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  • Causes of Childhood Blindness in the United States

    In the United States in 2018, the leading cause of childhood blindness reported in the IRIS Registry was retinopathy of prematurity (ROP), a treatable condition, reported Han Woong Lim, MD, PhD, speaking on Sunday during the Pediatric Ophthalmology, Strabismus Original Papers session.

    Childhood blindness has not been seen as important. Although children make up only 3% of the world’s blind population, the societal and familial burden is disproportionately greater because of delayed social, emotional, and learning development. However, the World Health Organization has now made eliminating childhood blindness a high priority.

    Few studies of childhood blindness in the United States. Because of the previous absence of a U.S.-based registry, most of the U.S. studies researching childhood blindness had focused on schools for the blind, which are attended by only 13% of school-aged blind children. But with the creation of the Academy IRIS Registry (Intelligent Research in Sight), the first comprehensive national eye disease registry, researchers now have a wealth of information at their fingertips.

    Extensive study of 2018 IRIS Registry data. The study included 81,164 children (aged ≤18 years) whose VA was 20/200 or worse. In patients with multiple diagnoses, the likely primary cause of visual loss was determined by reviewing all diagnoses.

    ROP is the main cause of childhood blindness. By far, the leading cause of childhood blindness was ROP, affecting 31.3% of the population of blind children. The next most common causes were nystagmus (8.1%), cataract (6.7%), and optic nerve atrophy (6.5%). However, while cortical visual impairment (CVI) is the most common cause of childhood blindness globally, only 2.4% of patients in this U.S. study had CVI. Reasons for these findings included:

    • Patients were diagnosed with nystagmus or amblyopia rather than CVI.
    • Patients with CVI might have had other disabilities that prevented them from having VA testing.

    Blindness is treatable, however. Fifty-two percent of patients had treatable causes of blindness, particularly ROP. This is consistent with studies conducted in other countries.

    What ophthalmologists can do. Given that over half of the patients had treatable diseases like ROP, Dr. Lim concluded the presentation by saying that “Ophthalmologic resources, including screening and treatment, should focus on these treatable diseases.”  —Stephanie Leveene, ELS

    Financial disclosures: Dr. Lim: None.

    Read more news about Subspecialty Day and AAO 2022.