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UK Childhood Blindness More Common Than Previously Thought (p 1359)

October 22, 2003

Increased ethnic diversity and greater survival of low-birthweight babies is contributing to a higher proportion of children becoming visually impaired or blind, according to authors of a UK study in this week's issue of THE LANCET. The study also highlights how childhood visual impairment is associated with lower socio-economic status.

The prevention of visual impairment and blindness in childhood is an international priority. However, many countries do not have contemporary information about incidence and causes, from which the scope and priorities for the prevention and treatment of visual impairment can be identified.

Jugnoo Rahi from the Institute of Child Health, London, UK, and colleagues identified (via ophthalmologists and paediatricians) 439 newly diagnosed (visually impaired or blind) children throughout the UK in 2000. More than three-quarters of these children had other diseases or disabilities in addition to visual impairment; visual impairment/blindness was greatest in the first year of life (frequency rate 4 per 10,000 population), with a cumulative frequency of 6 per 10,000 by age 16 years.

Prenatal causes accounted for around 60% of childhood visual impairment/blindness, and around three-quarters of the newly diagnosed children had visual impairment that could neither have been prevented nor treated with current scientific knowledge. Overall there were a complex array of underlying causes, influenced by the increased survival of low-birthweight babies and the susceptibility of children from ethnic minorities to certain ocular conditions.

Jugnoo Rahi comments: "Severe visual impairment and blindness in childhood in the UK is more common, occurs more frequently in the context of complex non-ophthalmic impairments, and has greater associated mortality, than previously assumed. Our findings indicate that visual impairment and blindness in children in industrialised countries should be viewed within the broader context of disability and chronic disease in childhood. New interventions are necessary to address the largely insurmountable burden of blinding eye disease in the industrialised world. Their development will require integration of ongoing clinical, epidemiological, and basic scientific research. The fruits of this labour will have an effect worldwide, since the trends in childhood visual disability in the UK can, inevitably, be expected to be replicated in countries currently in economic transition."

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