Childhood blindness

Childhood blindness is an important cause contributing to the burden of blindness.^[1] Blindness in children can be defined as a visual acuity of <3/60 in the eye with better vision of a child under 16 years of age.^[2] This means, generally, that the child cannot see something three feet (about one meter) away that another child could see if it was 60 feet (about 20 meters) away.^[3]

Causes

Human Eye

There are many causes of blindness in children. Blindness may be due to genetic mutations, birth defects, premature birth, nutritional deficiencies, infections, injuries, and other causes. Severe retinopathy of prematurity (ROP), cataracts and refractive error are also causes.^[4][5]

The most frequently affected parts of the eyes are:^[6][7]

• the whole globe (36%)
• cornea (36%)
• lens (11%)
• retina (6%)
• optic nerve (5%)
• uvea (2%)

Mechanism

Childhood blindness has many causes, and each cause has its own method of damaging the eyes.^[8] Leber congenital amaurosis primarily affects the retina, typically severe visual impairment begins in infancy. Mutations in Aryl hydrocarbon receptor interacting protein like-1 have been linked to Leber congenital amaurosis (LCA).^[9]

Treatment

Whether blindness is treatable depends upon the cause.^[10] Surgical intervention can be performed in PCG which is childhood glaucoma, usually starting early in childhood. Primary congenital glaucoma is caused by an abnormal drainage of the eye. However, surgical intervention is yet to prove effective.^[11]

Braille

Management

Braille is a universal way to learn how to read and write, for the blind. ^[12] A refreshable braille display is an assistive learning device that can help such children in school.^[13] Schools for the blind are a form of management, however the limitations of using studies done in such schools has been recognized. Children that are enrolled presently, usually, had developed blindness 5 or more years prior to enrollment, consequently not reflecting current possible causes.^[14] About 66% of children with visual impairment also have one other disability (comorbidity), be it, intellectual disabilities, cerebral palsy,or hearing loss.^[15] Eye care/screening for children within primary health care is important as catching ocular disease issues can lead to better outcomes.^[16]

Prevention

Vitamin A supplementation plays an important role,^[17] specifically Vitamin A deficiency is a top causes of preventable childhood blindness.^[18] Though in measles cases, the administration of the vitamin to offset visual impairment has not been proven effective, as of yet.^[19]

Epidemiology

The number of children who suffer from blindness worldwide is approximately 1.4 million. 75% of the world’s blind children live in Africa and Asia.^[20] A 2014 review indicated that an estimated of 238,500 children with bilateral blindness (rate 1.2/1,000) in the Eastern Mediterranean region.^[16]

Society and culture

VISION 2020 is a program launched by the International Agency for the Prevention of Blindness (IAPB) and is supported by the WHO in 1999 that has made controlling blindness in children a high priority.^[21]

See also

• Vitamin A deficiency

References

Further reading

• Hidalgo-de-Quintana, Juan; Schwarz, Nele; Meschede, Ingrid P.; Stern-Schneider, Gabriele; Powner, Michael B.; Morrison, Ewan E.; Futter, Clare E.; Wolfrum, Uwe; Cheetham, Michael E. (March 23, 2015). "The Leber Congenital Amaurosis Protein AIPL1 and EB Proteins Co-Localize at the Photoreceptor Cilium". PLoS ONE 10 (3): e0121440. doi:10.1371/journal.pone.0121440. PMC 4370678. PMID 25799540. 
• Rahi, J. S. (2007-01-01). "Childhood blindness: a UK epidemiological perspective". Eye 21 (10): 1249–1253. doi:10.1038/sj.eye.6702837. ISSN 0950-222X. 

External links

• Prevention of childhood blindness
• Childhood Blindness on IAPB