Avoidable blindness and its correction in schools for the blind in Gujarat, India
Keywords:Childhood blindness, Severely visually impaired, Magnifiers, Low vision devices, Non-optical devices
Background: The primary objectives of our study were to determine the causes of blindness in blind school students, to ascertain the need for spectacles and magnifiers as low vision devices (LVD) in these children with useful residual vision and to determine the acceptance of magnifiers in different ocular pathologies
Methods: The various causes of blindness were analysed in 179 blind female students in terms of the anatomical disorder present, the age of the child at the time of presentation with the visual disorder and the visual outcome observed after prescription of spectacles, magnifiers and non-optical devices.
Results: Microphthalmos (44%), corneal scars (13.4%), anophthalmos (11.7%), optic atrophy (10.6%) and retinal dystrophies (10.1%) accounted for the major causes of blindness. 63.1% of blind children had an undetermined age of onset of visual impairment. Majority of the cases with anophthalmos, retinitis pigmentosa, corneal degeneration, microphthalmos, buphthalmos, staphylomas and retinal dystrophies benefitted with the use of non-optical devices. 60% of the aphakic and pseudophakic eyes were prescribed magnifiers.
Conclusions: Spectacles and low vision devices do have a promising role in the visual rehabilitation of the ‘incurably blind children’.
World Health Organization. Programme for the Prevention of blindness and deafness - Global Initiative for the Elimination of Avoidable Blindness. Document no.: WHO/PBL/97.61 Rev.1; Geneva: World Health Organization; 1997.
Rahi JS, Gilbert CE, Foster A, Minassian D. Measuring the burden of childhood blindness. Br J Ophthalmol. 1999;83(4):387-8.
Bhattacharjee H, Das K, Borah RR, Guha K, Gogate P, Purukayastha S. et al. Causes of childhood blindness in the North-Eastern states of India. Indian J Ophthalmol. 2008;56:495-9.
Stelmack JA, Stelmack TR, Massof RW. Measuring low-vision rehabilitation outcomes with the NEI VFQ-25. Invest Ophthalmol Vis Sci. 2002;43:2859-68.
Gilbert C, Foster A, Negrel AD, Thylefors B. Childhood blindness: a new form for recording causes of visual loss in children. Bull World Health Organ. 1993;71(5):485-9.
Margrain TH. Helping blind and partially sighted people to read: the effectiveness of low vision aids. Br J Ophthalmol. 2000;84:919-21.
Gothwal V, Herse P. Characteristics of a low vision population in a private eye hospital in India. Ophthal Physiol Opt. 2000;20:212-9.
Gogate P, Deshpande M, Sudrik S, Taras S, Kishore H, Gilbert C, et al. Changing pattern of childhood blindness in Maharashtra, India. Br J Ophthalmol. 2007;91:8-12.
Titiyal JS, Pal N, Murthy GV, Gupta SK, Tandon R, Vajpayee RB, et al. Causes and temporal trends of blindness and severe visual impairment in children in schools for the blind in North India. Br J Ophthalmol. 2003;87:941-5.
Rahi JS, Sripathi S, Gilbert CE, Foster A. Childhood blindness due to vitamin A deficiency in India; regional variations. Arch Dis Child. 1995;72:330-3.
Rahi JS, Sripathi S, Gilbert CE, Foster A. The importance of prenatal factors in childhood blindness in India. Dev Med Child Neurol. 1997;39:449-55.
Hornby SJ, Adolph S, Gothwal VK, Gilbert CE, Dandona L, Foster A. Evaluation of children in six blind schools of Andhra Pradesh. Indian J Ophthalmol. 2000;48:195-200.
Silver J, Gilbert CE, Spoerer P, Foster A. Low vision in east African blind school students: need for optical low vision services. Br J Ophthalmol. 1995;79:814-20.
Sloan L. Reading aids for partially sighted-factors which determine success or failure. Arch Ophthalmol. 1968;76:101-5.
Hornby SJ, Adolph S, Gothwal VK, Gilbert CE, Dandona L, Foster A. Requirements for optical services in children with microphthalmos, coloboma and microcornea in southern India. Eye (Lond). 2000;14:219-24.
Hyvarinen L. Assessment of low vision for educational purposes and early intervention, Part 1. La Salle: Precision Vision; 1999: 28.
O’Connor AR, Stephenson TJ, Johnson A, Wright SD, Tobin MJ, Ratib S, et al. A comparison of findings on parents’ and teachers’ questionnaires and detailed ophthalmic and psychological assessments. Arch Dis Child. 2004;89;831-5.
Pal N, Titiyal JS, Tandon R, Vajpayee RB, Gupta S, Murthy G. Need for optical and low vision services for children in schools for the blind in North India. Indian J Ophthalmol. 2006;54:189-93.