Low Vision In Children Research Articles

Diagnosis of color vision in children with congenital partial atrophy of the optic nerve

Background. The study of color vision is of great importance in the diagnosis and monitoring of visual functions in patients with of the partial atrophy of optic nerve (PAON). Due to the fact that PAON is one of the main causes of blindness and low vision in children, there is no doubt about the importance of effective diagnosis of color vision not in children with this pathology.Purpose: to evaluate the effectiveness of the diagnosis of color vision in children with congenital partial atrophy of the optic nerve using developed own tests in comparison with classical methods. The Rabkin and Neitz-test tables create conditions under which the examined child is given two tasks at once – color discrimination and shape identification. At the same time, the integration of information about color and shape may be difficult in children with PAON.Materials and methods. In 2020–2022 years 72 school-age children were observed, who, after a standard ophthalmological examination, were divided into two groups: 1) 37 children with congenital bilateral PAON; 2) 35 children of the control group with no pathology of the fundus and normal indicators of visual functions. To study color vision, we used our own developed test images (Patent RU 2760085 of 02.04.2021), as well as classical tests – polychromatic tables E.B. Rabkin and Neitz-test.Results. In the control group, when studying color vision according to Rabkin tables, four children had some difficulties with determining the shape of test figure in three of the 27 main tables. At the same time, the children named the colors of individual circles that make up the images correctly. In the Neitz-test, only one child did not distinguish between the shapes of brown and green tones of minimal saturation. The other children correctly identified the colored shapes in all the test images. The study with the developed tests did not cause any difficulties for any of the children of the control group. With minimal saturation, all children distinguished chromatic images from achromatic ones and correctly distinguished shades. In the group of children with PAON in the study with classical tests, 15 (40.5%) children experienced significant difficulties with determining the shape of the test figure in some Rabkin tables (while correctly naming the colors of individual circles) and 12 (32.4%) children – in Neitz-test images. Normal trichromasia was detected in 18 (48.6%) children and in 4 (10.8%) children – abnormal trichromasia according to both Rabkin’s tables and Neitz-test. With the developed tests, 6 (16.2%) children had color vision disorders. At the same time, abnormal trichromasia was detected in 4 of them according to the Rabkin and Neitz-test tables.Conclusion. The test images developed by us are easy to perform and do not pose a difficult visual task for the child to identify the chromatic shape. In this regard, they allow for effective diagnosis of color vision in children in normal and ophthalmopathology, and are also promising for use in children not only of school age, but also of younger age.

Standardize the laser and anti-vascular endothelial growth factor treatment of retinopathy of prematurity

Retinopathy of prematurity (ROP) is a retinal vascular proliferative disease occurring in premature and low birth weight infants, which is the leading cause of blindness and low vision in children. Laser photocoagulation is still recognized as the gold standard of treatment in ROP. Recently, anti-vascular endothelial growth factor (VEGF) therapy has become a novel alternative approach in clinical practice for ROP. However, there are still many improper and deviations in identifying indications and selecting therapeutic modalities, resulting in generalization and abuse of anti-VEGF drugs in treatment of ROP. The aim of this article is to summarize and objectively evaluate the treatment indications and methods of ROP based on related research at home and abroad, in order to strictly control the theraputic indications and scientifically and rigorously select appropriate therapeutic modalities for the benefit of children with ROP.

Outcome of Visual Acuity Rehabilitation of Low Vision in Children after Congenital Cataract Surgery: A Case Series

Congenital cataract is the major cause of treatable visual impairment in children. The first 6 weeks of children’s age is the critical period for visual experience. Based on this, it is suggested that surgery in congenital cataract cases should be performed as soon as possible. The visual outcome after cataract surgery depends on the surgeon, the age of the children, and other visual conditions. Management of the visual rehabilitation in this case is very challenging. Most of the problem after congenital cataract surgery is amblyopia. The purpose of this paper is to report the visual acuity outcome after visual rehabilitation of children who had been performed cataract surgery. This case is a case series of the visual acuity outcome of children who had been performed bilateral cataract congenital surgery in dr Syaiful Anwar Hospital, Malang, Indonesia . The data was obtained from medical record and we compared the visual acuity before and after visual rehabilitation and the outcome based on their timing when they were performed the surgery and the visual acuity correction was obtained. There were 5 cases; 4 cases was bilateral aphakia because of microcornea and 1 case was bilateral pseudophakia with high myopia. Their ages ranged fom 20 months – 12 year old. Most of the children got spectacle for their visual acuity rehabilitation and the power of pectacle lens was based on streak retinoscopy. The aphakia and pseudophakia children obtained better visual acuity after visual rehabilitation. The younger the age in which they underwent surgery and the earlier they got visual correction after cataract surgery the better their visual acuity outcome will be. The success of visual rehabilitation depends on ocular condition, age, the visual rehabilitation technique and the compliance of the patients and the parents.

Causes of low vision in children: A systematic review

ObjectiveTo identify the ocular pathologies that are reported as causes of low vision in children. Material and methodsThe systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0−18 years of age, reporting visual acuity data between 20/60–20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. Results27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. ConclusionsCataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population.

Causas de la baja visión en los niños: revisión sistemática

ObjectiveTo identify the ocular pathologies that are reported as causes of low vision in children. Material and methodsThe systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. Results27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. ConclusionsCataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population.

Demographic Characteristics and Causes of Low Vision in Children: A Hospital–Based Study from Khartoum, Sudan

Purpose: To determine the demographic characteristics and causes of low vision in children who attended Alfaisal eye center, Khartoum Sudan.
 Place and Duration of Study: Alfaisal eye Center, Khartoum, Sudan, from February 2018 to October 2020.
 Study Design: Cross sectional observational study.
 Methods: Clinical record of 105 patients who visited the low vision clinic were retrieved. Demographic features, history, ocular examination, cause of low vision, refractive state of the eye (by self-luminance streak retinoscope, and auto refractometer), and type of low vision devices used by the patients were noted. Data was analyzed by using SPSS software version 20.
 Results: Mean age was 11.70 ± 2.19. Seventy three percent patients had Visual Acuity(VA) less than 6/60. Majority (59%) were male patients. Commonest refractive error associated with low vision was myopia (65.71%). Retinitis Pigmentosa, congenital glaucoma, and albinism were other major causes of pediatric low vision (19.5%). Progressive Myopia was seen in 15%. About 9.5% of children presented with cataracts, nystagmus in 9.5%, and congenital refractive error in 9.5%.The cause of low vision among children was not statistically different between males and females P=0.890. More than half of the children 78.1% used glasses and about 21.9% were corrected by telescope.
 Conclusion: Retinitis pigmentosa, albinism, and congenital glaucoma were the most common causes of pediatric low vision. Common low vision devices prescribed to these children were glasses and telescopes.
 Key Words: Retinitis Pigmentosa, Congenital glaucoma, Albinism, Myopia, Cataract.

Clinical Profile of Low Vision in Children

Introduction: Visual impairment in children is more common in developing countries like Nepal. A low vision service has been found to be effective in significantly improving their overall development and quality of life. The main aim of this study was to determine the causes of low vision in pediatric population along with their refractive error distribution and visual functions. Methods: A descriptive cross sectional study was carried out in Tribhuvan University, BP Koirala Lions Center for Ophthalmic Studies. A total of 50 low vision children were under went detail low vision examination. They were selected through purposive sampling. Data was analyzed by using the descriptive and inferential statistics with SPSS version 19.0. Results: The study findings showed, most common cause of visual impairment in low vision children was refractive error (20%), followed by congenital cataract (18%) and macular dystrophy (16%). The most commonly prescribed low vision device for distance was telescope and for near was spectacle magnifier. There was average acuity improvement of five lines in distance visual acuity with low vision devices. Conclusion: The study concluded that refractive error and congenital cataract being the commonest cause of low vision in children, which reflect poor accessibility of care service among Nepalese children. Refractive error, the major cause of visual impairment could have been managed even in primary eye care center in Nepal. Children with impairment have potential visual acuity that can be improved with low vision services.

MANAJEMEN LOW VISION PADA ANAK USIA SEKOLAH

Low vision according to the World Health Organization (WHO) is a person who has impaired visual function after treatment or standard refraction correction and has visual acuity less than 6/18 (20/60) until the light perception or field of view is less than 100 from the fixation point and is still can use residual vision to perform certain activities. Low vision cases according to WHO is 3-4 times greater than cases of blindness. The prevalence of blindness in children varies from region to region or country, ranging from 0.15 to 1.5 per 1000 children. Of the 1.4 million children who are blind, 90% are in developing countries. In addition, there are 7 million low vision children. The prevalence of low vision in children is 11 times more than blindness in children. Low vision in children can be caused by eye abnormalities both congenitally and including cataracts, glaucoma, retinitis pigmentosa, clouding of the cornea, and retinopathy of prematurity (ROP). The clinical symptoms are blurred vision, limited field of view, accompanied by functional complaints such as decreased contrast sensitivity, glare, and color vision disorders so that visual aids are needed in low vision. Low vision examination consists of anamnesis, visual acuity measurement (examination of visus distance and close range), visual field examination, contrast sensitivity test, glare examination, and color blindness test. In this paper, we report cases of low vision in children where the management uses low vision aids according to their needs. Keywords : low vision, etiology, clinical symptoms, examination, low vision aids , management

PSEUDOEXPHOLIATIVE SYNDROME

Today, the clouding of the lens is one of the common pathology of the organ of vision. The clouding of the lens-cataract is one of the most common causes of blindness and low vision in children and adults. According to most authors, the main method of cataract treatment is surgical. In modern cataract surgery, the leading place is occupied by the most common cataract extraction method, phacoemulsification. The modern level of phacoemulsification technology made it possible to perform operations less traumatic, gave a full restoration of visual functions. It makes no sense to talk about the indications of IOL implantation, since Currently, there is a wide range of IOL models that can be implanted for all types of complicated cataracts. It is advisable to talk about contraindications, in this case, the surgeon makes a decision based on the material capabilities, experience, and perfection of the surgical technique. There are various associated syndromes in the development of cataracts. One of the syndromes that occurs in cataracts is the pseudo-excoliation syndrome. This review addresses the unresolved issues of pseudoexfoliation syndrome. The results of studies of some scientists, data analysis, clinical cases and ways to solve this problem are considered. In particular, a number of questions remain about the tactics of patient administration before and after surgical interventions. This syndrome, as far as we know, affects the development and outcome of the disease. It is sometimes difficult to diagnose pseudo-excoliation syndrome at an early stage, sometimes contradictory statements about the initial appearance of the syndrome are encountered. The issues of prevention of postoperative complications, less traumatic surgical approaches at various stages of PES remain open.

Epidemiology of Childhood Blindness and Low Vision in Kinshasa–democratic Republic of the Congo

ABSTRACTPurpose: To determine the magnitude and causes of blindness and low vision in children in Kinshasa.Methods: A study was conducted to carry out a survey in 96 health areas in Kinshasa city. Children aged less than 16 years old with supposed visual problems (Visual acuity < 6/18) were identified by volunteers and surveyors in households and were thereafter examined by two ophthalmologists. Prevalence and causes of blindness and low vision were determined. For each child, anatomic sites of abnormality, etiologic factors and avoidable causes responsible for visual impairment were considered.Results: Thirty-six children with bilateral visual impairment were identified, including 10 cases of blindness and 26 cases of low vision. The prevalence of blindness and low vision was, respectively, 0.08% [95% CI 0.04–0.14] and 0.19% [95% CI 0.13–0.28].Optic nerve and whole globe were the main anatomical sites responsible for blindness in, respectively, in 30% and 20%. Optic nerve atrophy and glaucoma were the leading causes of childhood blindness. The globe apparently normal (50%), uvea (12%) and cornea (12%) were the most common anatomic site responsible for low vision with refractive errors (42%) and uveitis (12%) as the main causes. Childhood and hereditary factors accounted for, respectively, 16.7% and 13.9% of low vision cases. Visual impairment was due to avoidable causes in 69.4% of children.Conclusion: Damage to the optic nerve and refractive errors were respectively the maincauses of blindness and low vision among children in Kinshasa.

Final versus referral diagnosis of childhood visual impairment in an Italian tertiary low vision rehabilitation centre

To compare the final diagnosis of the causes of low vision in children attending a tertiary rehabilitation centre for visually impaired children versus referral diagnosis. Retrospective review of clinical charts of all children referred to the Robert Hollman Foundation, a tertiary centre for visually impaired children, between January 2010 and June 2011. The following clinical data were analysed: entry diagnosis made by the referral ophthalmologist and final diagnosis made at Robert Hollman Foundation based on a complete ophthalmic evaluation. Ninety-two consecutive children (mean age = 2.37 ± 1.98 years, range = 0-9) were included. A referral diagnosis was retrieved in 76 cases (82.6%), including cerebral visual impairment (14.1%), retinopathy of prematurity (14.1%), hereditary retinal diseases (10.9%), nystagmus (8.7%) and other rarer diseases (34.8%). In the remaining 16 children (17.4%), a precise referral diagnosis was unavailable. Final clinical diagnosis made at Robert Hollman Foundation was normal visual function in 8.7%, cerebral visual impairment in 30.4%, retinopathy of prematurity in 10.9%, hereditary retinal disease in 9.8% and other in 40.2%. In 17 cases (18.5%), the diagnosis made at the Robert Hollman Foundation did not confirm the entry diagnosis. Among patients where measurement of visual acuity was possible (84), 66.7% were blind or seriously visual impaired, and the main causes were cerebral visual impairment (32.1%) and retinopathy of prematurity (16.1%). The most frequent diseases were cerebral visual impairment, retinopathy of prematurity and hereditary retinal diseases. Approximately one-third of referred children had not a correct diagnosis at baseline. The activity of an ophthalmic tertiary centre is essential to offer a precise diagnosis to visually impaired (sometimes with other deficits) children.

Game accessibility guidelines for people with sequelae from macular chorioretinitis

Macular chorioretinitis is an ocular inflammation that may cause the permanent loss of the central vision. Researches indicate that the formation of macular scars, the potential sequela of that inflammation, is the leading cause of low vision in children. As we found no game accessibility guidelines in the literature that were specific to users with central vision loss in a preliminary review, this study thus aimed at surveying guidelines targeted at players with low vision. They were extracted through a systematic literature review conducted on digital libraries. There were some known guidelines that were not in the results of the systematic literature review and therefore we made a manual selection of other relevant sources. We also proposed a new guideline related to the sharpness of images because it was deemed important to improve game accessibility to the public concerned and it had not been presented in the literature. In total, we identified 25 general game accessibility guidelines for people with low vision, plus the one we proposed, and 20 of them were considered applicable to people with macular scars. Afterwards, based on classifications available in the literature and on the experience of the authors as developers, we assessed the feasibility of each guideline according to their impact, reach and an estimation of their implementation cost. The survey also confirmed that no guideline existed that was specific to players with central vision loss. In order to evaluate the new guideline and one of those identified in the literature from the player perspective, we developed a game prototype which implemented both. A qualitative analysis conducted with the game prototype indicated that the evaluated guidelines are applicable to the public concerned. We expect the results of this research to serve as a step towards determining how to make games more accessible to players with sequelae from macular chorioretinitis.

Reading performances of low vision children after using low vision aid

Introduction/Objective. The objectives of the paper are to assess the causes of low vision (LV) in pediatric population in Montenegro and to evaluate the influence of low vision aids (LVA) on reading performance regarding the speed of reading and the understanding of the read text. Methods. A prospective study was conducted on 40 ?treatable? LV children what represent all registered LV children in Montenegro. All participants read the same text before and after using LVA. Reading rate was calculated as the number of words read per minute. Functional speed of reading was calculated as the ratio of the rate of reading and the understanding of the read text multiplied by 100. Results. The study comprised 40 LV children with the mean age of 12.60 ? 4.06 years (20 boys and 20 girls). The most common cause of LV in children were premature retinopathy (10/40 or 25%), retinitis pigmentosa (8/40 or 20%), optic nerve anomaly (5/40 or 13%), degenerative myopia (4/40 or 10%), macular dysgenesis (4/40 or 10%), Stargardt disease (3/40 or 7%), optic nerve atrophy (2/40 or 5%), and albinism (2/40 or 5%). Nystagmus was found in 11 LV children or 28% of the group. LVA were prescribed to all of them. Reading speed before vs. after LVA use was 36.58 ? 35.60 vs. 73.83 ? 27.05 words/minute (p &lt; 0.001), while functional reading was 26.00 ? 30.43 vs. 59.41 ? 29.34 (p &lt; 0.001). Conclusion. LV children demonstrate a significant improvement in reading performance by using LVA.

Childhood amblyopia: current management and new trends.

With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can improve visual acuity, with residual amblyopia treated by part-time occlusion or pharmacological blurring of the better-seeing eye. Treatment after the end of the conventional 'critical period' can improve vision, but in strabismic amblyopia carries a low risk of double vision. It is not clear whether earlier vision screening would be cost efficient and associated with better outcomes. Optimization of treatment by individualized patching regimes or early start of occlusion, and novel binocular treatment approaches may enhance adherence to treatment, provide better outcomes and shorten treatment duration. Binocular treatments for amblyopia. Impact of amblyopia on education and quality of life; optimal screening timing and tests; optimal administration of conventional treatments; development of child-friendly, effective and safe binocular treatments.

Novel genetic causes for cerebral visual impairment.

Cerebral visual impairment (CVI) is a major cause of low vision in children due to impairment in projection and/or interpretation of the visual input in the brain. Although acquired causes for CVI are well known, genetic causes underlying CVI are largely unidentified. DNAs of 25 patients with CVI and intellectual disability, but without acquired (eg, perinatal) damage, were investigated by whole-exome sequencing. The data were analyzed for de novo, autosomal-recessive, and X-linked variants, and subsequently classified into known, candidate, or unlikely to be associated with CVI. This classification was based on the Online Mendelian Inheritance in Man database, literature reports, variant characteristics, and functional relevance of the gene. After classification, variants in four genes known to be associated with CVI (AHDC1, NGLY1, NR2F1, PGAP1) in 5 patients (20%) were identified, establishing a conclusive genetic diagnosis for CVI. In addition, in 11 patients (44%) with CVI, variants in one or more candidate genes were identified (ACP6, AMOT, ARHGEF10L, ATP6V1A, DCAF6, DLG4, GABRB2, GRIN1, GRIN2B, KCNQ3, KCTD19, RERE, SLC1A1, SLC25A16, SLC35A2, SOX5, UFSP2, UHMK1, ZFP30). Our findings show that diverse genetic causes underlie CVI, some of which will provide insight into the biology underlying this disease process.

Risk Factors of Low Vision in Children

Low vision and blindness is a vision disorder that becomes an important issue with regard to a person's independence. According to data owned by the World Health Organization in 2011, the number of blind people in the world reached 39 million, 246 million for low vision and 285 million for blindness. The purpose of this study was to know the incidence of risk factors in children with low vision in Low Vision Service Center Pertuni Yogyakarta, Indonesia. This study was an observational analytic study employed cross sectional design. The subject participated in this study was 139 children. Data were analyzed using correlation analysis. The instrument used was check list. There were relationships between the sex with low vision (p = 0.028, RR = 1.308), there was no relationship between regular eye checkup with low vision incidence (p = 0.801, RR = 1.054). There was relationship between the use of vision aids with low vision (p = 0.000, RR = 0.640), there was a relationship between the cataract with low vision (p = 0.000, RR = 1.472), there was a correlation between the refractive disorderwith low vision (p = 0.000, RR = 0.625).There should be an awareness of health behaviours in the use of vision aids as needed and balanced diet with sufficient physical activity and regular.

Risk Factors of Low Vision in Children

Low vision and blindness is a vision disorder that becomes an important issue with regard to a person's independence. According to data owned by the World Health Organization in 2011, the number of blind people in the world reached 39 million, 246 million for low vision and 285 million for blindness. The purpose of this study was to know the incidence of risk factors in children with low vision in Low Vision Service Center Pertuni Yogyakarta, Indonesia. This study was an observational analytic study employed cross sectional design. The subject participated in this study was 139 children. Data were analyzed using correlation analysis. The instrument used was check list. There were relationships between the sex with low vision (p = 0.028, RR = 1.308), there was no relationship between regular eye checkup with low vision incidence (p = 0.801, RR = 1.054). There was relationship between the use of vision aids with low vision (p = 0.000, RR = 0.640), there was a relationship between the cataract with low vision (p = 0.000, RR = 1.472), there was a correlation between the refractive disorderwith low vision (p = 0.000, RR = 0.625).There should be an awareness of health behaviours in the use of vision aids as needed and balanced diet with sufficient physical activity and regular.

Changes in causes of low vision between 1988 and 2009 in a Dutch population of children

Causes of low vision in the Netherlands may have changed over time. The purpose of this study is to assess trends over the last two decades. Socio-demographic and medical data, including ophthalmic diagnosis and inheritance patterns for 2843 children with low vision (0-21 years; 50% representation) referred to a Dutch institute for low vision (Bartiméus) over a 21-year period between 1988 and 2009, were included in the analysis. For the 19 most common diagnoses, inheritance and presence of mental impairment, trend analyses were performed with logistic regression models; odds ratios (OR) for a 10-year time span were reported. Cerebral visual impairment (CVI) was found in 27.2% (97% mental impairment), albinism in 8.0%. Over time, nystagmus (6.6%; OR = 1.42), retinitis pigmentosa (2.9%; OR = 1.61), cone-rod dystrophy (2.6%; OR = 1.98) and hyperopia (2.0%; OR = 3.66) increased significantly. Cataract (4.9%; OR = 0.64), aniridia (1.6%; OR = 0.42) and retinopathy of prematurity (ROP; 2.0%; OR = 0.45) decreased significantly. There was a significant increase in genetic disorders (41.0%; OR = 1.49) and in co-occurrence of mental impairment (52.2% OR = 1.16). In the last two decades, treatable or preventable disorders (such as cataract and ROP) have become a less common cause of low vision in children. However, the prevalence of complex (genetic) and untreatable disorders (CVI) has taken its place, as a result of increased survival of preterm and low birth weight children and improved diagnostic possibilities. Knowledge of the prevalence of low vision, its causes and trends over time may help policy makers to define effective intervention strategies and to monitor its impact.

Low vision in children and adolesents: Hospital based study

One thousand five hundred clinical recordswere chosen from the Medical Records Department of the eye clinic, Central Hospital, Benin, Edo State between 2000 and 2004 by cluster random sampling method. Data was classified according to the different etiologies of low vision, gender, congenital and acquired causes, anterior and posterior anomalies and according to World Health Organization's classification. Of the 246 found aged below 20yrs, 37 (15.04%) had low vision. The prevalence of low visionwas thus 15.04%.The leading cause of lowvision was cataract (23.32%).Myopia and optic atrophy contributed 16.22% respectively, aphakia/dislocated lens, 13.51%. retinitis pigmentosa 10.81%, macula degeneration 5.41%, glaucoma and nystagmus 2.70% respectively and the unknown cause 8.11%. 64.86% had moderate low vision, 10.81% was in the profound low vision group, 13.51% was in the near total blindness group, while 7.92% had unilateral loss of vision. 15.76% males were involved while females were 43.24%. Acquired anomaly was 1(2.70%) and posterior segment anomalies were 22(59.46%) respectively.Asignificant difference was found between the congenital causes of low vision and the acquired (P>0.05), congenital causes lead to more low vision cases. There was no significant difference in the sexes (P

Causes of visual impairment in children with low vision.

To determine the main causes of visual impairment in children with low vision. To assess the need of spectacles and low vision devices (LVDs) in children and to evaluate visual outcome after using their LVDs for far and near distance. Observational study. Khyber Institute of Ophthalmic Medical Sciences, Peshawar, Pakistan, from June 2006 to December 2007. The clinical record of 270 children with low vision age 4-16 years attending the Low Vision Clinic were included. All those children, aged 4-16 years, who had corrected visual acuity (VA) less than 6/18 in the better eye after medical or surgical treatment, were included in the study. WHO low vision criteria were used to classify into visually impaired, severe visually impaired and blind. Results were described as percentage frequencies. One hundred and eighty nine (70%) were males and 81 (30%) were females. The male to female ratio was 2.3:1. The main causes of visual impairment included nystagmus (15%), Stargardt's disease (14%), maculopathies (13%), myopic macular degeneration (11%) and oculocutaneous albinism (7%). The percentages of visually impaired, severe visually impaired and blind were 33.8%, 27.2% and 39.0% respectively. Spectacles were prescribed to 146 patients and telescopes were prescribed to 75 patients. Spectacles and telescope both were prescribed to 179 patients while Ocutech telescope was prescribed to 4 patients. Retinal diseases nystagmus and macular conditions were mainly responsible for low vision in children. Visually impaired children especially with hereditary/congenital ocular anomalies benefit from refraction and low vision services which facilitate vision enhancement and inclusive education.