Severe Visual Impairment In Children Research Articles

Distribution and causes of blindness and severe visual impairment in children at a tertiary referral centre in Rwanda

AimTo determine the prevalence and the causes of severe visual impairment and blindness (SVI/BL) in children at a tertiary referral centre in Rwanda.MethodsIn this retrospective study, files of all patients...

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.

Cortical Visual Impairments and Learning Disabilities.

Medical advances in neonatology have improved the survival rate of premature infants, as well as children who are born under difficult neurological conditions. As a result, the prevalence of cerebral dysfunctions, whether minimal or more severe, is increasing in all industrialized countries and in some developing nations. Whereas in the past, ophthalmological diseases were considered principally responsible for severe visual impairment, today, all recent epidemiological studies show that the primary cause of blindness and severe visual impairment in children in industrialized countries is now neurological, with lesions acquired around the time of birth currently comprising the commonest contributor. The resulting cortical or cerebral visual impairments (CVIs) have long been ignored, or have been confused either with other ophthalmological disorders causing low vision, or with a range of learning disabilities. We present here the deleterious consequences that CVI can have upon learning and social interaction, and how these can be given behavioral labels without the underlying visual causes being considered. We discuss the need to train and inform clinicians in the identification and diagnosis of CVI, and how to distinguish the diagnosis of CVI from amongst other visual disorders, including the specific learning disorders. This is important because the range of approaches needed to enhance the development of children with CVI is specific to each child’s unique visual needs, making incorrect labeling or diagnosis potentially detrimental to affected children because these needs are not met.

Genetic and clinical findings in a Chinese cohort with Leber congenital amaurosis and early onset severe retinal dystrophy

BackgroundLeber congenital amaurosis (LCA) and early onset severe retinal dystrophy (EOSRD) are clinically and genetically heterogeneous inherited retinal disorders that cause severe visual impairment in children. The objective of this...

Visual impairment in children with cerebral palsy: Croatian population-based study for birth years 2003-2008

AimTo evaluate visual impairment (VI) in children with cerebral palsy (CP).MethodsThis population-based study included 419 children from the Surveillance of Cerebral Palsy in Europe (SCPE) C28 RCP-HR – Register of Cerebral Palsy of Croatia born 2003-2008. Vision in children with CP (according to SCPE) was classified as normal or impaired, with the subcategory of severe VI. The proportion of children with VI was assessed in groups with different CP type/subtype, gross and fine motor function, and gestational age (GA).ResultsA total of 266 children had some degree of VI (266/400; 66.5%), 134 had normal vision, and data on VI were unknown for 19 children. Severe VI was present in 44 children (44/400; 11%). The proportion of children with VI and severe VI increased with the Gross Motor Function Classification System and Bimanual Fine Motor Function levels. Children with bilateral spastic CP had the highest frequency of severe VI (14.9%). The percentage of severe VI in children with bilateral spastic CP was 53.8% in the group born <28 weeks of GA, 13.3% in the group born 28-31 weeks of GA, 11.1% in the group born 32-36 weeks of GA, and 24.4% in the group born >36 weeks of GA (λ2 = 4.95; df = 6; P < 0.001).ConclusionChildren with CP have a high prevalence of VI and severe VI, which is increasing with the level of motor impairment. Severe VI is significantly more common in children with bilateral spastic CP, especially among extremely premature infants.

Ocular morbidity in school children in eastern region of Nepal

Background: Childhood blindness is a priority area because of the number of years of blindness that ensues. Data on the prevalence and causes of blindness and severe visual impairment in children are needed for planning and evaluating preventive and curative services for children.Objective: The aim of the study is to determine the prevalence of ocular morbidity among school children in eastern Nepal.Method: A cross-sectional study was designed to evaluate ocular status of primary school children in six government schools of the eastern region of Nepal. A complete eye examination was carried out in all children including slit lamp examination, fundus examination, retinoscopy and subjective refraction. Data was analyzed using Microsoft excel. The screening is based on the Indiana school vision screening guideline.Results: A total of 847 children were examined in visits. The mean age of study population was 10.25 years. Among them 450 were males and 397 were females. The results showed that 12.05% of the total students had ocular and visual morbidities. Refractive error was found to be the commonest abnormality (62%) in school children. The commonest type of refractive error found in the study was myopia followed by hyperopia. Alternate divergent squint is the commonest type of strabismus. Other abnormalities found were BSV (binocular single vision) abnormalities, amblyopia and conjunctival disorder.Conclusion: The vision screening program has proved to be very helpful in early detection, diagnosis, referral and management of ocular morbidities in school children. The results of the study strongly suggest that screening of school children for ocular problems should be done at regular intervals and it should be one of the prime components of school health program.Journal of Kathmandu Medical CollegeVol. 5, No. 3, Issue 17, Jul.-Sep., 2016, page: 95-97

Paediatric infectious keratitis: a case series of 107 children presenting to a tertiary referral centre

Background/aimsCorneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to...

Estimated Prevalence of Monocular Blindness and Monocular Severe Visual Impairment in Children of Cross Rivers State, Nigeria

Aim : The aim was to report on the prevalence of monocular blindness/monocular severe visual impairment (MB/MSVI) in children found in Cross River State Nigeria, using the key informant method (KIM). Settings and Design : A cross‑sectional study using the KIM. Patients and Methodology : Key informants were trained to identify children with vision problems through recognition of pictures of disease conditions, observation of behavior of the child and discussion with villagers during house to house visits, school visits, church visits, or market visits. They were instructed to bring the children to a predetermined health center for examination by a pediatric ophthalmologist led team. The children were examined, and findings recorded on the World Health Organization/prevention of blindness and low vision recording form for children. Statistical Analysis Used : Data were entered into MS Excel, transferred and analyzed with STATA 11. Results: Among 994 children with suspected visual impairment, 21.5% were diagnosed as MB/MSVI, with a population prevalence of 0.18/1000 children in the state. Males accounted for 61%. The leading anatomical causes were the cornea in 41%, the whole globe in 20%, and lens‑related in 19%. Boys were 2.6 times (95% confidence interval: 1.4–4.7, P = 0.002) more likely to have trauma as an etiology compared with girls. Conclusions : Monocular blindness/monocular severe visual impairment children are essentially “one‑eyed” children at risk of becoming blind individuals. The prevalence of MB/MSVI is 2.25 times that of bilateral blindness and severe visual impairment in children in this population. The main anatomical causes, as well as ocular trauma, are largely avoidable. Trauma that is avoidable was a significant etiology in boys compared with girls. MB/MSVI adds to the burden for child eye care services. Keywords : Child eye care services, monocular blindness, monocular severe visual impairment, Nigeria, ocular trauma

A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India

To identify the major causes of severe childhood visual impairment and blindness among students attending schools for the blind in a coastal district of Andhra Pradesh (AP) in South India. Children ≤ 16 years of age attending six schools for the blind in the study area were interviewed and examined in the year 2009, and causes were classified according to the World Health Organization Program for Prevention of Blindness (WHO/PBL) childhood blindness proforma. A total of 113 children underwent a detailed eye examination by an experienced ophthalmologist. The major causes of blindness were congenital eye anomalies in 46 children (41.4; 95% confidence interval (CI): 32.3-50.6), followed by retinal disorders in 21 children (18.9%; 95% CI: 11.6-26.2), cataract in 9 children (9.7%; 95% CI: 2.9-12.9), and corneal conditions (scar and Staphyloma) in 8 children (7.1%; 95% CI: 2.4-11.8). More than half the children (56.6%) were blind due to conditions that could have been treated or prevented. Congenital anomalies were found to be the most common cause of blindness. The majority of the cases were due to avoidable causes of blindness. Therefore, robust screening measures may help reduce the burden of visual impairment in children.

Causes of childhood blindness in the northeastern states of India

The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region. To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India. Survey of children attending special education schools for the blind in the NER. Blind and severely visually impaired children (best corrected visual acuity < 20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization's reporting form was used to code anatomical and etiological causes of visual loss. Microsoft Excel Windows software with SPSS. A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%). Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies.

Severe visual impairment in children with mild or moderate retinal residua following regressed threshold retinopathy of prematurity

To describe clinical features of patients from the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) trial who, after developing severe ROP in infancy, had minimal or moderate retinal residua in at least one eye but a visual acuity of worse than 20/200 in both eyes at the 10 year examination. Data from the 10 year CRYO-ROP Trial follow-up exams were evaluated to identify all patients with retinal outcomes of no retinopathy of prematurity (ROP) residua, straightened temporal vessels, or macular heterotopia in at least one eye, but visual acuity less than 20/200 in both eyes. Presence of optic atrophy, nystagmus, and optic disk cupping and developmental survey results were examined. Of 247 patients examined at 10 years, 16 met our inclusion criteria. At the last age at which the following data were recorded, seven had optic atrophy at the 10 year examination, one had optic disk cupping >0.5 at the 5(1/2) year examination, and eight had nystagmus under binocular conditions at the 24 month examination. Nine patients had a below-normal developmental test score on the Functional Independence Measure for Children (WeeFIM). After clinical data interpretation, we concluded that the predominant cause of visual impairment was postgeniculate disease in five patients, ROP in six patients, and combined anterior and posterior visual pathway disease in two patients; in three patients data were insufficient to make a determination. Poor visual function with mild to moderate retinal residua of severe ROP in at least one eye is relatively rare. In such patients, anterior, posterior, or combined visual pathway disease can occur.

Prevalence of optic atrophy and associated ocular and systemic diseases in a department of paediatric ophthalmology

Optic atrophy is one of the most common causes of severe visual impairment in children. So far an analysis of ocular and systemic findings comparing patients with and without optic atrophy has not performed. Ocular and systemic findings of a total of 1042 patients (examination of all patients in May 1995 [N = 485] and May 2001 [N = 557]) of the department of paediatric ophthalmology in Homburg/Saar were retrospectively evaluated and diagnoses of patients with and without optic atrophy were compared. Optic atrophy was diagnosed ophthalmoscopically and in 1/3rd of the patients by VEP as well. 18 % of all patients (N = 188; 87.2 % [N = 164] were children) had optic atrophy. Nearly half of these children were prematurely born (46.7 %). 53.2 % of patients with optic atrophy (N = 88) showed nystagmus (without atrophy: 10.7 %), especially sensory defect nystagmus. Median of visual acuity level was 0.2 with optic atrophy and 0.8 without. Albinism and buphthalmia were common findings. 69.5 % of all patients with optic atrophy suffered from systemic diseases (without atrophy: 25.2 %), especially mental retardation, neurologic findings and oculocutaneous albinism. In 10.4 % more than two systemic diagnoses could be found. 55.3 % of all the patients with optic atrophy were disabled, 31.9 % multiply disabled. Sequelae of prematurity, peripartal asphyxia and congenital brain damages are the main findings in patients with optic nerve atrophy. Such children are worst-case patients of any paediatric ophthalmology department with a high prevalence of severe visual impairment, mental retardation and multiple disability. Treatment in a specialised center is therefore necessary for an efficient therapy. In addition, the statistical survey shows that in children who survived the critical phases of prematurity secondary damages can lead to persistent impairment and to alterations of visual and general development.

Causes of childhood blindness in the People’s Republic of China: results from 1131 blind school students in 18 provinces

AIMSTo determine the anatomical site and underlying causes of blindness and severe visual impairment in children under 16 years of age in special education in the People’s Republic of China...

Prevalence of visual impairment in children: A review of available data

Data on the prevalence, magnitude and causes of blindness and severe visual impairment in children are needed for planning and evaluating preventive and curative services for children, and for planning special education and low vision services. Prevalence data can be obtained from a variety of different sources, each of which has limitations. The available data suggest that there may be a ten-fold difference in prevalence between the wealthiest countries of the world and the poorest, ranging from as low as 0.1/1000 children aged 0-15 years in the wealthiest countries to 1.1/1000 children in the poorest. In this paper, the available data are reviewed and the epidemiological methods and findings are discussed.

Visual impairment in Nordic children. III. Diagnoses.

The diagnoses, according to type and site and the degree of visual impairment, responsible for severe visual impairment in children below the age of 18, were analyzed in a material compiled from the national registers of visually impaired in Denmark, Finland, Iceland and Norway. Among 2527 children the predominant causes of visual impairment are ascribed to congenital malformations, neuro-ophthalmological diseases and retinal diseases. Optic atrophy is the leading single cause of severe visual impairment when all diagnoses are compared, and this also applies when all categories of visual impairment are included. Retinopathy of prematurity is the second principal cause of severe visual impairment, while cerebral amblyopia rates as the third most significant cause. Congenital cataract is also of considerable importance when all categories of visual impairment are compared. The differences registered between the Nordic countries were found to be within reasonable limits, except for a preponderance of neuro-ophthalmological diseases in the Danish material. This could be explained by a better medical supervision of mentally retarded patients in Denmark. Additional impairments occur in a large percentage of patients, but are unevenly distributed in the disease groups. A high frequency of additional impairments are found in the neuro-ophthalmological group and in the groups with congenital malformations, emphasizing the importance of a multidisciplinary evaluation when dealing with the visually impaired child.

Causes of severe visual impairment in children and their prevention

Concerning the fact that regarding causes of congenital visual impairment or visual impairment occurring during the first years of life, especially on the aetiology many problems have never been resolved, on instigation of The Netherlands a "Committee for the special study of severe visual impairment in children" has been founded by the International Association for Prevention of Blindness. The intention was that provisionally in this committee only 5 small West European countries should be represented, having more or less the same social and hygienic conditions, so that one could expect that comparison of the gained information in these countries should give some results concerning the aetiology. The contributing countries were: Belgium, Denmark, Sweden, Norway, and The Netherlands. For this purpose criteria for definition of severe visual impairment, a questionnaire and a codinglist were drawn up. The classification scheme of causes of blindness and partial sightedness of the I.A.P.B. was utilized for answering the questions "by site and type and by aetiology" of the eye affections. The total number of children who were involved in the investigation was 4306. The investigation confirmed that heredity still occupies the first place in the aetiology of the congenital severe visual impairment. Moreover, the investigation could prove that besides the already known role of rubella, toxoplasmosis and dysoxygenation, probably also other affections occuring during pregnancy, prematurity, and too low birth weight (dysmaturity) and birth injuries, like asphyxia of the new-born child, are of great importance. Probably there is a correlation with certain eye affections (cataracta congenita and optic nerve atrophy). Attention is paid to the possibilities of prevention. From the results it appears that a renewed investigation is necessary where one should have to dispose of more and especially more reliable information concerning pregnancy and delivery. Suggestions in this direction are given.

The prevalence of severe visual impairment in children in the Netherlands.

The prevalence of severe visual impairment in children in the Netherlands.

Causes of severe visual impairment in children and their prevention

Causes of severe visual impairment in children and their prevention