and journal, and the number of citations through descriptive statistics. Collaboration networks and keywords burst were visualized by VOSviewer and CiteSpace. Myopia citation network was visualized using CitNetExplorer.ResultsIn total, 11,172 publications on myopia were retrieved from 1900 to 2020, with most published by the United States. Saw SM, from the National University of Singapore, contributed the most publications and citations. Investigative Ophthalmology & Visual Science was the journal with highest number of citations. Journal of Cataract and Refractive Surgery with the maximum number of publications. The top 10 cited papers mainly focused on the epidemiology of myopia. Previous research emphasized myopia-associated experimental animal models, while recent keywords include “SMILE” and “myopia control” with the stronger burst, indicating a shift of concern from etiology to therapy and coincided with the global increment of incidence. Document citation network was clustered into six groups: “prevalence and risk factors of myopia,” “surgical control of myopia,” “pathogenesis of myopia,” “optical interventions of myopia,” “myopia and glaucoma,” and “pathological myopia.”ConclusionsBibliometrics analysis in this study could help scholars comprehend global trends of myopia research frontiers better. Hundred years of myopia research were clustered into six groups, among which “prevalence and risk factors of myopia” and “surgical control of myopia” were the largest groups. With the increasing prevalence of myopia, interventions of myopia control are a potential research hotspot and pressing public health issue.

Retinopathy of prematurity: contribution of inflammatory and genetic factors.

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder that represents an important cause of childhood visual impairment and blindness. Although oxidative stress has long been implicated in ROP etiology, other prenatal and perinatal factors are also involved. This review focuses on current research involving inflammation and genetic factors in the pathogenesis of ROP. Increasing evidence suggests that perinatal inflammation or infection contributes to ROP pathogenesis. Cytokines and chemokines with a fundamental role in inflammatory responses and that significantly contributing to angiogenesis are analyzed. Microglia cells, the retinal-resident macrophages, are crucial for retinal homeostasis, however, under sustained pathological stimuli release exaggerated amounts of inflammatory mediators and can promote pathological neovascularization. Current modulation of angiogenic cytokines, such as treatment with antibodies to vascular endothelial growth factor (anti-VEGF), has shown efficacy in the treatment of ocular neovascularization; however, some patients are refractory to anti-VEGF agents, suggesting that other angiogenic or anti-angiogenic cytokines need to be identified. Much evidence suggests that genetic factors contribute to the phenotypic variability of ROP. Several studies have implicated the involvement of candidate genes from different signaling pathways in the development of ROP. However, a genetic component with a major impact on ROP has not yet been discovered. Most studies have limitations and did not replicate results. Future research involving bioinformatics, genomics, and proteomics may contribute to finding more genes associated with ROP and may allow discovering better solutions in the management and treatment of ROP.

Age-Related Effects on the Spectrum of Cerebral Visual Impairment in Children With Cerebral Palsy.

BackgroundCerebral Visual Impairment (CVI) is a very common finding in children affected by Cerebral Palsy (CP). In this paper we studied the characteristics of CVI of a large group of children with CP and CVI, describing their neurovisual profiles according to three different age subgroups (subgroup 1: infants 6 months–2 years; subgroup 2: pre-school age 3–5 years; subgroup 3: school age ≥ 6 years).MethodsWe enrolled 180 subjects (104 males, mean age 66 ± 42.6 months; range 6–192 months) with CP and CVI for the study. We carried out a demographic and clinical data collection, neurological examination, developmental or cognitive assessment, and a video-recorded visual function assessment including an evaluation of ophthalmological characteristics, oculomotor functions, and basic visual functions. In school-aged children, we also performed an evaluation of their cognitive-visual profiles.ResultsThere were signs of CVI in all the three subgroups. Subgroup 1 (62 children) and subgroup 2 (50 children) were different for fixation (p = 0.02), visual acuity (p = 0.03) and contrast sensitivity (p < 0.01), being more frequently impaired in younger children. Comparing subgroup 2 with subgroup 3 (68 children), the older children presented more frequently myopia (p = 0.02) while the younger ones esotropia (p = 0.02) and alteration in smooth pursuit (p = 0.03) and saccades (p < 0.01). Furthermore, fixation, smooth pursuit, visual acuity, contrast sensitivity and visual filed (p < 0.01) were more frequently impaired in younger children (subgroup 1) compared to the older ones. Multiple correspondence analysis (MCA) confirmed the different neurovisual profiles according to age: younger children with CP showed more signs of CVI compared to the older ones. 34 out of 68 children belonging to subgroup 3 underwent the cognitive visual evaluation; an impairment of cognitive visual skills was detected in 21 subjects.ConclusionYounger children with CP showed more signs of CVI compared to the older ones, likely for the physiological maturation of visual system and mechanisms of neuroplasticity. In this direction, we suggest an early neurovisual evaluation to detect any weak visual functions.

Descriptive study family informational support for quality of life of visual impairement children in covid-19 pandemic

Family informational support for visually impaired children in quality of life must be a concern during the Covid-19 pandemic. The research aim is to describe the quality of life in physical, psychological, social, and environmental of visual impairment children, also to provide family informational support in Covid-19 pandemic at SLB Negeri Semarang. The method of research is a descriptive study with univariate analytics. The total sample is 25 respondent visual impairment children at SLB Negeri Semarang with their parents. This research is using total sampling. Results from it are most of the respondents with visual impairments have a good physical quality of life is about 21 respondents (84%), psychological quality of life in a good category is about 13 respondents (52%), quality of social life in a good category is about 16 respondent (64%), and environmental quality of life in a bad category is about 13 people (52%). Most respondents as a parent of blind children have a good category in family informational support is about 15 respondents (60%). The conclusion is most of the respondents with visual impairment respondent have a good category for quality of life of physical, psychological, social, and bad category for quality of life environmental. Family informational support with parents respondents mostly has a good category. The recommendation is this research can give concern to parents for always giving a family informational support to increase the quality of life of visually impaired children.

Parents' Awareness and Perception of Children's Eye Diseases in Madinah, Saudi Arabia: A Cross-Sectional Study.

BackgroundThe visual system becomes more susceptible to conditions causing abnormal binocular interaction or blurred visual input as it matures during the first six years of life. Therefore, detection and treatment of visual impairment at a young age can lower the burden of the condition in adulthood. According to estimates, there are 19 million children worldwide with visual impairment, and 1.4 million children suffer from blindness. One of the strategies to address blinding eye conditions and visual impairment is through health promotion. For children, the efficient way of intervention is through parents and their school environment. Therefore, the establishment of an effective health promotion model for addressing childhood blindness requires awareness building of parents and health care practices. Few studies were undertaken in Saudi Arabia to focus on the awareness of parents about childhood eye diseases and visual impairment. The aim of this study is to assess parents’ awareness and perception of children’s eye diseases in Madinah, Saudi Arabia.MethodsThis cross-sectional study was conducted in Madinah, Saudi Arabia, from January to December 2021. A self-administered questionnaire was randomly distributed to parents of children aged 15 and younger via WhatsApp. The survey consisted of four main sections: socio-demographic data, knowledge about eye care, knowledge about eye diseases, and eye care practice.ResultsThe knowledge about eye diseases in children was of excellent grade in 20 parents (3.6%), good in 101 (18.2%), and poor in 434 (78.2%). Knowledge was good in 287 parents (51.7%) for amblyopia, 65 (11.7%) for childhood cataract, and 69 (12.4%) for childhood glaucoma. The attitude regarding children wearing spectacles and undergoing ophthalmic surgery when needed was positive in 427 (76.9%) and 474 (85.4%) parents, respectively. Over half of the participants (58.6%) had visited an ophthalmology clinic for the examination of their children. Doctors, campaigns, and social media were the preferred modes of receiving knowledge. Participants aged 51 years or over (p = 0.022), with a higher income level (p = 0.004), of Saudi origin (p = 0.036), and those with a child with an eye disease (p = 0.001) had significantly higher knowledge scores about childhood eye diseases.ConclusionThe levels of knowledge, practice, and attitude among parents regarding pediatric eye diseases were unsatisfactory. Health promotion through utilizing parents’ preferred modes of media could improve the eye care of children in the study area.

Myopia prevalence in a population-based childhood visual impairment study in North India - CHVI-2.

Purpose:The aim of the study was to determine the prevalence of myopia at the community level.Methods:A population-based, cross-sectional study was planned in 40 clusters among children identified with subnormal vision in the urban community of Delhi. House-to-house visits were conducted for visual acuity screening of 20,000 children aged 0–15 years using age appropriate visual acuity charts. All the children with visual acuity of < 6/12 in any eye in the age group between 3 and 15 years and inability to follow light in age group 0–3 years were referred for detailed ophthalmic examination.Results:A total of 13,572 (64.7%) children belonged to the age group of 6–15 years. Of these, a total of 507 (3.7%) were found to be having myopia (spherical equivalent of -0.50 DS or worse in one or both eyes) with positive association with higher age groups.Conclusion:The estimated prevalence of myopia is 3.7%; the proportion of uncorrected myopia was 45%, which reflects that refractive error services need to be improved further.

Visual Acuity and Ophthalmic Outcomes 5 Years After Cataract Surgery Among Children Younger Than 13 Years

Cataract is an important cause of visual impairment in children. Data from a large pediatric cataract surgery registry can provide real-world estimates of visual outcomes and the 5-year cumulative incidence of adverse events. To assess visual acuity (VA), incidence of complications and additional eye operations, and refractive error outcomes 5 years after pediatric lensectomy among children younger than 13 years. This prospective cohort study used data from the Pediatric Eye Disease Investigator Group clinical research registry. From June 2012 to July 2015, 61 eye care practices in the US, Canada, and the UK enrolled children from birth to less than 13 years of age who had undergone lensectomy for any reason during the preceding 45 days. Data were collected from medical record reviews annually thereafter for 5 years until September 28, 2020. Lensectomy with or without implantation of an intraocular lens (IOL). Best-corrected VA and refractive error were measured from 4 to 6 years after the initial lensectomy. Cox proportional hazards regression was used to assess the 5-year incidence of glaucoma or glaucoma suspect and additional eye operations. Factors were evaluated separately for unilateral and bilateral aphakia and pseudophakia. A total of 994 children (1268 eyes) undergoing bilateral or unilateral lensectomy were included (504 [51%] male; median age, 3.6 years; range, 2 weeks to 12.9 years). Five years after the initial lensectomy, the median VA among 701 eyes with available VA data (55%) was 20/63 (range, 20/40 to 20/100) in 182 of 316 bilateral aphakic eyes (58%), 20/32 (range, 20/25 to 20/50) in 209 of 386 bilateral pseudophakic eyes (54%), 20/200 (range, 20/50 to 20/618) in 124 of 202 unilateral aphakic eyes (61%), and 20/65 (range, 20/32 to 20/230) in 186 of 364 unilateral pseudophakic eyes (51%). The 5-year cumulative incidence of glaucoma or glaucoma suspect was 46% (95% CI, 28%-59%) in participants with bilateral aphakia, 7% (95% CI, 1%-12%) in those with bilateral pseudophakia, 25% (95% CI, 15%-34%) in those with unilateral aphakia, and 17% (95% CI, 5%-28%) in those with unilateral pseudophakia. The most common additional eye surgery was clearing the visual axis, with a 5-year cumulative incidence of 13% (95% CI, 8%-17%) in participants with bilateral aphakia, 33% (95% CI, 26%-39%) in those with bilateral pseudophakia, 11% (95% CI, 6%-15%) in those with unilateral aphakia, and 34% (95% CI, 28%-39%) in those with unilateral pseudophakia. The median 5-year change in spherical equivalent refractive error was -8.38 D (IQR, -11.38 D to -2.75 D) among 89 bilateral aphakic eyes, -1.63 D (IQR, -3.13 D to -0.25 D) among 130 bilateral pseudophakic eyes, -10.75 D (IQR, -20.50 D to -4.50 D) among 43 unilateral aphakic eyes, and -1.94 D (IQR, -3.25 D to -0.69 D) among 112 unilateral pseudophakic eyes. In this cohort study, development of glaucoma or glaucoma suspect was common in children 5 years after lensectomy. Myopic shift was modest during the 5 years after placement of an intraocular lens, which should be factored into implant power selection. These results support frequent monitoring after pediatric cataract surgery to detect glaucoma, visual axis obscuration causing reduced vision, and refractive error.

Childhood Blindness and Visual Impairment in a Local Government Area in North-Central Nigeria: A Key Informant Survey.

To use the Key Informant survey to estimate the magnitude and to identify the major causes of blindness and severe visual impairment in children of Nassarawa Eggon Local Government Area of Nasarawa State, Nigeria. Twenty-eight trained Key Informants traced and referred children believed to be blind or visually impaired. Biodata record, history and eye examination were based on the operational definitions in the WHO/PBL coding instruction manual for childhood blindness. Data were entered and analyzed in the WHO/PBL Childhood Blindness Software (CBS) V 1.2.75 by an ophthalmologist and a statistician. The Key Informants identified 51 children of which 50 (98%) were examined. Eight (16%) of the children examined were blind, another 8 (16%) had severe visual impairment, 16 (32%) were visually impaired, 7 (14%) had monocular blindness and 11 (22%) were normal. The estimated crude prevalence of childhood blindness was 0.01% and of moderate-severe visual impairment was 0.03%. The major causes of blindness and severe visual impairment were cataract, corneal opacity, and refractive errors. Ninety-four percent of the causes of blindness and moderate-severe visual impairment in children were avoidable. It was estimated that some 415 children in Nasarawa state are blind or have moderate to severe visual impairment. The estimated magnitude of blindness and visual impairment in Nassarawa Eggon LGA is 8 and 24 children respectively with a crude blindness prevalence of 0.01% (1 per 10,000). Cataract was the commonest cause of childhood blindness and severe visual impairment in Nassarawa Eggon local government area with 93.8% of the causes of blindness and visual impairment being avoidable.

Relationship between the Children’s Visual Function Questionnaire and psychophysical measures of visual acuity and chromaticity discrimination in older visually impaired children

The Children’s Visual Function Questionnaire (CVFQ) is an instrument to measure the impact of visual impairment in children and their families. It can be used as a research tool to verify the effectiveness of treatment, therapy, and different methods for visual stimulation and rehabilitation. The aim of this study is to describe the relationship between General Health, General Vision Health, Personality, Family Impact, and Treatment – subscales of the CVFQ and psychophysical measures of visual acuity (VA) and chromaticity discrimination (CV). This prospective, cross-sectional study was conducted at the Sensory Psychophysiology Laboratory – University of São Paulo in partnership with the Ambulatory of Visual Stimulation in the Sector of Low Vision and Visual Rehabilitation – Federal University of São Paulo. The children who participated in this study were divided into two groups: study group (SG), composed of 11 children with a diagnosis of visual impairment and mean age of 55.36 months ( SD = 16.88), and control group (CG), composed of 8 children with normal vision and mean age of 64.87 months ( SD = 13.22). Both groups underwent the application of CVFQ, were tested for VA using the Teller Acuity Cards (TAC) test, and CV using the Cambridge Colour Test program for children (CCT Kids). The result of applying the CVFQ to groups of children over 3 years, comparing SG and CG, differences were observed in the following subscales: General Vision Health ( F = 10.00, p &lt; .001); Competence ( F = 7.03, p = .030); Personality ( F = 6.48, p = .010); Total Quality of Life ( F = 11.39, p = .010). These differences show a worse score for the SG. In the VA test using TAC, the data collected in groups of children over 3 years, comparing SG and CG, differences were observed in VA RE ( F = 19.25, p &lt; .001); VA LE ( F = 25.99, p &lt; .001); VA BE ( F = 15.45, p &lt; .001). These differences show worse scores for the SG. In the CV using the CCT Kids, the data collected in groups of children over 3 years, comparing SG and CG, no statistically significant differences for protan, tritan, and deutan groups were observed. For the SG, while for children over 3 years, correlations were found for General Vision Health, Competence, Family Impact, and General Quality of Life. We conclude that there are statistically significant differences when comparing the SG with the CG for the visual function of visual acuity and chromaticity discrimination, and we also demonstrated the sensitivity in the use of CVFQ in reflect VA and CV impairments.

Make it easier: 3-word strategies to help children with cerebral visual impairment use their vision more effectively

IntroductionCerebral Visual Impairment (CVI) is the most common cause of visual impairment in children in the United Kingdom. Management relies on identifying strategies and adaptations which enable the child to use their vision effectively and efficiently. The majority of published strategies involve lengthy inventories used in a specialist setting. Feedback from parent support groups cite the provision of immediate advice on strategies at the time of diagnosis as a key indicator of good care. The aim of the study was to use the Delphi technique to construct a set of three-word phrases to succinctly describe strategies for common visual dysfunctions in children with CVI.MethodA panel of twelve experts across health, education and those with lived experience was recruited. Four rounds of questionnaires were used to reach consensus on candidates symptoms and suggestions for 3-word-phrases. Consensus was defined as 70% agreement.ResultsResponse rates were 92, 67, 92 and 91% for each round respectively. The 3-word phrases reaching consensus were: Big Bold Bright; Keep it Still; Eyes or Ears; Show It High; Better on Left/Right; Clear the Clutter; Keep It Short; Give Me Time, My Vision Varies, Just One Thing.ConclusionThe intention is for the phrases presented to act as a ‘starter’ at the point of diagnosis and are appropriate for children of any developmental or visual ability. The real-life validation of this set of expert-consensus phrases will require further studies, evaluating both their effectiveness in terms of mapping to an intervention and impact on visual development.