Visual Impairment In Children Research Articles

Primary congenital glaucoma (PCG) surgery often leaves residual visual impairment in children. Evidence comparing rigid gas-permeable contact lenses (RGPCLs) vs spectacles for rehabilitation is needed. To compare the use of RGPCLs vs continued spectacle wear for improving visual outcomes for children after PCG surgery. This randomized clinical trial was conducted at Zhongshan Ophthalmic Center, a tertiary referral center in Guangzhou, China, from April 21, 2022, to August 21, 2023. Participants comprised 56 children (aged 4-15 years) with surgically managed PCG and poor spectacle response. Data were analyzed from October 11, 2023, to March 21, 2024. RGPCLs (n = 29) vs spectacles (n = 27) for 12 months, plus standardized amblyopia patching. The primary outcome was change in worse-eye best-corrected visual acuity (BCVA) at 12 months measured by the Early Treatment Diabetic Retinopathy Study chart with tumbling-E optotypes with children wearing their current best refractive correction. Secondary outcomes included contrast sensitivity function and near stereoacuity. Among 56 (of a total of 83 screened participants) randomized participants, 48 (85.7%) completed at least 1 follow-up visit and were included in the primary analysis. Baseline demographic and ocular characteristics for the RGPCL group vs the spectacles group included a mean (SD) age of 7.7 (2.7) vs 7.2 (3.2) years, 13 (54.2%) vs 14 (58.3%) male, and 11 (45.8%) vs 10 (41.7%) female. At 12 months, 22 of 29 participants (76.0%) in the RGPCL group and 19 of 27 participants (70.4%) in the spectacles group completed the final visit. The mean (SD) baseline worse-eye spherical equivalent was -6.55 (6.43) vs -5.17 (5.27) diopters, the mean (SD) BCVA was 0.99 (0.71) vs 1.02 (0.74) logMAR (approximate Snellen equivalent 20/200), and the mean (SD) intraocular pressure was 14.98 (3.14) vs 13.36 (3.92) mm Hg in the RGPCL vs the spectacles group, respectively. At 1 year, the RGPCL group had greater BCVA improvement (mean [SD], 0.31 [0.28] vs 0.12 [0.33] logMAR; adjusted treatment difference, -0.19 logMAR; 95% CI, -0.36 to -0.02 logMAR [approximately 10 letters]; P = .03). Achievement of 2 or more lines of BCVA improvement occurred in 15 of 24 participants (62.5%) in the RGPCL group vs 9 of 24 participants (37.5%) in the spectacles group (odds ratio, 6.83; 95% CI, 1.81-25.73; P = .01). The RGPCL group had greater contrast sensitivity function improvement (0.40 [0.27] vs 0.13 [0.32]; adjusted treatment difference, 0.24 log units; 95% CI, -0.01 to 0.49; P = .04). Near stereoacuity of 60 arcseconds or less was achieved by 12 participants (50.0%) vs 6 of 24 participants (25.0%) (odds ratio, 6.96; 95% CI, 2.41-6.51; P = .001). No serious adverse events occurred. These findings suggest that RGPCLs provided superior visual acuity and contrast sensitivity improvement vs continued spectacle wear for children after PCG surgery. These findings support using RGPCLs for children undergoing PCG surgery, including those with worse baseline visual acuity or poor spectacle response. Chinese Clinical Trial Registry Identifier: ChiCTR2100043776.

Introduction: Refractive errors arise when the eye’s optical system fails to properly focus incoming light onto the retina, resulting in blurred vision. They represent one of the most common and preventable causes of childhood visual impairment. This study aimed to assess the level of knowledge, attitudes, and practices related to refractive errors among school-going children in selected schools within the Chittagong Metropolitan Area, Bangladesh. Objective: To evaluate the awareness, perception, and behavioral practices concerning refractive errors among school children in the selected study area. Methodology: A descriptive cross-sectional design was adopted, involving 150 respondents. Data were gathered using a pre-tested and structured questionnaire administered through face-to-face interviews. Results: More than half of the participants (50.67%) reported being aware of refractive errors, with most (38.67%) gaining information from their parents. Approximately 52.5% of respondents were affected by refractive errors, while 52.67% reported having subnormal vision. Spectacles were identified by 52% as the preferred corrective measure. Eye examinations were common among 65.33% of students, and 64.29% had their vision checked regularly. A majority (58%) expressed positive attitudes toward individuals wearing spectacles. The primary perceived cause of refractive errors was the “use of electronic devices” (35.33%), though 32.67% were unaware of any causes. Vitamin A supplementation was reported by 57% of respondents. The most common sources of eye checkups were specialized eye hospitals (39.79%) and private ophthalmic clinics (34.69%). Regarding correction habits, 60.21% wore their glasses consistently, while 38.67% preferred using contact lenses in addition to spectacles. Discussion: The findings reveal a moderate level of knowledge and a somewhat favorable attitude toward refractive error management among students. However, awareness gaps remain, particularly regarding the causes and prevention of refractive errors. Conclusion: The results indicate the need for strengthened eye health education and awareness initiatives to enhance understanding and attitudes toward refractive errors among schoolchildren. Eye care professionals and educational institutions should collaborate to promote regular eye screening and preventive eye care practices. Future studies with larger and more diverse samples, extended time frames, and qualitative assessments are recommended to gain a deeper understanding of students’ perspectives and the underlying determinants of refractive errors.

S209W mutation enhance π-π interactions in the fourth Greek-key of βA3/A1-crystallin linking with aggregation formation and stress susceptibility.

Introduction: Congenital cataract is one of the leading preventable causes of childhood blindness, characterized by clouding of the lens present at birth or in the first months of life. This condition can seriously compromise a child’s visual development, leading to permanent deficits if not diagnosed and treated early. Early detection and appropriate treatment are essential for preserving a child’s vision and quality of life. Objectives: This study aims to review the scientific literature on congenital cataract, emphasizing the importance of prophylaxis, early diagnosis, and timely treatment. The aim is to highlight the main diagnostic methods, especially the Red Reflex Test (RRT), and the recommended therapeutic approaches, in addition to discussing the impact of early intervention on visual prognosis. Methodology: This is a narrative literature review, with research conducted in the SciELO, PubMed, and LILACS databases, using the descriptors: “congenital cataract,” “prophylaxis,” “early diagnosis,” “surgical treatment,” and “low vision.” Articles published between 2014 and 2024, in Portuguese and English, that address the topic in a manner relevant to clinical practice in pediatric ophthalmology were included. Results: The analyzed literature indicates that the Red Reflex Test, performed in the maternity ward, is the main screening test for early identification of congenital cataracts. Surgical intervention, when performed up to three months of age in unilateral cases and up to four months in bilateral cases, produces the best visual outcomes. Visual rehabilitation with corrective lenses and occlusion of the unaffected eye are essential measures to prevent amblyopia. Prophylaxis also includes prenatal care, such as rubella vaccination and adequate pregnancy monitoring. Conclusion: Congenital cataracts, although serious, have a good prognosis when identified and treated early. Public policies for neonatal screening, training of health professionals, and ensuring access to specialized treatment are essential to prevent childhood blindness. Investments in prevention, early diagnosis, and visual rehabilitation contribute significantly to the quality of life of affected children and to reducing childhood visual impairment rates.

To assess the prevalence of childhood visual impairment and refractive errors, as well as the causes and risk factors associated with visual impairment among children in the Qassim region of Saudi Arabia. This cross-sectional study included 850 children (aged 6–17 years) from six randomly selected primary schools in the Qassim region, conducted from March to May 2024. The study used the modified Refractive Error Study in Children (RESC) protocol. Refractive error was objectively assessed using a non-cycloplegic autorefractometer. Anterior eye examinations were performed using slit lamp biomicroscopy, while posterior segment examinations were conducted using a direct ophthalmoscope and 90 D fundus biomicroscopy. Visual impairment was classified according to the International Classification of Diseases, 11th revision (ICD-11), 2018. The prevalence of presenting childhood visual impairment was 25.5%, reduced to 7.1% with best correction. Presenting visual impairment included mild impairment in 15.5% of participants, moderate in 6.4%, severe in 2.1%, and 1.5% were classified as blind. The leading cause of childhood visual impairment was uncorrected refractive error (67.3%), followed by amblyopia (23.0%); cataract (5.5%); and congenital disorders (5.1%). The prevalence of hyperopia, myopia, and astigmatism were 30.5%, 19.3%, and 11.3%, respectively. The regression analysis showed that males had lower odds of visual impairment compared to females (OR: 0.57; P = 0.001). Children who never had their eyes checked had lower odds of visual impairment compared to those who had regular eye examinations (OR: 0.32; P < 0.001). Additionally, emmetropic children had lower odds of visual impairment compared to those with uncorrected refractive errors (OR: 0.22; P < 0.001). This study found a high prevalence of childhood visual impairment and refractive errors, with uncorrected refractive errors being the leading cause. Regular eye examinations and corrective measures are essential. Males had lower odds of visual impairment compared to females. These findings highlight the need for targeted interventions to enhance eye care services and reduce visual impairment in children.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-20318-w.

Diagnostic sensitivity and specificity of the teach CVI screening tool for identifying cerebral visual impairment in children.

Congenital eye malformations like microphthalmia–anophthalmia–coloboma (MAC), anterior segment dysgenesis (ASD), primary congenital glaucoma (PCG) and congenital cataracts (CC) are significant causes of childhood visual impairment. Phenotypic heterogeneity often complicates diagnosis. The goal of this study was to optimize the diagnostic strategy for next-generation sequencing (NGS)-based procedures, thereby aiming to identify genetic causes of congenital eye malformations. Forty patients with congenital eye malformations were included. A primary diagnostic testing (PD) of a limited number of genes was followed by multigene panel (MGP) testing, including 186 eye-related genes, and exome sequencing. Causative variants were identified in 17 patients (43%) and clinically relevant variants of uncertain significance (VUS) in 6 patients (15%). PD had a diagnostic yield (DY) of 15%, MGP of 29% and exome sequencing of 4%, leading to a cumulative DY of 43%. Diagnostic rates were highest in CC (75%), bilateral cases (46%), complex ocular phenotypes (78%), patients with extraocular manifestations (55%) and positive family history (70%). Rare and possible new genotype–phenotype correlations and candidate genes (FAT1, POGZ) could be identified. In total, eight (likely) pathogenic variants in six genes (CYP1B1, ADAMTS18, MAB21L2, NHS, MFRP, CRYBB1) were not yet reported. A stepwise genetic testing approach starting with a broad multigene panel followed by exome sequencing provides higher diagnostic yield than limited phenotype-specific testing. Comprehensive genetic diagnosis is essential for prognosis, treatment and genetic counseling, underscoring the need for routine genetic testing and interdisciplinary collaboration in managing congenital eye malformations.

The prevalence of visual impairment (VI) increases with axial length (AL) and spherical equivalent (SE). This study aims to explore the prevalence and associated factors of myopia and AL-related VI in children and adolescents, including analysis of sex-specific differences. This cross-sectional survey included 2595 children and adolescents aged 4–18 years from nine educational institutions in a large municipality. The survey comprised a questionnaire, visual acuity examination, refractive screening and AL measurement. The prevalence of myopia and AL-related VI were 56.53% and 50.98% respectively and increased with age (P < 0.01). The myopia rate was higher in females than in males (60.23% vs. 52.71%, χ2 = 14.93, P < 0.05), with a significant difference observed in those aged 9 years and older. However, there was no sex difference between in the prevalence of AL-related VI (51.37% vs. 50.61%, χ2 = 0.15, P = 0.70). The research showed that older adolescent was a risk factor for both myopia (OR = 2.28, 95%CI = 2.06–2.53) and AL-related VI (OR = 2.49, 95%CI = 2.23–2.77). Having a myopic parent was also significantly associated with myopia (OR = 1.21, 95%CI = 1.12–1.32) and AL-related VI (OR = 1.25, 95%CI = 1.16–1.36). The prevalence of myopia and AL-related VI were high and increased with age in children and adolescents, with sex-specific differences in myopia but not in AL-related VI. Therefore, it is possible to predict the risk of myopia by considering age- and sex-specific factors.

Socioeconomic Determinants of Unmet Vision Care Needs and Gaps in Eye Examinations in Pediatric Populations From 2016 to 2022.

Amblyopia is the most common cause of vision impairment in children and presents as reduced visual acuity caused by suppression of neurologic signals from an eye. Traditional treatments include penalizing the better-seeing eye by occlusion, most commonly with patching. This does not address the binocular vision deficits of amblyopia and leaves most patients with unresolved disease and permanent vision loss. Digital, dual-acting therapy (Luminopia, Luminopia, Inc) was cleared in October 2021 via US Food and Drug Administration de novo market authorization for the treatment of amblyopia associated with anisometropia and/or with mild strabismus in children aged 4-7years. Binocular digital therapy is now included in the American Academy of Ophthalmology's amblyopia treatment guidelines, the Amblyopia Preferred Practice Pattern (PPP). The pivotal randomized, controlled phase 3 trial evaluating Luminopia was recognized in the PPP as Level I+ evidence. Pediatric ophthalmologists and national and regional health plan leaders formed a roundtable panel to evaluate disease impact, the current treatment landscape, and guideline-based treatment principles. At the conclusion of this discussion, the panel developed a unanimous recommendation for the appropriate clinical and value-driven use of Luminopia and payer coverage recommendations. Luminopia is recommended for use to treat amblyopia and should be covered by payer policies. Duration of therapy should be based on patient needs as determined by prescribing physician expertise. Luminopia may be covered under either medical or pharmacy benefit. Step-edits may be used, and documentation of inadequate response to other therapies may be necessary to obtain coverage. Clinical documentation and medical letters of exception may also be needed for off-label use of Luminopia. The recommendations achieved in this roundtable based on the clinical evidence available provide a justification for broad payer coverage and improved patient access to a full range of evidence-based amblyopia treatments.

Associations of pre- and postnatal levels of three heavy metals with visual impairment in 3-year-old children.

Abstract Amblyopia (lazy eye) is a leading cause of preventable visual impairment in children, where one eye fails to achieve normal visual acuity. If left untreated, it can lead to permanent vision loss. The survey assesses its prevalence in children, aiming to raise awareness of early detection to prevent long-term visual issues. This descriptive survey was conducted in Tetouan, Morocco, on pediatric patients (&amp;lt; 16), who came for visual disturbances, between July 2022 and July 2023. All patients underwent a complete ophthalmological examination with refraction measurements. It included 714 children, 390 girls and 324 boys. 45% of the children were consulting an ophthalmologist for the first time. The study revealed 39.5% cases of amblyopia. The visual disorder was suspected by parents in 46% of cases, and by schools in 41%. The amblyopic child only reported it themselves in 9% of cases. The average age was 8 years. 54% of the amblyopic children were over 8 years old, and 14% were over 12 years old. Examination identified hyperopia in 58% of amblyopic children and myopia in 37%. Results reveal the high prevalence of amblyopia in early childhood. Amblyopia often goes unnoticed, so this finding highlights the need for early screening in children. Parents are often the first to notice signs of visual problems, but schools are also essential in identifying learning difficulties. Children, however, may not be aware of the visual impairment, making the amblyopia go unnoticed for a long time. This emphasizes the importance of routine eye exams. The fact that more than half of the children were over 8 (and 14% over 12) raises concerns, as amblyopia can become more challenging to treat at this stage. Therefore, incorporating early vision screening into primary school programs and routine pediatric checkups should be a public health priority to prevent long-term visual impairment. Key messages • Amblyopia is highly prevalent and often undetected; early childhood screening is essential to prevent irreversible visual impairment. • Parental and school-based detection play a critical role, supporting the integration of routine vision checks into pediatric and educational systems.

Purpose: To evaluate the knowledge and attitude of Iraqi family physicians regarding pediatric sight threatening diseases and to identify factors influencing their approaches. Study Design: Cross sectional, Observational study. Place and Duration of Study: Primary health care centers of Iraq, from March 2024 to March 2025. Methods: This study included 385 family physicians working in primary health care centers. Participants completed a structured, self-administered, web-based survey distributed via social media groups. The survey included demographic questions and assessed knowledge and attitudes toward common pediatric eye disorders. Data was analyzed using SPSSversion 22. Results: Among the participants, 55.3% were residents. Knowledge variedsignificantly with 51.6% demonstrating good knowledge, 67.5% moderate, and 81% poor. Family medicine consultants exhibited the highest knowledge levels (78.4% “good”), compared to specialists (68.1%) and residents (10.3%). Physicians with less than one year of experience showed the most significant knowledge gaps (p=0.000). Attitudes toward pediatric eye care were generally positive, but knowledge deficiencies hindered effective practice. Conclusion: The study reveals substantial knowledge gaps among Iraqi family physicians, particularly among residents and those with limited clinical experience. Experience and professional role strongly correlated with higher knowledge levels. To address preventable childhood vision impairment, targeted educational interventions, like structured training programs, mentorship, and the integration of pediatric ophthalmology into family medicine curricula, are urgently needed. These efforts could significantly reduce the burden of preventable vision loss in children.

Background/Objectives: Childhood eye disorders, including refractive errors, strabismus, and amblyopia, are prevalent yet often underdiagnosed in Saudi Arabia. Limited data on barriers to pediatric eye care hinder efforts to optimize service delivery. This study aimed to identify barriers to accessing pediatric eye care and to develop consensus-based strategies for improvement. Methods: A Delphi technique involving three iterative rounds of questionnaires was conducted with a panel of 22 eye care experts across Saudi Arabia. Consensus was defined as ≥80% agreement among participants. In total, 30 statements were developed from thematic analysis of open-ended responses and a supporting literature review. Panelists rated each statement on a five-point Likert scale, and descriptive statistics were applied. Internal consistency across rounds was assessed using Cronbach's alpha. Results: Of the 30 proposed statements, 25 (83.3%) reached consensus, with a mean agreement score of 4.45 ± 0.59. Internal consistency was high (Cronbach's alpha = 0.92). High-priority recommendations included implementing mandatory vision screening, integrating optometrists into primary healthcare, and establishing specialized pediatric eye care centers. Other recommendations emphasized expanding mobile clinics and increasing public awareness. Areas that did not reach consensus included referral inefficiencies, adequacy of the current workforce, and school accommodations for children with visual impairment. Conclusions: This study presents the first national consensus on pediatric eye care in Saudi Arabia and provides actionable recommendations to strengthen services. The findings offer a strategic framework to guide policy, enhance workforce development, and reduce childhood visual impairment through early detection and intervention.

Cerebral visual impairment (CVI) is now the most frequent cause of childhood visual impairment in high-income nations, yet school systems remain poorly equipped to meet its distinctive—largely neurological—learning needs. Because CVI originates in cerebral, not ocular, dysfunction, effective schooling requires specialized strategies that integrate multisensory instruction, environmental simplification, and functional-vision assessment. International evidence shows persistent under-diagnosis and limited professional training; recent European policy reforms that replace specialist teachers of the visually impaired (TVIs) with general special educators’ risk widening these gaps. This cross-sectional study surveyed 84 Turkish special-education teachers—working in a context that discontinued TVI certification in 2016—about their knowledge, competence, and training on CVI. Results were stark: 88.1 % had never encountered the term CVI , and only 8.4 % received any related coursework during preservice preparation. More than four in five respondents felt unprepared to conduct functional-vision assessments or adapt instruction. Teachers who had received even brief CVI-specific training ( n = 22) reported substantially higher confidence, underscoring the leverage of targeted continuing professional development. Findings highlight an urgent need for reinstated TVI pathways, evidence-based in-service programs, and interdisciplinary collaboration. Without systemic reform, learners with CVI will continue to face educational inequities, underlining the need for policy action and further empirical research.

Childhood visual impairment is an important public health concern considering the social, emotional and economic consequences. Lack of access to eye care services contributes to this growing problem. Therefore, integrating primary eye care into existing primary healthcare would facilitate improved access to equitable, effective and affordable eye care services, particularly for children. The study assessed the provision of primary paediatric eye care services in health facilities in the Ashanti region of Ghana. The study was conducted at the primary health facilities in the Ashanti region of Ghana. Stratified random sampling was used to select 145 health facilities in this descriptive study. The eye care professionals in these facilities completed a questionnaire concerning primary eye care services for children. Data were analysed using descriptive and inferential statistics. Eye care services were available in 131 (90%) of the health facilities resourced with essential eye equipment. Refraction services were provided by 129 (98.5%) despite limited coverage by the national health insurance scheme. More than 80% of participants lacked continuing education and 59% had poor awareness of management guideline. Barriers identified included lack of specialised equipment and inadequate resources. The study highlights disparities in the provision of child eye care services among the health facilities in the Ashanti region of Ghana.Contribution:This study provides useful information to inform policy on targeted interventions for child eye care services to ensure accessible, equitable and comprehensive services.

BackgroundInherited retinal diseases (IRDs) are a leading cause of visual impairment in children and young adults. Individuals with IRDs have an increased prevalence of high refractive errors (REs). This study aims to characterise the natural progression of REs in patients with early onset IRDs and identify associations with specific IRDs and genes.MethodsRetrospective cohort study of patients diagnosed with IRD’s up to the age of 10 years. Data collected included demographic information, IRD type, molecular analysis (when available), and cycloplegic REs from the first and last visits.ResultsA total of 199 patients (384 refractive measurements) were included in this study. Retinitis Pigmentosa (RP) and Achromatopsia were associated with high hypermetropia in early visits, with a decreasing RE trend over time. CNGA3, CNGB3, and CRB1 were associated with high hypermetropia, remaining high with time in CRB1. In contrast, Congenital Stationary Night Blindness (CSNB) and Blue Cone Monochromacy (BCM) demonstrated high myopia, worsening over time in CSNB, with an increasing rate in high myopia from 51.5% to 69.7% from first to last visit. Mean myopic progression in TRPM1-patients was 0.56 dioptres/year.ConclusionsIn patients with early onset IRDs, refractive errors have a general tendency towards lower spherical equivalents with time. TRPM1-related myopia keeps progressing during the first decade of life, warranting regular screening and consideration of early myopia control interventions to mitigate the risk of myopia-related sight-threatening complications. High hypermetropia is common in RP, staying especially high in CRB1-related cases, highlighting the importance of early screening and refractive correction.

Mental Health of US Children With Vision Impairment: An Analysis of the National Health Interview Survey.

Reach-to-grasp behavior is a key developmental milestone in infants, involving coordinated actions such as arm transport, hand pre-shaping, and hand opening and closing. Vision guides the development of these skills, and delays in visual input can impact infants with early visual impairments. However, the effects of a congenital visual impairment on reach-to-grasp behavior in early life remain largely unexplored. To address this gap, we compared the reach-to-grasp abilities of sighted (S) and visually impaired (VI) infants and children, focusing on temporal (Movement and Pick-up times) and motor parameters (body midline crossing with one or two hands and hand preference). We hypothesized that VI children would face greater challenges in planning and executing a rapid and accurate reach-to-grasp movement, particularly during the pick-up phase. To investigate this, we asked sighted and VI infants and children to grasp black spheres of different sizes, placed centrally, on the right, or the left of a table in a dimly lit room. Three key findings emerged from our analysis. First, VI children required more time to pick up the spheres compared to their sighted peers. Second, VI children showed a reduced frequency of one-handed body midline crossing when reaching for lateral spheres, but showed an age-related increase, especially when using both hands. Third, VI children showed no hand preference, unlike S children who favored their right hand for crossing the body midline. These results highlight the role of visual experience in developing effective goal-directed movements and support creating early evidence-based rehabilitation procedures. A video abstract of this article can be viewed at https://youtu.be/bjwkMQmdFoE. SUMMARY: Understanding the impact of visual impairment on exploration abilities is crucial, especially in early developmental stages. Currently, there is a significant research gap concerning fine motor skills, particularly reaching and grasping, in visually impaired infants during development. We proposed a playful task to collect behavioral data on reaching and grasping skills in visually impaired children. Results shed light on the pivotal role of visual experience during the first years of life in shaping the maturation of reaching and grasping skills.

Retinoblastoma is the most common intraocular tumour in children. This study aimed to assess the visual outcomes and risk factors leading to visual impairment in children with retinoblastoma in the Indian population. This is a single-centre retrospective analysis of all patients with unilateral or bilateral retinoblastoma presenting from the year 2014 to mid-2024. A total of 426 eyes in 306 patients were included in the study. 240 (78.43%) had unilateral macular tumours, while 45 (14.71%) had bilateral macular tumours. 29 (24.17%) patients were classified as visually impaired, and 22 (18.33%) patients were legally blind. The visual impairment and legal blindness observed in groups D and E (55.18% vs 68.18%) was statistically significant compared with groups A-C, with a p value of <0.05. Visual impairment and legal blindness were noted in only 27.59% and 0.05% of patients without macular tumours. Three patients had motor and speech delay. Out of 120 patients with bilateral tumour, 45 successfully underwent occlusion therapy. Macular involvement and late-stage presentation were major predictors of poor vision. This study underscores the importance of early diagnosis and treatment, and improved access to paediatric vision screening and visual rehabilitation.