Severe visual Impairment and blindness in infants: Causes and opportunities for control

Abstract

Childhood blindness has an adverse effect on growth, development, social, and economic opportunities. Severe visual impairment (SVI) and blindness in infants must be detected as early as possible to initiate immediate treatment to prevent deep amblyopia. Although difficult, measurement of visual acuity of an infant is possible. The causes of SVI and blindness may be prenatal, perinatal, and postnatal. Congenital anomalies such as anophthalmos, microphthalmos, coloboma, congenital cataract, infantile glaucoma, and neuro-ophthalmic lesions are causes of impairment present at birth. Ophthalmia neonatorum, retinopathy of prematurity, and cortical visual impairment are acquired during the perinatal period. Leukocoria or white pupillary reflex can be cause by congenital cataract, persistent hyperplastic primary vitreous, or retinoblastoma. While few medical or surgical options are available for congenital anomalies or neuro-ophthalmic disorders, many affected infants can still benefit from low vision aids and rehabilitation. Ideally, surgery for congenital cataracts should occur within the first 4 months of life. Anterior vitrectomy and primary posterior capsulotomy are required, followed by aphakic glasses with secondary intraocular lens implantation at a later date. The treatment of infantile glaucoma is surgery followed by anti-glaucoma medication. Retinopathy of prematurity is a proliferation of the retinal vasculature in response to relative hypoxia in a premature infant. Screening in the first few weeks of life can prevent blindness. Retinoblastoma can be debulked with chemotherapy; however, enucleation may still be required. Neonatologists, pediatricians, traditional birth attendants, nurses, and ophthalmologists should be sensitive to a parent’s complaints of poor vision in an infant and ensure adequate follow-up to determine the cause. If required, evaluation under anesthesia should be performed, which includes funduscopy, refraction, corneal diameter measurement, and measurement of intraocular pressure.

Vision-related quality of life in children with retinopathy of prematurity

“…Retinal immaturity can interfere with visual development during some child growth stages, making these infants susceptible to retino pathy, refractive variation and amblyopia, strabismus, and low vision (3)(4)(5)(6) . Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease with a multifactorial etiology that affects premature infants as a result of their immaturity and other risk factors (7) .…”

Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi

“…The leading maternal risk factor was premature rupture of membranes, probably due to an infection commonly passed during the 28 th week of gestation 7. Ophthalmia neonatorum is one of the most preventable causes of blindness in neonates, in addition to cortical impairment from birth asphyxia and retinopathy of prematurity worldwide 8. Close to 80% of neonates in this study were born preterm thus increasing their risk for ophthalmia neonatorum if the mother had an STI.…”

Influência ambiental para a (in)dependência da criança cega: perspectiva da família

“…Só assim poderá compreendê-lo, desenvolver-se satisfatoriamente e adaptar-se de forma integrada a ele. É preciso que a criança seja estimulada a interagir no ambiente por meio do uso de seus sentidos preservados com a finalidade de superar dificuldades oriundas da falta visual (16).…”