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  • Tackling Pediatric Visual Impairment Requires Extra Vigilance

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    British Journal of Ophthalmology
    Published online Oct. 13, 2022

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    Children who are blind or otherwise visually impaired are at risk for poor health, low education, low socioeco­nomic status, and adverse psychosocial outcomes. Data on vision-impairing conditions affecting children are lacking for many countries, and there are disparities in the definitions of avoidable, preventable, and treatable blinding disorders. Solebo et al. set out to address the information gap and quantify the current burden of avoid­able childhood visual impairment (VI) in the United Kingdom. They found that about 30% of children have a disorder that is considered treatable or preventable.

    The investigation, known as the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), is a national prospective longitudinal study of pediatric patients with a new diagnosis of vision worse than 0.48 log­MAR in both eyes. Outcome measures were the proportion of participants with an avoidable disorder, defined as “treatable” (isolated disorder for which readily available effective interventions can improve vision or halt visual loss) or “potentially preventable” (isolated disorder with interventions proven to reduce disease incidence). Treatable conditions included cataract, glauco­ma, tumors of the visual pathway, and retinopathy of prematurity (ROP). Potentially preventable disorders included eye injury, congenital infec­tions, autosomal inherited disorders with an established family history, and hypoxic-ischemic encephalopathy in the absence of a coexisting cause of unavoidable blindness.

    Among the 784 children in BCVIS2, 313 had moderate VI, and 471 had severe VI. Of those with purely isolated causes of VI, 132 had disorders that were potentially preventable, including hypoxic-ischemic encephalopathy (n = 64) and autosomal inherited disorders (n = 46). Another 99 children had treatable conditions; the most common were cataract (n = 42), ROP (n = 27), and glaucoma (n = 21).

    The World Health Organization has developed supranational guidance for community- and hospital-based eye and vision care, but uptake of the strat­egies to prevent and treat key blinding disorders in children varies through­out the world, reflecting transitions in health care that accompany economic changes.

    Although many high-income nations have substantially improved ef­forts to address childhood VI in recent decades, greater vigilance is needed to ensure effective implementation of prevention and treatment programs, said the authors.

    The original article can be found here.