Evaluation of children in six blind schools of Andhra Pradesh.

PURPOSE: 1. To determine the anatomical site and underlying causes of severe visual impairment and blindness in children in special education in Andhra Pradesh, India. 2. To compare the causes of blindness in two different regions in the state. 3. To evaluate improvement with correction of refractive error and low-vision devices (LVDs). METHODS: Children in 6 schools for the blind and in 3 integrated education programmes were examined by one ophthalmologist, and were refracted and assessed for LVDs by an optometrist. The major anatomical site and underlying aetiology of severe visual impairment and blindness (SVI/BL; < 6/60 in the better eye) were recorded using the standardised WHO reporting form. RESULTS: Two hundred and ninety one students under 16 years were examined, and after refraction, 267 (91.7%) were classified as being severely visually impaired or blind. The most common anatomical sites of SVI/BL were retina in 31.1% children; cornea in 24.3%; and whole globe in 20.2%. The aetiology was unknown in 38.2%, hereditary in 34.8% and childhood causes in 24%. 114 children (39.2%) had functional low vision (i.e. visual acuity < 6/18 to light perception with navigational vision). In this group, 36 children improved with spectacles and 16 benefited by LVDs. 41 children (15.4%) were able to read N10 point though they were studying Braille. CONCLUSION: Overall 37.4% of children had "avoidable" causes of blindness. The major avoidable causes were vitamin-A deficiency and cataract. Vitamin-A deficiency and congenital anomalies were more common in the dry plateau areas of the state. One in seven children could read normal print with optical support.

Planning to reduce childhood blindness in India.

Reduction of blindness in children assumes particular significance since a blind child suffers from more blind-years than a blind adult. Estimates of the number of children blind in India and the causes of blindness are relatively crude as there are little reliable epidemiologic data. As a result of this, there is no organised approach to the control of childhood blindness in India. In order to address this issue, a workshop on childhood blindness was held at the L.V. Prasad Eye Institute, Hyderabad in November 1996. The aim of this workshop was to review available data, consider possible strategies, and make recommendations concerning the control of childhood blindness in India. These recommendations along with background information about childhood blindness are presented in this paper.