Childhood blindness and visual impairment in an underserved population in South West Nigeria: A clinic-based study

Background: Knowledge of the causes of poor vision among children will contribute to interventions and policies to prevent childhood blindness and visual impairment.
Methods: This was a 3-year descriptive study of consecutive cases presenting to the secondary eye clinic at State Specialist Hospital in Osogbo, Nigeria. Sociodemographic characteristics were documented, and full clinical eye examinations were done. Descriptive analyses were carried out.
Results: Among 214 children examined, 59.3% were male and the mean age was 9.3 ± 3.5 years. The predominant age group was 0 to 5 years (40.2%). Common causes of blindness and visual impairment were: refractive error (22.9%), corneal disease (21.5%), and cataract (19.6%). Refractive error was significantly more common among participants between 11 and 16 years of age (P < 0.001). All cases of retinoblastoma occurred among participants 0 to 5 years old (P < 0.001). Blindness most commonly resulted from corneal opacities (31.1%), severe visual impairment most commonly resulted from cataracts (35.4%), and moderate visual impairment was most often the result of refractive error (47.8%). According to the World Health Organization classification of visual impairment, 74 participants (34.6%) were blind, 48 (22.4%) had severe visual impairment, and 92 (42.9%) had moderate visual impairment.
Conclusions: The causes of blindness and visual impairment are mainly avoidable. Provision of adequate manpower, necessary equipment in the hospitals for subsidised refractive and cataract surgical services, and uptake of these services are required towards prevention.

Keywords
childhood blindness; visual impairment; eye healthcare facilities; advocacy; Nigeria