Abstract
AIMS—To determine the anatomical site and underlying causes of blindness and severe visual impairment in children under 16 years of age in special education in the People's Republic of China with a view to determining potentially preventable and treatable causes. METHODS—A national study of children attending schools for the blind in China was conducted between April and June 1998 using the WHO Prevention of Blindness Programme (WHO/PBL) eye examination record for children with blindness and low vision. Eight Chinese ophthalmologists attended a training workshop before conducting the study. 36 blind schools in 18 provinces of China were included. RESULTS—1245 children aged between 5 and 15 years were examined, of whom 1131 (91%) were blind or severely visually impaired (visual acuity less than 6/60 in the better eye). The commonest anatomical sites of visual loss were whole globe (mainly microphthalmos) 25.5% and retina (mainly dystrophies) 24.9%. Lens was the major site in 18.8%, optic nerve in 13.6%, and glaucoma in 9%. Corneal scarring was not a major cause of visual loss. The aetiology was unknown in 52.9%, hereditary factors were responsible in 30.7%, and childhood causes in 14%. 15% of cases were considered potentially preventable and 22.5% potentially treatable. CONCLUSION—The pattern of childhood blindness seen in this study is likely to reflect the improved health and socioeconomic status of China but may partly reflect bias in admission to, and location of, blind schools, with higher socioeconomic groups overrepresented. Nutritional and infective causes of blindness are uncommon, and hereditary and unknown factors are now the predominant causes.
Full Text
The Full Text of this article is available as a PDF (72.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bittles A. H., Mason W. M., Greene J., Rao N. A. Reproductive behavior and health in consanguineous marriages. Science. 1991 May 10;252(5007):789–794. doi: 10.1126/science.2028254. [DOI] [PubMed] [Google Scholar]
- Eckstein M. B., Foster A., Gilbert C. E. Causes of childhood blindness in Sri Lanka: results from children attending six schools for the blind. Br J Ophthalmol. 1995 Jul;79(7):633–636. doi: 10.1136/bjo.79.7.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foster A., Gilbert C. Epidemiology of childhood blindness. Eye (Lond) 1992;6(Pt 2):173–176. doi: 10.1038/eye.1992.34. [DOI] [PubMed] [Google Scholar]
- Foster A., Sommer A. Corneal ulceration, measles, and childhood blindness in Tanzania. Br J Ophthalmol. 1987 May;71(5):331–343. doi: 10.1136/bjo.71.5.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilbert C., Foster A. Causes of blindness in children attending four schools for the blind in Thailand and the Philippines. A comparison between urban and rural blind school populations. Int Ophthalmol. 1993 Aug;17(4):229–234. doi: 10.1007/BF01007745. [DOI] [PubMed] [Google Scholar]
- Gilbert C., Foster A., Négrel A. D., Thylefors B. Childhood blindness: a new form for recording causes of visual loss in children. Bull World Health Organ. 1993;71(5):485–489. [PMC free article] [PubMed] [Google Scholar]
- Gilbert C., Rahi J., Eckstein M., Foster A. Hereditary disease as a cause of childhood blindness: regional variation. Results of blind school studies undertaken in countries of Latin America, Asia and Africa. Ophthalmic Genet. 1995 Mar;16(1):1–10. doi: 10.3109/13816819509057847. [DOI] [PubMed] [Google Scholar]
- Gilbert C., Rahi J., Eckstein M., O'Sullivan J., Foster A. Retinopathy of prematurity in middle-income countries. Lancet. 1997 Jul 5;350(9070):12–14. doi: 10.1016/S0140-6736(97)01107-0. [DOI] [PubMed] [Google Scholar]
- Rahi J. S., Sripathi S., Gilbert C. E., Foster A. Childhood blindness in India: causes in 1318 blind school students in nine states. Eye (Lond) 1995;9(Pt 5):545–550. doi: 10.1038/eye.1995.137. [DOI] [PubMed] [Google Scholar]
- Warburg M. Classification of microphthalmos and coloboma. J Med Genet. 1993 Aug;30(8):664–669. doi: 10.1136/jmg.30.8.664. [DOI] [PMC free article] [PubMed] [Google Scholar]