Background The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School ...Background The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School （SBCS） can provide useful information on childhood blindness in Shanghai. Methods A cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness （WHO/PBL） eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS. Results Of the 146 children observed, 80 children （54.8%） were blind （best corrected best visual acuity less than 0.05）, 27 children （18.5%） had severe visual impairment （best corrected visual acuity less than 0.1 but better than or equal to 0.05）, and 34 children （23.3%） had moderate visual impairment （best corrected visual acuity less than 0.3 but better than or equal to 0.1）. The major affected anatomic sites in the 107 children with severe visual impairment and blindness （SVI/BL） were retina （47.7%）, whole globe （16.8%）, optic nerve （13.1%） and lens （9.3%）. The leading causes of SVI/BL were retinopathy of prematurity （ROP, 25.2%）, followed by retinal dystrophy （15.9%）, optic nerve atrophy （9.3%） and microphthalmos （9.3%）. The two leading etiologic categories of SVI/BL were perinatal/neonatal （36.4%） and congenital/hereditary groups （29.0%）. The leading cause of moderate visual impairment was aphakia after cataract surgery （congenital cataract, 44.1%）. Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens （cataract and aphakia） significantly decreased.展开更多
Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with c...Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.展开更多
文摘Background The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School （SBCS） can provide useful information on childhood blindness in Shanghai. Methods A cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness （WHO/PBL） eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS. Results Of the 146 children observed, 80 children （54.8%） were blind （best corrected best visual acuity less than 0.05）, 27 children （18.5%） had severe visual impairment （best corrected visual acuity less than 0.1 but better than or equal to 0.05）, and 34 children （23.3%） had moderate visual impairment （best corrected visual acuity less than 0.3 but better than or equal to 0.1）. The major affected anatomic sites in the 107 children with severe visual impairment and blindness （SVI/BL） were retina （47.7%）, whole globe （16.8%）, optic nerve （13.1%） and lens （9.3%）. The leading causes of SVI/BL were retinopathy of prematurity （ROP, 25.2%）, followed by retinal dystrophy （15.9%）, optic nerve atrophy （9.3%） and microphthalmos （9.3%）. The two leading etiologic categories of SVI/BL were perinatal/neonatal （36.4%） and congenital/hereditary groups （29.0%）. The leading cause of moderate visual impairment was aphakia after cataract surgery （congenital cataract, 44.1%）. Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens （cataract and aphakia） significantly decreased.
文摘Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.
