Skip to main content

  • ROP Is Leading Cause of Blindness in U.S. Children Seen By Ophthalmologists

    By Kathleen Erickson, MLIS 
    Selected by Russell N. Van Gelder, MD, PhD
    Pediatric Ophth/Strabismus, Retina/Vitreous
    Add to My Bookmarks

    Journal Highlights

    Ophthalmology, September 2023

    Download PDF

    Previous research has shown that the leading causes of childhood blindness vary according to a country’s human development index (HDI): cortical visual impairment (CVI) tops the list in high-HDI countries, whereas cataract, inherited retinal diseases, and congenital abnormalities are the most common causes in low-HDI countries. However, there have been few studies on the causes of childhood blindness in the United States specifically. Lim et al. used the IRIS Registry to gather data on legally blind U.S. children who had seen an ophthalmologist. They found that retinopathy of prematurity (ROP) was the most common diagnosis, most conditions were treatable, and factors associated with childhood blindness included age, sex, ethnicity/race, and geographic setting.

    IRIS Registry data from 2018 revealed 961 patients ≤18 years of age with cor­rected VA of 20/200 or worse (logMAR ≥1.0) in their better-seeing eye. The primary study outcomes were causes of blindness, which were classified by diagnosis and by anatomic site.

    The leading causes of blindness were ROP (31.3%), nystagmus (8.1%), cata­ract (6.7%), optic nerve atrophy (6.5%), and CVI (2.4%). These results differ from those for other high-HDI coun­tries, which had lower rates of ROP and cataract than the United States. Anatomically, 47.7% of cases were in the retina, 11.6% in the optic nerve, and 10.0% in the lens.

    Compared with the IRIS Registry general pediatric population, children with blindness were more likely to be 0 to 2 years of age (29.3% vs. 5.5%), male (54.8% vs. 48.2%), Hispanic/ Latino (30.2% vs. 11.9%), or Black (11.3% vs. 7.8%); they also were more likely to reside in an urban setting (64.8% vs. 28.4%) and to live in the south (46.8% vs. 35.8%).

    Even though the IRIS Registry does not capture all children with blindness in the United States, the data suggest that the disease burden for ROP and cataract is substantial. Given that potentially half of pediatric blindness nationwide is attributable to treatable conditions (primarily ROP patholo­gy), the authors suggest focusing on this area and on improving access to eye care for refractive and amblyopic management.

    The original article can be found here.