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Rogerson T, Ath SS, Meng N, Casson R. A 12-year follow up survey of childhood blindness at schools for the blind in Cambodia. BMC Ophthalmol 2024; 24:62. [PMID: 38350914 PMCID: PMC10863079 DOI: 10.1186/s12886-024-03285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cambodia is a low-income country in South East Asia with a population of 15.5 million people of whom 4.9 million (38%) are under the age of 16. The causes of childhood blindness in Cambodia have not been investigated since the first survey of schools for the blind done in 2009 by our group. Given the large demographic and economic shifts in Cambodia since 2009 it is important to determine if these causes have changed in order to ensure intervention programmes are appropriately targeted. The purpose of the present study is to investigate the prevalence of causes of childhood blindness at schools for the blind in Cambodia. METHODS Students between the ages of 5 and 16 years who were attending schools for the blind in Cambodia were examined by a consultant paediatric ophthalmologist and had clinical photographs taken. Distance visual acuity was measured using a logMAR tumbling E chart and the WHO definitions of blindness and severe visual impairment were used. The examining ophthalmologist recorded the anatomical site and aetiology of vision loss using the WHO Prevention of Blindness eye examination record for children. Collected data were compared to a previous survey from 2009. RESULTS Data from 73 students were included for analysis. The most common anatomical location of abnormality causing vision loss was the cornea (n = 20, 33.9%) followed by the lens and retina (n = 11, 18.64% each). Hereditary factors (n = 29, 49.15%) and childhood diseases (n = 27, 45.76%) were the most common aetiological causes of childhood blindness. The majority (71.19%) of childhood blindness was avoidable. The present study did not demonstrate 0a significant difference in the causes of childhood blindness compared to 2009. CONCLUSIONS Corneal pathologies continue to represent the most common cause of vision loss amongst the surveyed population and the majority of causes of childhood blindness continue to be avoidable. These findings will facilitate the development of evidence-based targeted interventional programmes in Cambodia.
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Affiliation(s)
- Thomas Rogerson
- Sight For All Foundation, Adelaide, South Australia, Australia.
- Department of Ophthalmology, The Royal Adelaide Hospital, Port Road, 5000, Adelaide, South Australia, Australia.
- Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, South Australia, Australia.
| | - Sith Sam Ath
- Sight For All Foundation, Adelaide, South Australia, Australia
- National Programme for Eye Health, Ministry of Health, Phnom Penh, Cambodia
| | - Ngy Meng
- National Programme for Eye Health, Ministry of Health, Phnom Penh, Cambodia
| | - Robert Casson
- Sight For All Foundation, Adelaide, South Australia, Australia
- Department of Ophthalmology, The Royal Adelaide Hospital, Port Road, 5000, Adelaide, South Australia, Australia
- Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, South Australia, Australia
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El-Khoury S, Strittmatter S, Tuyisabe T, Preussner PR, Abdelmassih Y. Distribution and causes of blindness and severe visual impairment in children at a tertiary referral centre in Rwanda. Br J Ophthalmol 2024; 108:280-284. [PMID: 36596661 DOI: 10.1136/bjo-2022-321522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
AIM To determine the prevalence and the causes of severe visual impairment and blindness (SVI/BL) in children at a tertiary referral centre in Rwanda. METHODS In this retrospective study, files of all patients <18 years presenting during the year 2019 at the Kabgayi Eye Unit in Rwanda with SVI/BL (presenting visual acuity of <6/60 Snellen or lack of preferential looking behaviour) in at least one eye were analysed for age, sex, laterality, province of origin and cause of SVI/BL. Causes were categorised according to WHO standard classification. RESULTS Out of 3939 children presenting to the clinic, 428 (10.9%) had SVI/BL in at least one eye. 165 (4.2%) patients had bilateral and 263 (6.7%) had unilateral condition. Of patients with BL/SVI, 36.7% were below the age of 6 years. In bilateral BL/SVI, the main causes were cataract (18%), refractive error (18%), keratoconus (13%), congenital eye anomaly (9%), glaucoma (8%), cortical blindness (8%) and retinoblastoma (6%). In unilateral BL/SVI it was trauma (46%), cataract (8%), keratoconus (8%), infectious corneal disease (7%) and retinoblastoma (7%). In preschool children, retinopathy of prematurity accounted for 7% of bilateral BL/SVI. Avoidable BL/SVI accounted for 87% of all cases. CONCLUSION The high number of avoidable causes for SVI/BL may be reduced through several cost-effective ways.
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Affiliation(s)
- Sylvain El-Khoury
- Eye Unit, Kabgayi Hospital, Muhanga, Rwanda
- Department of Ophthalmology, Centre Hospitalier de Grasse, Grasse, France
| | - Sophia Strittmatter
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | | | - Paul-Rolf Preussner
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Youssef Abdelmassih
- Pediatric Ophthalmology, The Fondation Adolphe de Rothschild Hospital, Paris, France
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Satav KA, Satav AR, Dani VS, Gogate PM, Kumbhare SD, Reddy P. Ocular morbidity among children (aged 6-18 yr) of the tribal area of Melghat, India: A community-based study. Indian J Med Res 2023; 158:370-377. [PMID: 38006342 DOI: 10.4103/ijmr.ijmr_3228_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND OBJECTIVES Most of the ocular morbidities among school children are preventable or treatable. Melghat, a difficult to access, hilly, forest, tribal area with poorly developed infrastructure in the Amravati district of Maharashtra. Scarcity of ophthalmologists and low health-seeking behaviour of tribal people contributes to the high burden of ocular morbidity. Given the lack of published studies on the ocular morbidity among children in Melghat, outreach programmes are essential to diagnose and treat visual impairments promptly. The objective was to determine the prevalence of ocular morbidity among children in the tribal area of Melghat. METHODS A community-based observational study was carried out in the Chikhaldara and Dharni blocks of Melghat. Children from 15 tribal villages were screened for eye disorders by trained paramedics. Most of the children were examined by an ophthalmologist. We used Chi-square test for categorical variables. RESULTS A total of 4357 children aged between 6 and 18 yr were examined. Of these 2336 (53.6%) were females and 2021 (46.4%) were males. Out of 4357 children, 507 (11.63%) had an ocular morbidity. The prevalence of ocular morbidity and refractive error increased in the age group of 8-10 yr (P<0.05 and <0.001, respectively). Refractive error was the most common ocular morbidity (n=339; 7.8%), followed by vitamin A deficiency (VAD) (n=120; 2.8%). INTERPRETATION CONCLUSIONS The prevalence of refractive error and VAD in this study was significantly higher than the rest of India and the world. For the prevention of childhood blindness, immediate intervention programme, including eye screening by trained paramedics, treatment by an ophthalmologist and prophylaxis, is crucial.
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Affiliation(s)
- Kavita A Satav
- Department of Ophthalmology, Mahatma Gandhi Tribal Hospital, MAHAN Trust, Dharni, Amravati, Maharashtra, India
| | - Ashish R Satav
- Department of Community Health, Mahatma Gandhi Tribal Hospital, MAHAN Trust, Dharni, Amravati, Maharashtra, India
- Department of Medicine, Mahatma Gandhi Tribal Hospital, MAHAN Trust, Dharni, Amravati, Maharashtra, India
| | - Vibhawari S Dani
- Department of Research, MAHAN Trust, Dharni, Amravati, Maharashtra, India
| | - Parikshit M Gogate
- D. Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, India
| | - Shraddha D Kumbhare
- Department of Ophthalmology, Mahatma Gandhi Tribal Hospital, MAHAN Trust, Dharni, Amravati, Maharashtra, India
| | - Pradeep Reddy
- Department of Ophthalmology, Mahatma Gandhi Tribal Hospital, MAHAN Trust, Dharni, Amravati, Maharashtra, India
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Prakash WD, Marmamula S, Mettla AL, Keeffe J, Khanna RC. Visual impairment and refractive errors in school children in Andhra Pradesh, India. Indian J Ophthalmol 2022; 70:2131-2139. [PMID: 35647998 PMCID: PMC9359223 DOI: 10.4103/ijo.ijo_2949_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization's (WHO) combating blindness strategies. The primary aim of this study was to estimate the prevalence of VI, causes, and its risk factors in school children in Krishna district, Andhra Pradesh, India. Methods Children aged 4-15 years were screened in schools using the 6/12 Snellen optotype by trained community eye health workers, and those who failed the test and those reported or found to have obvious eye conditions were referred to primary (VC), secondary (SC), or tertiary (TC) care centre appropriately, where they underwent a complete eye examination including cycloplegic refraction and fundus examination. Results A total of 56,988 children were screened, of whom 51.18% were boys. The mean age was 9.69 ± 3.26 years (4-15 years). Overall, 2,802/56,988 (4.92%) children were referred to a VC, of which 632/56,988 (1.11%) required referral to SC/TC. PVA of <6/12 was found in 1.72% (95% confidence interval [CI]: 1.61-1.83). The prevalence of refractive error (corrected and uncorrected) was 2.38% (95% CI: 2.26-2.51) and myopia was 2.17% (95% CI: 2.05-2.29). In multivariable analysis, older children, those in urban schools, private schools, and children with a disability had an increased risk of VI and myopia. Additionally, the risk of myopia was higher among girls than boys. Of those referred and reached SC/TC, 73.64% were due to avoidable causes. Conclusion Childhood VI prevalence was 1.72% in this region. Uncorrected refractive error (URE) was the major cause of VI in children. Older age, schools in urban locations, private schools, and the presence of disability were associated with the risk of VI among children.
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Affiliation(s)
- Winston D Prakash
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare; Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute Hyderabad, Telangana, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare; Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute Hyderabad, Telangana, India
| | - Asha Latha Mettla
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jill Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare, L V Prasad Eye Institute; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
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Bhaskaran S, Flora J, Perumalsamy V, Durairaj DC. Visual impairment in children with multiple disabilities in schools for children with special needs in South India. Indian J Ophthalmol 2022; 70:1307-1311. [PMID: 35326042 PMCID: PMC9240527 DOI: 10.4103/ijo.ijo_1851_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
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 CVI Conclusion: 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.
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Affiliation(s)
- Sahithya Bhaskaran
- Department of Paediatric Ophthalmology and Strabismus, Aravind Eye Care System, Madurai, Tamil Nadu, India
| | - Jeyaseeli Flora
- Vision Rehabilitation Centre, Aravind Eye Care System, Madurai, Tamil Nadu, India
| | - Vijayalakshmi Perumalsamy
- Department of Paediatric Ophthalmology and Strabismus, Aravind Eye Care System, Madurai, Tamil Nadu, India
| | - Deepa Chitra Durairaj
- Junior Resident, Department of Ophthalmology, Aravind Eye Care System, Madurai, Tamil Nadu, India
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Kulkarni S, Gilbert C, Giri N, Hankare P, Dole K, Deshpande M. Visual impairment and blindness among children from schools for the blind in Maharashtra state, India: Changing trends over the last decade. Indian J Ophthalmol 2022; 70:597-603. [PMID: 35086244 PMCID: PMC9023984 DOI: 10.4103/ijo.ijo_1930_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose: To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India. Methods: Children aged <16 years, enrolled in the schools for the blind in Maharashtra state, India were examined between October 2018 and December 2019. The anatomical sites and etiology for blindness were recorded using the World Health Organization’s standard reporting form. Causes of blindness were compared among different regions of the state and also by different age groups. Results: Of the 1,969 students examined from 39 schools for the blind, 188 children (9.5%) had severe visual impairment and 1,666 children (84.6%) were blind. Whole globe anomalies (794, 42.8%) were the most common anatomical site of vision loss in children, followed by corneal (289, 15.6%) and retinal abnormalities (280, 15.2%). Corneal causes were second most common in the poorer districts of Vidarbha (15.3%) and Marathwada (14.6%), whereas retinal causes were second most common in the wealthier regions of western Maharashtra (18.3%) and Khandesh (24.1%). Nearly one-third (593, 32%) of children were blind from potentially avoidable causes. Preventable blindness consisting of corneal causes and retinopathy of prematurity was seen in 281 (15.2%) cases, whereas treatable causes comprising of lens-related causes, glaucomas, refractive errors, amblyopia, and uveitis accounted for another 311 (16.8%). Among the younger children (≤10 years), the proportion of corneal blindness was lower (83/623, 13.3% vs. 206/1232, 16.7%) and that of retinal blindness was higher (119/623, 19% vs. 163/1232, 13.2%) than the older children. Conclusion: Whole globe anomalies constitute a major cause of SVI and blindness in Maharashtra. There seems to be an increase in the proportion of retinal blindness, especially retinopathy of prematurity, suggesting a need for increased screening coverage.
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Affiliation(s)
- Sucheta Kulkarni
- Department of Community Ophthalmology and Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Clare Gilbert
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Nilesh Giri
- Department of Community Ophthalmology and Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Pravin Hankare
- Department of Community Ophthalmology and Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Kuldeep Dole
- Department of Community Ophthalmology and Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - M Deshpande
- Department of Community Ophthalmology and Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
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Pujari A, Modaboyina S, Agarwal D, Saluja G, Thangavel R, Rakheja V, Saxena R, Sharma N, Titiyal JS, Kumar A. Myopia in India. Clin Ophthalmol 2022; 16:163-176. [PMID: 35082484 PMCID: PMC8786354 DOI: 10.2147/opth.s349393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
India is a culturally and geographically diverse nation. Its vast demographic nature does not allow a single definition for any of the given medical conditions in its territory. One important clinical condition which has created an uproar in the rest of the world is myopia. Its cause, prevalence, etiopathogenesis and other factors are being explored constantly; however, data with respect to Indian subcontinent are genuinely missing. Hence, in this review, we enumerate the country’s myopia journey from last 4 decades. The epidemiology, genetics, ocular/systemic association, quality of life, imaging, and management in myopia with necessary future directives are discussed to augment the overall management in future.
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Affiliation(s)
- Amar Pujari
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
- Correspondence: Amar Pujari, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Room no. 212, RPC-1, AIIMS, New Delhi, India, Email
| | - Sujeeth Modaboyina
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Agarwal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Gunjan Saluja
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeswari Thangavel
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Rakheja
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan S Titiyal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Tariq M, Uddin Q, Ahmed B, Sheikh S, Ali U, Mohiuddin A. Prevalence of Pediatric Cataract in Asia: A Systematic Review and Meta-Analysis. J Curr Ophthalmol 2022; 34:148-159. [PMID: 36147271 PMCID: PMC9487007 DOI: 10.4103/joco.joco_339_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose: To conduct a systematic review and meta-analysis for estimating the prevalence of pediatric cataracts across Asia. Methods: A detailed literature search of PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases, from 1990 to July 2021, was performed to include all studies reporting the prevalence of cataracts among children. Two researchers performed the literature search and screening of articles independently, and a third researcher critically reviewed the overall search and screening process to ensure the consistency. The JBI Critical Appraisal Checklist for studies reporting prevalence data was used to assess the methodological quality of the included studies. Results: Of the 496 identified articles, 35 studies with a sample size of 1,168,814 from 12 Asian countries were included in this analysis. The estimated pooled prevalence of pediatric cataracts in Asian children is 3.78 (95% confidence interval: 2.54–5.26)/10,000 individuals with high heterogeneity (I[2] = 89.5%). The pooled prevalence by each country per 10,000 was 0.60 in Indonesia, 0.92 in Bangladesh, 1.47 in Iran, 2.01 in Bhutan, 3.45 in Laos, 3.68 in China, 4.27 in Thailand, 4.47 in India, 5.33 in Malaysia, 5.42 in Nepal, 9.34 in Vietnam, and 10.86 in Cambodia. Conclusions: This study utilizes existing literature to identify the prevalence of cataracts in Asian children. Moreover, it highlights the need for more epidemiological studies with large sample sizes from other countries in Asia to accurately estimate the burden of disease.
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Yekta A, Hooshmand E, Saatchi M, Ostadimoghaddam H, Asharlous A, Taheri A, Khabazkhoob M. Global Prevalence and Causes of Visual Impairment and Blindness in Children: A Systematic Review and Meta-Analysis. J Curr Ophthalmol 2022; 34:1-15. [PMID: 35620376 PMCID: PMC9128433 DOI: 10.4103/joco.joco_135_21] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/05/2022] Open
Abstract
Purpose: To determine the global prevalence and common causes of visual impairment (VI) and blindness in children. Methods: In this meta-analysis, a structured search strategy was applied to search electronic databases including PubMed, Scopus, and Web of Science, as well as the list of references in the selected articles to identify all population-based cross-sectional studies that concerned the prevalence of VI and blindness in populations under 20 years of age up to January 2018, regardless of the publication date and language, gender, region of residence, or race. VI was reported based on presenting visual acuity (PVA), uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA) of equal to 20/60 or worse in the better eye. Blindness was reported as visual acuity worse than 20/400 in the better eye. Results: In the present study, 5711 articles were identified, and the final analyses were done on 80 articles including 769,720 people from twenty-eight different countries. The prevalence of VI based on UCVA was 7.26% (95% confidence interval [CI]: 4.34%–10.19%), PVA was 3.82% (95% CI: 2.06%–5.57%), BCVA was 1.67% (95% CI 0.97%–2.37%), and blindness was 0.17% (95% CI: 0.13%–0.21%). Refractive errors were the most common cause of VI in the subjects of selected articles (77.20% [95% CI: 73.40%–81.00%]). The prevalence of amblyopia was 7.60% (95% CI: 05.60%–09.10%) and congenital cataract was 0.60% (95% CI: 0.3%–0.9%). Conclusion: Despite differences in the definition of VI and blindness, based on PVA, 3.82%, and based on BCVA, 1.67% of the examined samples suffer from VI.
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Affiliation(s)
- Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Asharlous
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Taheri
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bhattacharjee H, Magdalene D, Javeri HJ, Buragohain S, Mohapatra SSD, Garg M. Changing pattern of childhood blindness in eight North-Eastern states and review of the epidemiological data of childhood blindness of India. Indian J Ophthalmol 2021; 70:214-222. [PMID: 34937241 PMCID: PMC8917543 DOI: 10.4103/ijo.ijo_1038_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess the causes of visual impairment and blindness in children in all the schools for the blind in eight northeastern states and to determine its temporal trend, and to analyze the result with reference to various regional epidemiological data on childhood blindness in India. Methods: Children aged ≤16 years, with a visual acuity of ≤6/18 in the better eye, attending 17 schools for the blind were examined between November 2018 and March 2020. WHO protocol and reporting format was used for the evaluation, diagnosis, and classification of the causes. Results: Out of 465 eligible study participants, 93.76% were blind and only 12.26% of causes were avoidable. Anatomical causes of childhood blindness were whole globe (43.2%), cornea (17.20%), optic nerve (12.04%), retina (9.68%), and lens (9.46%). Etiological causes were unknown (52.69%), hereditary (26.02%), intrauterine (15.05%), and 26.08% had blinding congenital ocular abnormality (s). Regional temporal trend revealed a decrease in corneal and childhood causes and an increase in retina, optic nerve, hereditary, and intrauterine causes. Conclusion: A constellation of causes were differentiable but matched with the overall emerging trend of childhood blindness in India. Higher corneal, unavoidable, and unknown causes suggest a region-specific action plan for controlling childhood blindness as well as rehabilitation.
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Affiliation(s)
| | - Damaris Magdalene
- Paediatric Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Henal Jagdip Javeri
- Paediatric Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | | | | | - Mohit Garg
- Paediatric Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
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Nsiangani Lusambo N, Kilangalanga Ngoy J, Dilu Ahuka A, Munyeku Bazitama Y, Moanda Kapopo A, Ilunga Muleya J, Makwanga Mankiew E, Stahnke T, Guthoff R. Prevalence and patterns of childhood ocular morbidity in Kinshasa. A population-based study. GLOBAL EPIDEMIOLOGY 2021; 3:100054. [PMID: 37635715 PMCID: PMC10445959 DOI: 10.1016/j.gloepi.2021.100054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
Context Childhood ocular disorders can seriously impact on development and education, future employment opportunities and quality of life, their consequences are especially severe in low resource settings. There is a lack of data on pattern and prevalence of ocular morbidities among children in Democratic Republic of the Congo (DRC). Objective The aim of this study was to determine the pattern and magnitude of childhood ocular disorders in children in Kinshasa, the capital city of DRC. Methods A population-based cross-sectional study was conducted from July to August 2017. Children aged less than 16 years old were screened by volunteers in households and those with ocular pathologies were examined by two ophthalmologists. Prevalence and pattern of ocular diseases were determined. Results A total of 4307 households were visited by the surveyors and 13,197 children were screened. Ocular pathologies were diagnosed among 399 children. Girls represented 50.7% of the children and the mean age ± SD was 9.2 ± 4.1 years. The overall prevalence of ocular morbidity in our population was 3.6% [95% CI 3.3-3.9]. Allergic conjunctivitis was the most frequent pathology (56.2%) followed by refractive errors (27.4%) and strabismus (5%). Age of children was the only risk factor with a significant impact on the frequency of ocular pathology. Forty-five percent of children had never benefited from any treatment, self-medication, and recourse to traditional treatments concerned respectively 18.%, and 2.3% of children. Conclusion Childhood ocular morbidity in Kinshasa city was dominated by allergic conjunctivitis and refractive errors. The frequency of these conditions varies depending on the age of the children. Very few parents consult medical staff when their children have ocular problems, ignorance and limited financial resources are the principal barriers to consult.
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Affiliation(s)
- Nadine Nsiangani Lusambo
- Eye department, University Clinic, Medical School, University of Kinshasa, Democratic Republic of the Congo
| | - Janvier Kilangalanga Ngoy
- Eye department, University Clinic, Medical School, University of Lubumbashi, Democratic Republic of the Congo
| | - Angèle Dilu Ahuka
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yannick Munyeku Bazitama
- Department of Health Laboratories, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Astride Moanda Kapopo
- Department of Childhood Blindness, Rehabilitation A Base Communautaire, Archidiocese de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Josette Ilunga Muleya
- National Program for Vision and Eye Health, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Emile Makwanga Mankiew
- National Program for Vision and Eye Health, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Thomas Stahnke
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
| | - Rudolf Guthoff
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
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Adhikari S, Elsman EBM, van Nispen RMA, van Rens F, Oli RU, Thapa SS, van Rens GHMB. Translation and cross-cultural adaptation of a Nepali version of the Dutch Participation and Activity Inventory for Children and Youth (PAI - CY) with visual impairment. J Patient Rep Outcomes 2021; 5:77. [PMID: 34432179 PMCID: PMC8387525 DOI: 10.1186/s41687-021-00342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Visual impairment is an important cause of disability in children. There is a lack of information on rehabilitation needs and low vision support services for children with visual impairment in Nepal. This is a pilot study designed to translate, culturally adapt and pre-test the Dutch version of the Participation and Activity Inventory for Children and Youth (PAI-CY) with visual impairment aged 7–17 years to develop a Nepali version. Questionnaires (PAI-CY versions for 7–12 and 13–17 years) were translated using standardized methods and were culturally adapted by a panel of experts. They were pretested to evaluate comprehensibility and relevance among six children with visual impairment and blindness. Finally, participants completed a questionnaire evaluation form. Results The translation and cultural adaptation process resulted in the adaptation of nine items to make them suitable for Nepali culture. Most children had comprehensibility problems with some specific items because of vocabulary, sentence structure and the composition of items. Most of the children were satisfied with the questionnaires. Conclusion The study resulted in the development of a Nepali version of the PAI-CY. We worked with a small group of content experts and a small but representative sample of children which allowed us to use rigorous translation procedures to address language and cultural differences. A population based study has been planned to investigate the psychometric properties of these questionnaires.
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Affiliation(s)
- Srijana Adhikari
- Tilganga Institute of Ophthalmology, PO Box 561, Gaushala, Kathmandu, Nepal.
| | - Ellen Bernadette Maria Elsman
- Department of Ophthalmology, VU University Medical Centre and the Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ruth Marie Antoinette van Nispen
- Department of Ophthalmology, VU University Medical Centre and the Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | | | - Radhika Upreti Oli
- Tilganga Institute of Ophthalmology, PO Box 561, Gaushala, Kathmandu, Nepal
| | - Suman S Thapa
- Tilganga Institute of Ophthalmology, PO Box 561, Gaushala, Kathmandu, Nepal
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Wadhwani M, Vashist P, Senjam SS, Gupta V, Saxena R, Tandon R. A population-based study on the prevalence and causes of childhood blindness and visual impairment in North India. Indian J Ophthalmol 2021; 69:1381-1387. [PMID: 34011705 PMCID: PMC8302266 DOI: 10.4103/ijo.ijo_2408_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/27/2020] [Accepted: 01/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This was a population-based study to determine the prevalence and causes of visual impairment in children less than 16 years in Urban North India. Methods This cross-sectional study was conducted in 40 clusters of urban Delhi. 20,955 children aged less than 16 years underwent visual acuity screening using age-appropriate visual acuity charts. Unaided visual acuity of enumerated children aged over 2 years was assessed by using Lea symbols chart in 3-5 years age group and logMAR tumbling E charts for the 6-15 years age group. For children aged 0-2 years, fixation and following to torch light was assessed. All the children with unaided visual acuity of <6/12 in any eye in age group 3-15 years and inability to follow the light in age <3 years were referred for detailed ophthalmic examination. Results Amongst 20,955 children examined for visual acuity a total of 789 children were referred to the central clinic for detailed ophthalmic examination. Of these referred children, a total of 124 had presenting visual acuity <6/18 in the better eye. The prevalence of visual impairment (VI) was 5.92 per thousand (95% CI: 4.96-7.05). The prevalence of moderate to severe visual impairment was maximum in the age group of 11 to 15 years. The main cause of avoidable VI in these children was a refractive error (75.7%). The prevalence of blindness was 0.42 per thousand. Conclusion Optic nerve abnormalities were the most important cause of blindness in children. Refractive error is the most important cause of visual impairment amongst children and needs to be addressed.
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Affiliation(s)
- Meenakshi Wadhwani
- Department of Pediatric Ophthalmology, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India
| | | | | | - Vivek Gupta
- Community Ophthalmology, RP Center, AIIMS, New Delhi, India
| | - Rohit Saxena
- Squint and Neuro Ophthalmology Unit, RP Center, AIIMS, New Delhi, India
| | - Radhika Tandon
- Head, Cornea Services, RP Center, AIIMS, New Delhi, India
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Jain M, Anjani P, Krishnamurthy G, Sachdeva V, Kekunnaya R. One-year Profile of Eye Diseases in Infants (PEDI) in secondary (rural) eye care centers in South India. Indian J Ophthalmol 2021; 69:906-909. [PMID: 33727457 PMCID: PMC8012936 DOI: 10.4103/ijo.ijo_1084_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: The aim of this study was to report the proportion and patterns of eye diseases observed among infants seen at two rural eye care centers in South India. Methods: A retrospective review of case records of infants seen between January 1, 2017 and December 31, 2017 at two rural secondary eye care centers attached to L V Prasad Eye Institute, Hyderabad. Data were collected regarding their demographic profile, the pattern of eye problems observed, management at the facility itself, and need for referrals. Results: During this period, a total of 3092 children were seen. Among them, 141 were infants (4.56%, 71 boys: 70 girls, median age: 8 months). Twenty-five percent of infants were less than 6 months of age. The most common eye problem was congenital nasolacrimal duct obstruction (n = 76, 53.90%), followed by conjunctivitis (n = 33, 23.40%), retinopathy of prematurity (n = 4, 2.84%) and strabismus (n = 3, 2.13%). One case each of congenital cataract and suspected retinoblastoma were identified. Majority of the cases (58.8%) belonged to the oculoplastic and orbital surgery sub-specialty. Sixteen percent of the infants (n = 23) had sight-threatening eye problems. Twenty percent (n = 28) were referred to tertiary care hospital for further management. Conclusion: Profile of eye disease in infants in secondary or rural eye care centers ranged from simple to complex, including sight-threatening diseases. While our study concluded that nearly 4/5th of these eye problems were simple and could be managed by a well-trained comprehensive ophthalmologist, 20% of these cases required a referral to a tertiary care center.
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Affiliation(s)
- Mayank Jain
- L V Prasad Eye Institute, KAR Campus, Banjara Hills, Hyderabad, Telangana, India
| | - Pratap Anjani
- L V Prasad Eye Institute, KAR Campus, Banjara Hills, Hyderabad, Telangana, India
| | | | - Virender Sachdeva
- L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India
| | - Ramesh Kekunnaya
- L V Prasad Eye Institute, KAR Campus, Banjara Hills, Hyderabad, Telangana, India
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Priscilla JJ, Verkicharla PK. Time trends on the prevalence of myopia in India – A prediction model for 2050. Ophthalmic Physiol Opt 2021; 41:466-474. [DOI: 10.1111/opo.12806] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Jacinth J Priscilla
- Myopia Research Lab Prof. Brien Holden Eye Research Centre Brien Holden Institute of Optometry and Vision Sciences L V Prasad Eye Institute Hyderabad India
| | - Pavan K Verkicharla
- Myopia Research Lab Prof. Brien Holden Eye Research Centre Brien Holden Institute of Optometry and Vision Sciences L V Prasad Eye Institute Hyderabad India
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Agarwal D, Saxena R, Gupta V, Mani K, Dhiman R, Bhardawaj A, Vashist P. Prevalence of myopia in Indian school children: Meta-analysis of last four decades. PLoS One 2020; 15:e0240750. [PMID: 33075102 PMCID: PMC7571694 DOI: 10.1371/journal.pone.0240750] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 12/28/2022] Open
Abstract
Background India is the second most populated country in the world with 41% of the population (492 million) under 18 years of age. While numerous studies have shown an increasing prevalence of myopia worldwide, there continues to be uncertainty about the magnitude of myopia in Indian school going population. Design Systematic review and meta-analysis. Methods We systematically identified published literature of last four decades from 1980 to March 2020 and assessed them for methodological quality. Data were gathered into 5-year age groups from 5–15, in urban or rural populations, and standardized to definition of myopia as refractive error ≥ -0.50 dioptre. Random effects meta-analysis was done. Results We included data from 59 quality assessed studies, covering nearly 1,66,000 urban and 1,20,000 rural children. The overall crude prevalence of myopia over last four decades is 7.5% (95% CI, 6.5–8.5%) in 5-15-year age group. The prevalence of myopia is 8.5% (95% CI, 7.1–9.9%) in urban and 6.1% (95% CI, 4.5–7.7%) in rural children, with highest prevalence in urban 11-15-year age group [15.0% in last decade]. A significant increment in prevalence is noted in the last decade in rural children from 4.6% to 6.8%, reflecting changing rural environment. Conclusion Myopia is an emerging public health problem in both urban and rural school going adolescents in India requiring urgent efforts.
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Affiliation(s)
- Divya Agarwal
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
- * E-mail:
| | - Vivek Gupta
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rebika Dhiman
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Bhardawaj
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Tibrewal S, Subhedar K, Sen P, Mohan A, Singh S, Shah C, Nischal KK, Ganesh S. Clinical spectrum of non-syndromic microphthalmos, anophthalmos and coloboma in the paediatric population: a multicentric study from North India. Br J Ophthalmol 2020; 105:897-903. [PMID: 32829301 DOI: 10.1136/bjophthalmol-2020-316910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/23/2020] [Indexed: 11/04/2022]
Abstract
AIMS To describe the clinical features, visual acuity and causes of ocular morbidity in children (0-18 years) with microphthalmos, anophthalmos, and coloboma (MAC) from North India. METHODS A retrospective study conducted between October 2017 and September 2018 in three tertiary eye institutes, part of the Bodhya Eye Consortium with consensus led common pro formas. Children with complete clinical data and without syndromic/systemic involvement were included. The clinical phenotype was divided into isolated ocular coloboma (CB), coloboma with microcornea (CBMC), colobomatous microphthalmos (CBMO), non-colobomatous microphthalmos (MO) and anophthalmos (AO). RESULTS A total of 532 children with MAC were examined. Seventeen records were excluded due to incomplete data (0.2%). 515 children (845 eyes) were included: 54.4% males and 45.6% females. MAC was unilateral in 36% and bilateral in 64%. CB, CBMC, CBMO, MO and AO were seen in 26.4%, 31%, 22%, 8% and 12.5% of eyes, respectively. Nystagmus was found in 40%, strabismus in 23%, cataract in 18.7% and retinal detachment in 15%. Best-corrected visual acuity (BCVA) of <3/60 was seen in 62.4% eyes. Blindness (BCVA <3/60 in better eye) was seen in 42.8% of bilateral patients. Those with microcornea or microphthalmos with coloboma had worse BCVA (p<0.001). There were regional differences in the type of MAC phenotype presenting to the three institutes. CONCLUSION The MAC group of disorders cause significant ocular morbidity. The presence of microcornea or microphthalmos with coloboma predicts worse BCVA. The variation of the MAC phenotype with the district of origin of the patient raises questions of aetiology and is subject to further studies.
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Zakir SM, Alam MS, Askari SN, Imran M. Pattern of ocular morbidity among students in a school for visually impaired children in North India. Oman J Ophthalmol 2020; 13:24-28. [PMID: 32174736 PMCID: PMC7050457 DOI: 10.4103/ojo.ojo_194_2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022] Open
Abstract
AIMS: The aim of this study was to identify the ocular morbidity pattern among children attending a blind school in North India and comparing the data with similar studies conducted across India and abroad. STUDY DESIGN: This was a cross-sectional observational study. MATERIALS AND METHODS: A cross-sectional study was performed during September 2017 where 94 students attending a blind school were interviewed, and a detailed ocular examination was performed by an ophthalmologist. RESULTS: Sixty-three (67%) children were blind since birth and 29 (30.9%) had absolute blindness. Anatomical site of blindness included retinal disorders in 38 (40.42%), whole globe pathology in 20 (21.40%), optic nerve disorders in 17 (18.09%), corneal diseases in eight (8.51%), and congenital cataract in four (4.26%). A history of consanguinity among parents was reported by 12 (12.8%) students. Blindness was potentially avoidable in 22 (23.4%) children. CONCLUSION: Retinal pathologies were the most common cause for blindness in the present study. The proportion of corneal scarring and congenital cataract is decreasing and majority of cases had unavoidable or incurable blindness. Health education about consanguineous marriages, establishment of pediatric ophthalmology units across the country is essential to eliminate or minimize avoidable blindness among children.
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Affiliation(s)
- Shaik Mohammed Zakir
- Institute of Ophthalmology, J N Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Md Shahid Alam
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
| | - Saiyid Nasir Askari
- Institute of Ophthalmology, J N Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohd Imran
- Institute of Ophthalmology, J N Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Wadhwani M, Vashist P, Singh SS, Gupta V, Gupta N, Saxena R. Prevalence and causes of childhood blindness in India: A systematic review. Indian J Ophthalmol 2020; 68:311-315. [PMID: 31957718 PMCID: PMC7003592 DOI: 10.4103/ijo.ijo_2076_18] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/24/2019] [Accepted: 08/13/2019] [Indexed: 12/03/2022] Open
Abstract
Childhood blindness is one of the priority targets of Vision 2020-Right To Sight due to its impact on the psychological and social growth of the child. An extensive search was performed to locate research papers on childhood blindness prevalence and its causes in the community based and blind schools, respectively, conducted from 1990 onward up to the present. Cross references were also manually searched along with expert consultation to enlarge the reference data. A total of five community-based studies on the prevalence including two refractive error studies conducted all over India in children less than 16 years were found. The causes of childhood blindness from the available blind school studies revealed that causes of childhood blindness have mainly shifted from corneal causes to whole globe abnormalities. This article highlights that though with the availability of proper healthcare facilities, the trend is changing for the causes but still a lot of effort in the form of timely neonatal eye care facilities, pediatric surgical services and proper refraction strategies is required.
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Affiliation(s)
- Meenakshi Wadhwani
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Praveen Vashist
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Suraj Senjam Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Vivek Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Vinekar A, Shetty B, Shetty R, Jayadev C. Taking subspecialty pediatric eye care to the community – The Narayana Nethralaya model. Indian J Ophthalmol 2020; 68:301-302. [PMID: 31957713 PMCID: PMC7003588 DOI: 10.4103/ijo.ijo_19_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Panda L, Nayak S, Warkad VU, Das T, Khanna R. Tribal Odisha Eye Disease Study (TOES) report # 5: Comparison of prevalence and causes of visual impairment among tribal children in native and urban schools of Odisha (India). Indian J Ophthalmol 2019; 67:1012-1015. [PMID: 31238398 PMCID: PMC6611277 DOI: 10.4103/ijo.ijo_1995_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: To compare the prevalence and causes of blindness and visual impairment in tribal school students in the rural day-care and in a residential urban school. Methods: This was a cross-sectional comparative study. The 4-Stage screening in the native habitat of the tribal students performed in the school and hospital involved the trained school teachers, optometrists, comprehensive ophthalmologist, and pediatric ophthalmologist. The 2-Stage screening in the urban school involved only the optometrists and pediatric ophthalmologist. In both instances, vision (presenting and best corrected) was recorded and refraction performed. In addition, fundus photo was taken in all students in the urban school using a non-mydriatic fundus camera. Results: The comparison of blindness, visual impairment, and ocular anomalies were between tribal children (153,107 children; mean age 9.3 ± 2.7 years) examined in the native school and tribal children (10,038 children; mean age 8.8 + 1.64 years) in an urban residential school. Mild and moderate visual impairment was higher in the urban settings (P < 0.05), but severe visual impairment and blindness were similar in both settings. Refractive error, amblyopia, and posterior segment anomaly were detected more often in an urban settings (P < 0.05). Vitamin A deficiency (Bitot's spot) was detected only in children studying in the native schools (P < 0.05). Conclusion: The location, urban or rural, did not influence the visual impairment profile of tribal children. The food habit and environment seem to impact nutritional status.
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Affiliation(s)
- Lapam Panda
- L V Prasad Eye Institute, MTC Campus Patia Bhubaneswar, Bhubaneswar, India
| | - Suryasmita Nayak
- L V Prasad Eye Institute, NMB Eye Centre and JK Centre for Tribal Eye Disease, Rayagada, Odisha, India
| | | | - Taraprasad Das
- L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India
| | - Rohit Khanna
- L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India
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Prevalence of childhood ocular morbidity in a peri-urban setting in Bangladesh: a community-based study. Public Health 2019; 170:103-112. [DOI: 10.1016/j.puhe.2019.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/14/2019] [Accepted: 02/27/2019] [Indexed: 11/17/2022]
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Li Y, Yan J, Wang Z, Huang W, Huang S, Jin L, Zheng Y, Tan X, Yi J, Yip J, Xiao B. Prevalence and causes of childhood blindness in Huidong County, South China, primary ascertained by the key informants. BMJ Open Ophthalmol 2019; 4:e000240. [PMID: 30997405 PMCID: PMC6440593 DOI: 10.1136/bmjophth-2018-000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose The aim of this study is to ascertain the prevalence and causes of childhood blindness and severe visual impairment (BL/SVI) in Huidong, South China. Methods This cross-sectional study was conducted in early 2017 in areas of 139 816 children at the age of 0–15 as the study subjects. We used the trained key informants (KIs) to do preliminary visual test in the communities and refer those children suspected with blindness or unable to count fingers with both eyes at 5 m to hospital for further examination by paediatric ophthalmologist for causes. The WHO’s definition of BL/SVI was used, as blindness is best-corrected visual acuity worse than 0.05 in better eye and SVI is equal to or better than 0.05 but worse than 0.1 in better eye. Results Three hundred and fourteen KIs were trained. In total, 42 children with BL/SVI were found, and among them over half (22, 52.4%) were due to posterior segment disorders by anatomic site and 18 (42.9%) children were potentially preventable; these included BL/SVI caused by factors at children’s development in intrauterine and after birth. This established the prevalence of BL/SVI was at 0.31/1000 (95% CI 0.28 to 0.34/1000). Conclusion A low prevalence of childhood blindness was documented in this study. Establishment of surveillance system for disabled children including those with BL/SVI and better health education on eye care to the public according to the surveillance outcomes would help to reduce avoidable children’s BL/SVI further in China.
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Affiliation(s)
- Yanping Li
- Outpatients Department, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Jianhua Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Zhonghao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Shengsong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
| | - Jinglin Yi
- Outpatients Department, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Jennifer Yip
- The International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Baixiang Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China
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Mahesh KM, John D, Rose A, Paul P. Prevalence of ocular morbidity among tribal children in Jawadhi hills, southern India: A cross-sectional study. Indian J Ophthalmol 2019; 67:386-390. [PMID: 30777958 PMCID: PMC6407384 DOI: 10.4103/ijo.ijo_795_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Childhood blindness is second to cataract in terms of blind person years; population-based prevalence of ocular morbidity among tribal children has not been studied. We conducted this study to determine the prevalence of ocular morbidity in tribal children age 15 years or younger in Jawadhi hills, southern India. Methods A population-based cross-sectional study was conducted in four tribal villages where all children below 15 years of age were invited to participate in the study. After appropriate consent/assent, an optometrist assessed uncorrected vision refraction and best-corrected visual acuity using suitable techniques. A comprehensive ophthalmic examination was also done by an ophthalmologist to determine the presence of ocular morbidity. Children requiring cycloplegic refraction or further treatment were referred to the base hospital. Results Among 260 children examined, the prevalence of ocular morbidity was 10.8% [95% confidence interval (CI): 6.3-13.7]. Vitamin A deficiency (VAD) was the foremost morbidity: 4.6% (95% CI 1.6-6.3) followed by refractive error (2.7%). Three (10.7%) children had more than one ocular morbidity. Nearly 1 in 10 tribal children suffer from ocular morbidity and 1 in 57 had low vision. Conclusion VAD is a public health problem in this tribal region which requires immediate intervention with prophylaxis and treatment. Uncorrected refractive errors in school-age children also need to be attended.
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Affiliation(s)
- K M Mahesh
- Department of Ophthalmology, Schell Eye Hospital, Christian Medical College, Vellore, Tamil Nadu, India
| | - Deepa John
- Department of Ophthalmology, Schell Eye Hospital, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Rose
- Department of Community Medicine, CHAD Hospital, Christian Medical College, Vellore, Tamil Nadu, India
| | - Padma Paul
- Department of Ophthalmology, Schell Eye Hospital, Christian Medical College, Vellore, Tamil Nadu, India
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Hamm LM, Boluk KA, Black JM, Dai S, Thompson B. Phenomenological approach to childhood cataract treatment in New Zealand using semi-structured interviews: how might we improve provision of care. BMJ Open 2019; 9:e024869. [PMID: 30782745 PMCID: PMC6352803 DOI: 10.1136/bmjopen-2018-024869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To understand how we might improve the provision of medical care for children with cataracts. DESIGN A phenomenological design was employed. Semi-structured interviews were conducted to capture rich descriptions of the phenomena. Our goal in the interview and the analysis was to understand the sources of distress associated with treatment for cataract and deprivation amblyopia which (1) could be addressed by the medical community and (2) related to treatment adherence. SETTING Interviews were conducted by a non-clinician researcher in New Zealand (NZ) in a location chosen by informants. In NZ, the red reflex screening test is performed shortly after birth, and surgery to remove paediatric cataracts is publicly funded. PARTICIPANTS Families of children who had a history of cataract in Auckland, NZ were posted an invitation to participate. Twenty families were interviewed. RESULTS Our analysis illustrated that informants described a wide range of experiences, from declined cataract surgery to full adherence to medical advice including years of patching for more than 4 hours a day. Across these experiences, we identified three relevant themes; timing of diagnosis, communication between the parent and clinician, and parental social support networks. CONCLUSION The medical community may be better placed to support families dealing with childhood cataract by improving detection of childhood cataract, building appropriate communication pathways and promoting social support, with an emphasis on empathetic, individualised care.
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Affiliation(s)
- Lisa M Hamm
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Karla A Boluk
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Shuan Dai
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
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Kemmanu V, Giliyar SK, Shetty BK, Singh AK, Kumaramanickavel G, McCarty CA. Emerging trends in childhood blindness and ocular morbidity in India: the Pavagada Pediatric Eye Disease Study 2. Eye (Lond) 2018; 32:1590-1598. [PMID: 29891899 DOI: 10.1038/s41433-018-0142-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/03/2018] [Indexed: 11/09/2022] Open
Abstract
AIM To discuss the aims, methods, and results of a population-based cross-sectional prevalence survey of children ≤15 years, in South India and compare it with a study conducted earlier, in the same area. We also discuss the changing trends in the domain of childhood blindness in India. METHODS A population-based cross-sectional prevalence survey of children ≤15 years, in Pavagada and Madhugiri taluks of Tumkur district in Karnataka state in south India, was conducted in 2 phases. One trained medical-social-worker and one field-investigator identified eligible children and brought them to a makeshift clinic in the village school, where they were examined by an ophthalmologist. Children with minor problems were treated on the field and those with major conditions were referred to the pediatric ophthalmologist in the tertiary hospital. The prevalence of specific diseases were calculated in percentages. RESULTS The prevalence of childhood ocular morbidity (COM) was 6.54%. Refractive errors (2.77%) constituted the major cause of COM. The prevalence of blindness (best corrected visual acuity of <3/60 in the better eye) was 0.09%. Whole-globe anomalies (25%) and uveal coloboma (25%) constituted the main cause of blindness. CONCLUSION A major proportion of the blindness was due to unavoidable causes. Unlike several earlier studies, corneal blindness is no longer the main cause of blindness. This shows that there is a changing trend in the pattern of childhood blindness in India. The current data demonstrate the need for low vision rehabilitative services and a review of public health strategy in India.
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Negiloni K, Ramani KK, Jeevitha R, Kalva J, Sudhir RR. Are children with low vision adapted to the visual environment in classrooms of mainstream schools? Indian J Ophthalmol 2018; 66:285-289. [PMID: 29380777 PMCID: PMC5819114 DOI: 10.4103/ijo.ijo_772_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: The study aimed to evaluate the classroom environment of children with low vision and provide recommendations to reduce visual stress, with focus on mainstream schooling. Methods: The medical records of 110 children (5–17 years) seen in low vision clinic during 1 year period (2015) at a tertiary care center in south India were extracted. The visual function levels of children were compared to the details of their classroom environment. The study evaluated and recommended the chalkboard visual task size and viewing distance required for children with mild, moderate, and severe visual impairment (VI). Results: The major causes of low vision based on the site of abnormality and etiology were retinal (80%) and hereditary (67%) conditions, respectively, in children with mild (n = 18), moderate (n = 72), and severe (n = 20) VI. Many of the children (72%) had difficulty in viewing chalkboard and common strategies used for better visibility included copying from friends (47%) and going closer to chalkboard (42%). To view the chalkboard with reduced visual stress, a child with mild VI can be seated at a maximum distance of 4.3 m from the chalkboard, with the minimum size of visual task (height of lowercase letter writing on chalkboard) recommended to be 3 cm. For 3/60–6/60 range, the maximum viewing distance with the visual task size of 4 cm is recommended to be 85 cm to 1.7 m. Conclusion: Simple modifications of the visual task size and seating arrangements can aid children with low vision with better visibility of chalkboard and reduced visual stress to manage in mainstream schools.
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Affiliation(s)
- Kalpa Negiloni
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai; Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur; Elite School of Optometry, Chennai, India
| | | | - R Jeevitha
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Jayashree Kalva
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Rachapalle Reddi Sudhir
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai, India
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Bakkar MM, Alzghoul EA, Haddad MF. Clinical characteristics and causes of visual impairment in a low vision clinic in northern Jordan. Clin Ophthalmol 2018; 12:631-637. [PMID: 29662299 PMCID: PMC5892951 DOI: 10.2147/opth.s153754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim The aim of the study was to identify causes of visual impairment among patients attending a low vision clinic in the north of Jordan and to study the relevant demographic characteristics of these patients. Subjects and methods The retrospective study was conducted through a review of clinical records of 135 patients who attended a low vision clinic in Irbid. Clinical characteristics of the patients were collected, including age, gender, primary cause of low vision, best corrected visual acuity, and current prescribed low vision aids. Descriptive statistics analysis using numbers and percentages were calculated to summarize categorical and nominal data. Results A total of 135 patients (61 [45.2%] females and 74 [54.8%] males) were recruited in the study. Mean age ± standard deviation for the study population was 24.53 ± 16.245 years; age range was 5–90 years. Of the study population, 26 patients (19.3%) had mild visual impairment, 61 patients (45.2%) had moderate visual impairment, 27 patients (20.0%) had severe visual impairment, and 21 patients (15.6%) were blind. The leading causes of visual impairment across all age groups were albinism (31.9%) and retinitis pigmentosa (RP) (18.5%). Albinism also accounted for the leading cause of visual impairment among the pediatric age group (0–15 years) while albinism, RP, and keratoconus were the primary causes of visual impairment for older patients. A total of 59 patients (43.7%) were given low vision aids either for near or distance. The only prescribed low vision aids for distances were telescopes. For near, spectacle-type low vision aid was the most commonly prescribed low vision aids. Conclusion Low vision services in Jordan are still very limited. A national strategy programme to increase awareness of low vision services should be implemented, and health care policies should be enforced to cover low vision aids through the national medical insurance.
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Affiliation(s)
- May M Bakkar
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman A Alzghoul
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mera F Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Warkad VU, Panda L, Behera P, Das T, Mohanta BC, Khanna R. The Tribal Odisha Eye Disease Study (TOES) 1: prevalence and causes of visual impairment among tribal children in an urban school in Eastern India. J AAPOS 2018; 22:145.e1-145.e6. [PMID: 29555516 DOI: 10.1016/j.jaapos.2017.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 10/04/2017] [Accepted: 10/27/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE To estimate the prevalence and causes of visual impairment and other ocular comorbidities among tribal children in an urban school population in eastern India. METHOD In this cross-sectional study, vision screening tests were administered to tribal school children. Demographic data, including name, age, sex, home district, height, and weight of each child, and examination data, including unaided and pinhole visual acuity, external eye examination with a flashlight, slit-lamp examination, intraocular pressure (IOP) measurement, and undilated fundus photography, were collected. Children with visual acuity of less than 20/20, abnormal anterior or posterior segment findings, and IOP of >21 mm Hg were referred for further evaluation. RESULTS Of 10,038 children (5,840 males [58.2%]) screened, 335 (median age, 9 years; range, 6-17 years) were referred. Refractive error was the most common cause of visual impairment (59.52%; 95% CI, 51.97-66.65) followed by amblyopia (17.2%; 95% CI, 12.3-23.6) and posterior segment anomaly (14.88%; 95% CI, 10.2-21.0). The prevalence of best-corrected visual acuity of 20/40 was 0.13%. The prevalence of blindness was 0.03%. CONCLUSIONS Visual impairment among tribal children in this residential school is an uncommon but important disability.
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Affiliation(s)
- Vivekanand U Warkad
- Miriam Hyman Children's Eye Care Centre, L V Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India.
| | - Lapam Panda
- Miriam Hyman Children's Eye Care Centre, L V Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India
| | - Pradeep Behera
- Miriam Hyman Children's Eye Care Centre, L V Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India
| | - Taraprasad Das
- International Centre for Advancement of Rural Eye Care, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Bikash C Mohanta
- Indian Oil Centre For Rural Eye Health, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Rohit Khanna
- International Centre for Advancement of Rural Eye Care, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
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Maitreya A, Rawat D, Pandey S. A pilot study regarding basic knowledge of "cortical visual impairment in children" among ophthalmologists. Indian J Ophthalmol 2018; 66:279-284. [PMID: 29380776 PMCID: PMC5819113 DOI: 10.4103/ijo.ijo_425_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: A pilot study was done to evaluate knowledge regarding “cortical visual impairment (CVI) in children” among ophthalmologists. Methods: This study was conducted during the annual conference of a zonal ophthalmological society. All ophthalmologists who attended the conference were requested to participate in this study. Those who agreed were given a validated questionnaire to assess knowledge regarding CVI. Cronbach's alpha of the questionnaire was 0.6. Participants were asked to respond to multiple choice questions by choosing the single best option. The responses obtained were then evaluated. Results: The total number of registered delegates in the conference was 448. A total of 103 ophthalmologists showed interest to participate in the study with a response rate of 22.9%. Only 89/103 interested delegates were included in the study as remaining were unaware of CVI. No participant gave correct answers to all questions. Although more than 80% of them knew the most common association (87%) and site of pathology (84%), only 52% were sure about clinical features and even lesser respondents (39%) knew that magnetic resonance imaging is the correct investigation of choice. The majority responded correctly that these children need eye examination (89%) and can be managed by rehabilitation through multidisciplinary approach (82%), but only 58% could recognize differential diagnoses and had a correct idea regarding the prognosis of CVI. There was no correlation between the number of patients diagnosed per month by the respondent with knowledge of the disease. Conclusion: In this pilot study, ophthalmologists were found to have limited knowledge regarding clinical features, investigation, differential diagnosis, and visual prognosis of CVI in children. There is a need to improve awareness regarding CVI among ophthalmologists.
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Affiliation(s)
- Amit Maitreya
- Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Darshika Rawat
- Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Shubham Pandey
- Department of Bio-statistics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Kemmanu V, Rathod P, Rao HL, Muthu S, Jayadev C. Management of cataracts and ectopia lentis in children: Practice patterns of pediatric ophthalmologists in India. Indian J Ophthalmol 2017; 65:818-825. [PMID: 28905824 PMCID: PMC5621263 DOI: 10.4103/ijo.ijo_896_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: To analyze the current practice patterns of Indian pediatric ophthalmologists in the management of lens anomalies. This study was conducted in a tertiary eye care hospital and involved an online questionnaire survey for practicing pediatric ophthalmologists in India. Methods: A questionnaire was devised by the authors, which included the various options available for the management of lens anomalies in children. The questionnaire was sent to each of them using an online portal. Commercial software (Stata ver. 13.1; StataCorp, College Station, TX, USA) was used for statistical analysis. Results: In unilateral cataracts in children aged <6 months, 85.42% of surgeons did not prefer to insert an intraocular lens (IOL). In the age group of 6–12 months, almost half of them preferred to insert an IOL. In the age group of 12–24 months and >24 months, 92.63% and 88.54%, respectively, preferred to insert an IOL. In bilateral cataracts, in children aged <6 months, 91.84% of surgeons did not prefer to insert an IOL, whereas in the age group of 6–12 months, 69.39% did not prefer to insert an IOL. In the age group of 12–24 months and >24 months, 80.61% and 90.82%, respectively, preferred to insert an IOL. Seventy-four percent of surgeons preferred to use a single-piece hydrophobic acrylic IOL. Conclusion: The management of lens anomalies by pediatric ophthalmologists in India varies with laterality and appears to be comparable to that followed worldwide.
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Affiliation(s)
- Vasudha Kemmanu
- Department of Pediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pragnya Rathod
- Department of Pediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Harsha L Rao
- Department of Glaucoma Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sumitha Muthu
- Department of Pediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Vitreo-Retina Services, Narayana Nethralaya, Bengaluru, Karnataka, India
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Abstract
The World Health Organization estimates that 19 million children are visually impaired, among whom, 1.4 million are blind. Childhood blindness is an excellent indicator of the state of child health and primary care services in a country. Childhood blindness is important not just due to the number of children blind but also because the number of years that the surviving child has to live with blindness (blind years lived). Childhood blindness is next only to adult cataract in terms of the number of blind person years lived. Under-five mortality rates have been used as a proxy measure to compute the prevalence of childhood blindness in low and middle income countries due to limitations of other methods of data collection. In India, it is estimated that there are 0.8 blind for 1000 children. Whole globe lesions, corneal scarring, retinal pathology and afflictions of the lens are important anatomical sites in children. Causes operating in childhood and hereditary causes are important in etiology of childhood blindness. In 38.2%-68.4% cases across the region, a specific cause of blindness could not be identified in South Asia. The proportion of blindness that can be prevented or treated (avoidable) in children is less than 50%. Therefore a comprehensive eye care system needs to be in place to cater to the needs of children with avoidable and those with incurable blindness. Early detection and prompt management are critical for success of programs targeting avoidable blindness in children.
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Affiliation(s)
- Venkata S Murthy Gudlavalleti
- Indian Institute of Public Health, Hyderabad, India. .,International Centre for Eye Health, Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E7HT, UK. .,, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, 500033, India.
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Sakki HEA, Dale NJ, Sargent J, Perez-Roche T, Bowman R. Is there consensus in defining childhood cerebral visual impairment? A systematic review of terminology and definitions. Br J Ophthalmol 2017; 102:424-432. [DOI: 10.1136/bjophthalmol-2017-310694] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/28/2017] [Accepted: 10/06/2017] [Indexed: 01/24/2023]
Abstract
The childhood condition of visual difficulties caused by brain damage, commonly termed cortical or cerebral visual impairment (CVI), is well established but has no internationally accepted definition. Clarification of its core features is required to advance research and clinical practice. This systematic review aimed to identify the definitions of childhood CVI in the original scientific literature to describe and critically appraise a consensual definition of the condition. MEDLINE, EMBASE, PsychINFO, CINAHL and AMED databases were searched in January 2017. Studies were included if they (1) were published original research, (2) contained a childhood CVI sample, (3) contained a definition of CVI and (4) described their CVI identification/diagnostic method. Thematic analysis identified concepts within definitions and narrative synthesis was conducted. Of 1150 articles, 51 met inclusion criteria. Definitions were subdivided according to detail (descriptive definition, description not reaching definition status and diagnostic/operationalising criteria). Three themes concerning visual deficits, eye health and brain integrity were identified (each containing subthemes) and analysed individually across definitions. The most common themes were ‘visual impairment’ (n=20), ‘retrochiasmatic pathway damage’(n=13) and ‘normal/near normal eye health’ (n=15). The most consensual definition identified here may not be the best quality for advancing our understanding of CVI. We argue for the alternative definition: CVI is a verifiable visual dysfunction which cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. We propose reporting guidelines to permit comparison across studies and increase the evidence base for more reliable clinical assessment and diagnosis.
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Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child 2017; 102:853-857. [PMID: 28465303 DOI: 10.1136/archdischild-2016-310532] [Citation(s) in RCA: 187] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 01/25/2023]
Abstract
An estimated 1.4 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during childhood and to die in childhood than a child not living with blindness. This update of a previous review on childhood visual impairment focuses on emerging therapies for children with severe visual disability (severe visual impairment and blindness or SVI/BL).For children in higher income countries, cerebral visual impairment and optic nerve anomalies remain the most common causes of SVI/BL, while retinopathy of prematurity (ROP) and cataract are now the most common avoidable causes. The constellation of causes of childhood blindness in lower income settings is shifting from infective and nutritional corneal opacities and congenital anomalies to more resemble the patterns seen in higher income settings. Improvements in maternal and neonatal health and investment in and maintenance of national ophthalmic care infrastructure are the key to reducing the burden of avoidable blindness. New therapeutic targets are emerging for childhood visual disorders, although the safety and efficacy of novel therapies for diseases such as ROP or retinal dystrophies are not yet clear. Population-based epidemiological research, particularly on cerebral visual impairment and optic nerve hypoplasia, is needed in order to improve understanding of risk factors and to inform and support the development of novel therapies for disorders currently considered 'untreatable'.
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Affiliation(s)
- Ameenat Lola Solebo
- Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK.,Great Ormond Street Hospital/Institute of Child Heath, NIHR Biomedical Research Centre, London, UK.,Visual function and integrative epidemiology, Moorfields Eye Hospital and Institute of Ophthalmology NIHR Biomedical Research Centre, London, UK.,Ulverscroft Vision Research Group, London, UK
| | - Lucinda Teoh
- Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK
| | - Jugnoo Rahi
- Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK.,Ulverscroft Vision Research Group, London, UK.,Great Ormond Street Hospital/Institute of Child Heath, NIHR Biomedical Research Centre, London, UK.,Visual function and integrative epidemiology, Moorfields Eye Hospital and Institute of Ophthalmology NIHR Biomedical Research Centre, London, UK
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Cao Q, Lin Y, Xie Z, Shen W, Chen Y, Gan X, Liu Y. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. Paediatr Anaesth 2017; 27:629-636. [PMID: 28414899 DOI: 10.1111/pan.13148] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. METHODS One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg-1 , n = 71) or oral chloral hydrate (80 mg·kg-1 , n = 70). The primary endpoint was successful sedation to complete the examinations including slit-lamp photography, tonometry, anterior segment analysis, and refractive error inspection. The secondary endpoints included quality of eye position, intraocular pressure, onset time, duration of examination, recovery time, discharge time, any side effects during examination, and within 48 h after discharge. RESULTS Sixty-one children were sedated by dexmedetomidine with a success rate of 85.9%, which is significantly higher than that by chloral hydrate (64.3%) [OR 3.39, 95% CI: 1.48-7.76, P = 0.003]. Furthermore, children in the dexmedetomidine group displayed better eye position in anterior segment analysis than in chloral hydrate group median difference. All children displayed stable hemodynamics and none suffered hypoxemia in both groups. Oral chloral hydrate induced higher percentages of vomiting and altered bowel habit after discharge than dexmedetomidine. CONCLUSIONS Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children.
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Affiliation(s)
- Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yiquan Lin
- Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhubin Xie
- Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Weihua Shen
- Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ying Chen
- Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoliang Gan
- Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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