Etiological profile of visual impairment in children

Introduction: Vision 2020—the right to sight programme is a global initiative to eliminate avoidable blindness worldwide by the year 2020. The control of blindness in children is one of the priority areas of the World Health Organization's Vision 2020. The aim of this study was to identify the major causes of visual impairment in children and to identify the avoidable, i.e. readily preventable or treatable, causes of severe visual impairment/ blindness. Materials and Methods: It was an observational cross sectional study, conducted in the Out Patient Department (OPD) of an ophthalmology unit of a tertiary hospital in northern India between; June 2012 to May 2017. The study population was all new patients aged 16 years and younger. 1543 children < 16> A detailed history was elicited. Refraction was performed as and when required. Anterior segment examination was done with torch and slit lamp. Posterior segment examination was performed using direct and indirect ophthalmoscopy. Results: Among the study population, 54.2% were females with a Female: Male ratio of 1.18:1. Maximum numbers of children were of the age group of 12-15yrs. Anatomical sites affected in these patients were whole globe (microphthalmos, anophthalmos, phthisis) in 3.5%, cornea (staphyloma, scar) 11%, retina (dystrophy, post inflammatory retinal scarring and retinopathy of prematurity) 6.5%, lens 37%. Maximum number of cases having visual impairment due to lenticular causes (cataract, aphakia, pseudophakia) and others (Refractive errors including High Pathological Myopia, Strabismus, Ptosis)were seen in the age group 12-15yrs. (p<0> Refractive errors included cases of myopia, hypermetropia and astigmatism. Conclusion: Although most ocular lesions are preventable but due to ignorance and carelessness of being not attended to, they cause impairment of vision or even blindness. Our findings can be of great assistance to existing school eye health programmes that are focusing mainly on the problems of refractive errors in children.