THE IMPORTANCE OF PRENATAL FACTORS IN CHILDHOOD BLINDNESS IN INDIA

The causes of visual loss in 1411 children attending schools for the b lind in different geographical areas in India are described. Ninety-th ree percent (1318) of the children were severely visually impaired (SV I) or blind (i.e. corrected acuity in the better eve of < 20/200 [< 6/ 60]), In 60% of SVI/blind children vision loss was attributable to fac tors operating in the prenatal period, in 47% the prenatal factors wer e known and definite, and in 13% prenatal factors were the most probab le causes, Hereditary retinal dystrophies and albinism were seen in 19 % of SVI/blind children and 23% had congenital ocular anomalies, There were variations in the relative importance of different causes by sta te. The observed pattern of causes of visual loss is intermediate betw een those seen in industrialised countries and in the poorest developi ng countries, This suggests that strategies to combat childhood blindn ess in India need to address concurrently both preventable and treatab le causes. The need for aetiological studies, particularly on anophtha lmos and microphthalmos, is highlighted.