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Causes of Childhood Vision Impairment in the School for the Blind in Eritrea

Gyawali, Rajendra MOptom, FAAO1,2*; Moodley, Vanessa R. BOptom, MOptom, PhD2

doi: 10.1097/OPX.0000000000001142
Original Investigations

SIGNIFICANCE Our study provides the much-needed evidence on causes of childhood blindness in Eritrea. This will assist authorities to plan appropriate strategies and implement preventive, curative, and rehabilitative services to address these causes of vision loss in children in this resource-limited country.

PURPOSE This study aims to identify the causes of severe vision impairment and blindness in children attending the only school for the blind in Eritrea.

METHODS All children enrolled in the school were examined, and the World Health Organization form for the examination of visually impaired children was used to record the data. Examination included visual acuity, refraction, anterior segment, and fundus assessment. Causes of vision loss for children with severe vision impairment (visual acuity <6/60 to 3/60) and blindness (visual acuity <3/60) are reported. Causes were classified by the anatomical site affected and by underlying etiology based on the timing of the insult and causal factor.

RESULTS A total of 92 children were examined, and 71 (77.2%) of them had severe vision impairment and blindness. The major causes of vision loss were corneal scars (16.9%), cataract (12.7%), phthisis bulbi (11.3%), congenital eye deformities (11.3%), optic atrophy (9.3%), and presumed chorioretinal Toxoplasma scars (7.0%). Hereditary factors were the major known etiological category (15.5%) followed by the sequel of eye injuries (12.7%). Blindness due to vitamin A deficiency was not found, whereas infectious causes such as measles and ophthalmia neonatorum were relatively absent (one case each). Potentially avoidable causes of vision impairment were accounted for in 47.9% of children.

CONCLUSIONS This study provides the first direct evidence on childhood vision impairment in Eritrea. Despite the limitations, it is clearly shown that nearly half of the vision loss is due to avoidable causes. Thus, preventive public health strategies, specialist pediatric eye care, and rehabilitative services are recommended to address childhood vision impairment in Eritrea.

1Department of Optometry, Asmara College of Health Sciences, Asmara, Eritrea

2Discipline of Optometry, College of Health Sciences, University of KwaZulu Natal, Durban South Africa *gyawali.rajendra@gmail.com

Submitted: January 14, 2017

Accepted: August 3, 2017

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions and Acknowledgments: Conceptualization: RG, VRM; Data Curation: RG; Formal Analysis: RG; Investigation: RG; Methodology: RG, VRM; Project Administration: RG; Writing – Original Draft: RG; Writing – Review & Editing: RG; Conceptualization, Methodology, Writing – Review & Editing: VRM.

The authors thank Mr. Bharat Kumar Bhayal, Dr. Arjun Shrestha, and Dr. Rabindra Prasad Shah from Asmara College of Health Sciences and Mr. Solomon Tezare from Abraha Bahta School for their support during this study. They are especially thankful to the optometry students and optometry technicians at the college for their assistance during data collection.

© 2017 American Academy of Optometry