ArticlesSevere visual impairment and blindness in children in the UK
Section snippets
Background
Visual impairment in childhood affects the child's development, and education, and the care given by families and professionals. It also shapes the adult the child becomes, affecting employment and social prospects. Although less common than in adulthood,1 the associated life-long burden of disability is substantial and has high economic costs.2 The incidence and pattern of causes of visual impairment and blindness in children at a given time will reflect the prevailing balance between the
Participants
In the UK, ophthalmologists and paediatricians are involved in management of visually impaired children. To enhance ascertainment, eligible children were identified through both the British Ophthalmological3 and the British Paediatric4 Surveillance Units, whose reporting bases consist of all consultant ophthalmologists and paediatricians, respectively, participating in national active surveillance schemes5 that have facilitated successful studies of uncommon disorders in ophthalmology3 and
Procedures
For 12 months from January, 2000, active surveillance was undertaken, simultaneously but independently, through both units. Every month clinicians reported all children younger than 16 years who were newly diagnosed as severely visually impaired or blind (SVI/BL) as a result of any disorder. Such a definition included children with corrected distance visual acuity of worse than 6/60 (or equivalent using other optotypes) in the better eye–ie, SVI/BL (WHO international taxonomy6); those eligible
Results
During 2000, 439 children with newly diagnosed SVI/BL were reported to us by clinicians. Numerators are presented for individual analyses since some data were missing for a few cases. 54% (237 of 439) of all children were boys, 72% (298 of 413) were white, 24% (96 of 408) weighed less than 2500 g at birth, and 40% (166 of 411) were in the most deprived national quintile of the Carstairs index (figure 1). 77% (336 of 438) of children had SVI/BL plus. Those of low birthweight (<2500 g) were more
Discussion
At least four of every 10 000 children born in the UK will be diagnosed as severely visually impaired or blind by their first birthday, increasing to nearly six per 10 000 by the age of 16 years. Children of low birthweight and from ethnic minorities have the highest rates, with those from the most deprived socioeconomic groups over-represented. In more than three-quarters of children, visual loss occurs in the context of significant non-ophthalmic impairments or disorders, resulting in death
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