A Survey of Severe Visual Impairment and Blindness in Children Attending Thirteen Schools for the Blind in Sri Lanka

Abstract

Purpose: To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending schools for the blind in Sri Lanka, and to provide optical devices and ophthalmic treatment where indicated.

Methods: Two hundred and six children under 16 years from 13 schools for the blind in Sri Lanka were examined by a team of ophthalmologists and optometrists. Data were entered in the World Health Organization Prevention of Blindness Eye Examination Record for Childhood Blindness (WHO/PBL ERCB).

Results: Of the 206 children, 83.5% were blind (BL = Visual acuity [VA] <3/60), and 9.2% had severe visual impairment (SVI = VA <6/60 to 3/60 in the better eye). The major anatomical site of BL/SVI was the retina in 35.9% of cases, followed by the whole globe in 22.4% of cases. The major underlying aetiologies of BL/SVI were unknown in 43.8% of cases and hereditary in 37.5%. Avoidable causes of BL/SVI accounted for 34.9% of cases; retinopathy of prematurity made up the largest proportion of this subgroup. One third of the children required an optical device to improve their vision.

Conclusion: Just over one third of the children in schools for the blind in Sri Lanka had potentially avoidable causes of BL/SVI. Vision could also be improved in a third of children. The data support the need to develop specialized pediatric ophthalmic services, particularly in the face of advancing neonatal life support in Sri Lanka, and the need for increased provision of optical support.

KEYWORDS::

• Blindness
• Children
• Sri Lanka
• Survey
• Visual impairment

ACKNOWLEDGEMENTS

The authors would like to thank Mr. K.B. Pilapitiya for coordinating the study in Sri Lanka, and the College of Ophthalmologists of Sri Lanka for their support. All low vision devices and lenses when required were provided by the National Low Vision Program Sri Lanka.

The survey was fully funded by South Australian Institute of Ophthalmology.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.