Causes of vision impairment and assessment of need for low vision services for students of blind schools in Nepal

Abstract

Background: The present study is ¿ rst of its kind to evaluate causes of visual impairment of blind students in Nepal and assess their need for low vision rehabilitation services. Aim: To evaluate causes of vision impairment of students enrolled in blind schools in Nepal and assess the need for low vision rehabilitation services in these students. Materials and methods: A survey was conducted in 12 blind schools in Nepal, which were registered with Nepal Association for Welfare of Blindness (NAWB).It was conducted by a team of an ophthalmologist and an optometrist, by using standard eye examination protocols of the World Health Organization Prevention of Blindness Program (WHO/ PBL). Results: Of the 345 students enrolled in 12 schools, 285 students were examined (response rate of 82.61%). The students were in the 5 -29 years age group. Nearly three-fourth of the children had become blind within one year of age and 52.3% visually impaired at birth and 20.7% developed vision impairment within one year of age. After refraction, 26 students (9.12%) had mild visual impairment, 21 students (7.37%) had severe visual impairment and 238 students (83.51%) were blind. The main cause of vision impairment was found to be corneal 35.79% and retina diseases, mainly dystrophy, 20.35% followed by problems with the whole globe, lens and optic nerve, accounting for 13.33%, 12.63% and 12.98% respectively. The major etiological factors were those of childhood such as Vitamin A de¿ ciency, measles and similar causes (42.11%) followed by hereditary causes (25.26%). Of the total students examined, 48.07% were visually impaired due to preventable causes and 16.14% treatable aggregating to 64.21% of avoidable blindness. Fifty seven (28.22%) students could read smaller than 2 M print size after low vision assessment for near and 33(15.78%) students bene¿ ted with telescopic trial for distance low vision. Conclusion: In Nepal, renewed focus on providing best possible quality of life for visually impaired children by proper low vision assessment and eye health education focusing on, general public and community health workers, with governmental and institutional support is required to achieve Vision 2020 objectives to decrease childhood blindness.

Magnitude and Causes of Low Vision Disability Moderate and Severe Visual Impairment among Students of Al-Noor Institute for the Blind in Al-Hassa , Saudi Arabia : A Case Series

“…In developing countries, blindness and SVI were due to avoidable causes like poor nutrition and lack of timely treatment. 2,[17][18][19][20][21] By comparison, in industrialised countries, they were mainly due to retinal, optic nerve diseases and birth defects. [22][23][24] A study in Iran showed an unusually high rate (81%) of SVI among children studying in schools for the blind and suggested that half of these cases were due to retinal diseases.…”

“…[1][2][3] A large number of children with low vision also study in these schools, either due to lack of facilities for low vision care, or to lack of awareness regarding integrated education for those with low vision disability. Often these children are only assessed at the time of admission and not subsequently revaluated.…”

Childhood corneal blindness: a retrospective study in a tertiary eye hospital of eastern region of Nepal

“…According to Nepal Blindness Study 1981, nutritional causes accounted for 17.9% of childhood blindness (Brilliant GE, 1988). A study shows 15.44% of the children blind or visually impaired due to nutritional factors (Kansakar I et al, 2009). No case of trachoma (active or inactive) presented to our OPD.…”

“…Similarly, another study conducted in the schools for blind and visually imapaired reported that 64.1% of children were blind due to avoidable causes, out of which 48.07% were preventable and 16.14% were treatable. Almost 36% of the students were blind because of the corneal cause (Kansakar I et al, 2009). …”

“…Among the various causes, corneal cause accounts for the most number of the cases (Shrestha JB et al, 2012;Kansakar I et al, 2009;Gilbert CE et al, 1999). Corneal causes for childhood blindness are also important as most of them are preventable as suggested by various published studies from Nepal (Shrestha JB et al, 2012;Kansakar I et al, 2009;Adhikari S et al, 2015).…”