Childhood blindness in a rural population of southern India: Prevalence and etiology

Purpose: To determine the prevalence and etiology of childhood blindness in a rural population in southern India through a population based study. Methods: A cross sectional, house-to-house survey to screen for childhood blindness included 14,423 children < 16 years. Blindness was defined as best corrected visual acuity < 3/60 in the better eye. The first stage of screening for blindness was done by interns under supervision of ophthalmology residents. Senior residents examined the referred cases from the first stage. Those detected to be blind were brought to a tertiary care hospital for detailed examination. Results: Fifty-four children were referred after first stage of screening of 13,241 children. Of these 14 were bilaterally blind giving a prevalence of 1.06/1000 (95% confidence interval (CI), 0.50 to 1.61); 6 (42.9%) had lens and related complications, 4 (28.6%) had globe anomalies (2 Microphthalmos and 2 Anophthalmos), 2 (14.3%) had retinal dystrophy and 1 (7.1%) each of glaucoma and optic atrophy. Among the parents of blind children, 71.4% (p = 0.002) had consanguineous marriage (83.3% in cataract blind children). Conclusions: More than half of the blindness detected was potentially avoidable. Genetic counseling, early identification and access to tertiary care would reduce the burden of childhood blindness in the local community.