CHILDHOOD BLINDNESS IN INDIA - CAUSES IN 1318 BLIND SCHOOL STUDENTS IN 9 STATES

It is estimated that at least 200 000 children in India have severe vi sual impairment or blindness and approximately 15 000 are in schools f or the blind. Although this represents a small percentage of the estim ated 5 million blind in India, it is significant in terms of 'blind-ye ars'. Strategies to combat childhood blindness require accurate data o n the causes to allocate resources to appropriate preventive and curat ive services, Since socio-economic factors vary in different areas of this industrialising country data should be representative of the coun try as a whole. This is the first multi-state study to be undertaken i n India using the Record for Children with Blindness and Low Vision fr om the World Health Organization/PBL Programme. A total of 1411 childr en in 22 schools from nine states in different geographical zones;were examined by an ophthalmologist and optometrist. Of these, 1318 childr en were severely visually impaired or blind (SVI/BL), The major causes of SVI/BL in this study were: (1) corneal staphyloma, scar and phthis is bulbi (mainly attributable to vitamin A deficiency) in 26.4%; (2) m icrophthalmos, anophthalmos and coloboma in 20.7%; (3) retinal dystrop hies and albinism in 19.3%; and (4) cataract, uncorrected aphakia and amblyopia in 12.3%. This mixed pattern of causes lies in an intermedia te position between the patterns seen in developing countries and thos e seen in industrialised countries. The causes identified indicate the importance both of preventive public health strategies and of special ist paediatric ophthalmic and optical services in the management of ch ildhood blindness in India.