Sj. Hornby et al., Causes of childhood blindness in the People's Republic of China: results from 1131 blind school students in 18 provinces, BR J OPHTH, 83(8), 1999, pp. 929-932
Aims-determine the anatomical site and underlying causes of blindness and s
evere visual impairment in children under 16 years of age in special educat
ion in the People's Republic of China with a view to determining potentiall
y preventable and treatable causes.
Methods-A national study of children attending schools for the blind in Chi
na was conducted between April and June 1998 using the WHO Prevention of Bl
indness Programme (WHO/PBL) eye examination record for children with blindn
ess and low vision. Eight Chinese ophthalmologists attended a training work
shop before conducting the study. 36 blind schools in 18 provinces of China
were included.
Results-1245 children aged between 5 and 15 years were examined, of whom 11
31 (91%) were blind or severely visually impaired visual acuity less than 6
/60 in the better eye). The commonest anatomical sites of visual loss were
whole globe (mainly microphthalmos) 25.5% and retina (mainly dystrophies) 2
4.9%. Lens was the major site in 18.8%, optic nerve in 13.6%, and glaucoma
in 9%. Corneal scarring was not a major cause of visual loss. The aetiology
was unknown in 52.9%, hereditary factors were responsible in 30.7%, and ch
ildhood causes in 14%. 15% of cases were considered potentially preventable
and 22.5% potentially treatable.
Conclusion-The pattern of childhood blindness seen in this study is Likely
to reflect the improved health and socioeconomic status of China but may pa
rtly reflect bias in admission to, and location of, blind schools, with hig
her socioeconomic groups overrepresented. Nutritional and infective causes
of blindness are uncommon, and hereditary and unknown factors are now the p
redominant causes.