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Childhood blindness is a significant public health problem in India, with one in 1,000 children in the country suffering from blindness, and one child becomes blind bilaterally every minute. Unlike adults in whom 80% of the causes of blindness are preventable, in children this figure is only 50%, according to Dr Bindiya Hapani, consultant ophthalmologist, Dr Agarwals Eye Hospital, Bengaluru.
There are approximately 1.5 million blind children worldwide, and an additional 18 million children have moderate to severe visual impairment. Almost three-quarters of them live in low- and middle-income countries where the prevalence is 1.5 per 1,000 children, unlike high-income countries where the prevalence is only 0.3 per 1,000 children .
Noted Dr. Bindiya Hapani: “Common causes of childhood blindness in India include untreated refractive errors, corneal opacities due to measles, vitamin A deficiency, eye infections like neonatal ophthalmia or toxicity from traditional eye remedies, congenital cataracts. , congenital glaucoma and ROP. The causes of childhood blindness have evolved over the years. In studies conducted between 1999 and 2007, corneal-related causes were among the major factors of childhood blindness in India. However, studies between 2007 and 2018 showed a trend of progression to world-wide problems like microphthalmia (small eye), anophthalmia (no eye), and retinopathy of prematurity (ROP).
She added: “Global problems as a cause of childhood blindness are due to genetic abnormalities caused by consanguineous marriages, maternal alcohol consumption and her exposure to fertilizers and pesticides during pregnancy. In urban India, retinopathy of prematurity has become a major cause of childhood blindness due to better availability of neonatal care services, whereby more low birth weight babies are surviving. In rural India, on the other hand, the mortality rate for low birth weight newborns is much higher than in the cities. ”
Noted Dr. Bindiya Hapani: “A change in the causes of childhood blindness over the years shows the success of the government’s health and immunization programs and the growing socio-economic development of the country. Yet challenges remain in preventing childhood blindness. The availability of good primary health care is essential to combat childhood blindness. Good nutrition, maternal and child care facilities, immunization, and proper diagnosis and treatment of common eye conditions are also important. In rural areas, the availability of tertiary care facilities with well-trained ophthalmologists remains a big challenge. ”
She added: “Pediatric eye care facilities are inadequate and not evenly distributed across the country. Better ratios are observed in southern and western India, compared to northern and eastern India. Although pediatric ophthalmology is now developing as a separate subspecialty in the country, the number of pediatric ophthalmologists is much lower than that of the infant population. However, most pediatric eye conditions can be diagnosed and treated by general ophthalmologists. Pediatric ophthalmologists are needed for complex conditions such as congenital cataracts, strabismus, and retinopathy of prematurity. ”
Speaking about how parents can tell if their child is headed for blindness, Dr Bindiya Hapani said children are born with an immature visual system. If prompt treatment is not provided for eye conditions in a child, it can lead to failure of normal visual maturation (amblyopia), which cannot be treated in adulthood.
She added: “If a child develops strabismus in the eye or if a white reflex is seen from the pupil (leukocoria), an ophthalmologist should be consulted immediately. A major cause of visual impairment in children is refractive error. Therefore, it is important to have a preschool eye exam of the child. Blindness can severely restrict children’s academic, emotional, psychological and social development. Severe visual impairment can also delay their developmental stages and increase the risk of hospitalization. ”
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