International Journal of Pediatrics

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

A Profile of Visually Impaired Children: A Ten-Year Retrospective Study

Document Type : original article

Authors

1 Optometry Department/Faculty of Applied Medical Sciences JORDAN UNIVERSITY OF SCIENCE AND TECHNOLOGY

2 Optometry Department, Faculty of Allied Medical Sciences ,Al-Ahliyya Amman University, Amman-Jordan

Abstract

Background: Causes of visual impairment among children vary worldwide. While there is a scarcity of such data, this study aims to describe the profile of a large cohort of visually impaired children. In addition, it will provide evidence to advocate the importance of the provision of low vision services to children and improve referrals for such services.
Methods: A retrospective study reviewed the profile of visually impaired children who attended a multidisciplinary vision rehabilitation service in the period of 2011-2021. Recorded data included demographics, clinical attributes (Binocular best-corrected distance visual acuity BCVA, near visual acuity, contrast threshold, causes of visual impairment, the presence of concurrent disability or disorder, whether the child was underweight or premature at birth), and the prescribed low vision aids. Data were analyzed using SPSS 20.0.
Results: Demographic and clinical records of 443 children (54% boys and 46% girls; median age 6 years) were analyzed. The median best corrected binocular distance visual acuity and contrast threshold were significantly improved from 0.86LogMAR to 0.62LogMAR and from 25% to 10%, respectively. The main source of referral to the association was ophthalmologists (35.5%) followed by schools/kindergartens (33%), whereas the least frequent source of referral was pediatricians (1.6%). The major causes of visual impairment were retinopathy of prematurity and cortical visual impairment.
Conclusion: visual functions were improved with the appropriate low vision aids, which explains the necessity for early referral of children to low vision services. Awareness training for pediatricians is important regarding the need for early detection and timely referral of visually impaired children. There is also a need for an awareness campaign about the causes and risk factors of retinopathy of prematurity.

Keywords

References
  1. Pascolini D, Mariotti S. Global Estimates of Visual Impairment: 2010. Br J Ophthalmol 2012; 96(5):614-8.
  2. Schieman M, Wick B. Clinical management of binocular vision: Heterophoric, accommodative, and eye movement disorders. 4th ed. Philadelphia: Lippincott Williams & willkins; 2013.
  3. Mahoney E, Kumar N, Porter S. Effect of Visual Impairment upon Oral Health Care: A Review. Br Dent J (Online) 2008 [cited 2020 May 13]; 204(2):63–7. Available from: https://www.nature.com/articles/bdj.2008.2
  4. Holden B. Blindness and Poverty: A Tragic Combination. Clin Exp Optom 2007; 90(6):401–3.
  5. Atowa U, Hansraj R, Wajuihian S. Visual problems: A Review of Prevalence Studies on Visual Impairment in School-age Children. Int J Ophthalmol 2019; 12(6).
  6. Bunce C, Wormald R. Leading Causes of Certification for Blindness and Partial Sight in England & Wales. BMC Public Health 2006; 6(1).
  7. Binns A, Bunce C, Dickinson C, Harper R, Tudor-Edwards R, Woodhouse M, Alan Suttie PL, Jackson J, Lindsay J, Wolffsohn J, Hughes L, Margrain TH. How effective is Low Vision Service Provision? A Systematic Review. Surv Ophthalmol 2012; 57(1):34–65.
  8. Dandona R, Dandona L. Refractive Error Blindness. Bull World Health Organ 2001; 79(3): 237-243.
  9. Castagno V, Fassa A, Carret M, Vilela M, Meucci R. Hyperopia: A Meta-analysis of Prevalence and a Review of Associated Factors Among School-aged Children. BMC Ophthalmol (Online) 2014; 14(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391667/
  10. Aldebasi Y. Prevalence of Correctable Visual Impairment in Primary School Children in Qassim Province, Saudi Arabia. J Optom 2014; 7(3):168–76.
  11. Rahi J, Cable N. Severe Visual Impairment and Blindness in Children in the UK. The Lancet 2003; 362(9393):1359–65.
  12. The economic impact of partial sight and blindness in the UK adult population. Access Economics. Royal National Institute for the Blind; 2009 p. 202.
  13. Bakkar M, Alzghoul E, Haddad M. Clinical Characteristics and Causes of Visual Impairment in a Low Vision Clinic in Northern Jordan. Clin Ophthalmol 2018; 12:631–7.
  14. Abu-Yaghi N, Meqbil J, Sharif Z, Helwa L, Al-Imam M, Abumanneh Z. Characteristics of Visual Impairment and the Impact of Low Vision Assessment in a Tertiary Academic Hospital in Jordan. Clinical Optometry 2022; 14:67–74.
  15. Needham W, Acton J, Eldridge L. Psychological Disorders of Blind Persons and Success in Residential Rehabilitation. J Vis Impair Blind 1992; 86(3):144–7.
  16. McCabe P, Nason F, Demers Turco P, Friedman D, Seddon J. Evaluating the Effectiveness of a Vision Rehabilitation Intervention Using an Objective and Subjective Measure of Functional Performance. Ophthalmic Epidemiol 2000; 7(4):259–70.
  17. Haymes S, Johnston A, Heyes A. The Development of the Melbourne Low-vision ADL Index: A Measure of Vision Disability. Invest Ophthalmol Vis Sci 2001; 42(6):1215-25.
  18. Lamoureux E, Pallant J, Pesudovs K, Ress G, Hassel J, Keeffe J. The Impact of Vision Impairment Questionnaire: An Assessment of Its Domain Structure Using Confirmatory Factor Analysis and Rasch Analysis. Invest Ophthalmol Vis Sci 2007; 48(3):1001.
  19. Stelmack J, Rinne S, Mancil R, Dean D, Moran D, Tang X, Cummings R, Massof R. Successful Outcomes from a Structured Curriculum Used in the Veterans Affairs Low Vision Intervention Trial. J Vis Impair Blind 2008; 102(10):636–48.
  20. Stelmack J, Massof R. Using the VA LV VFQ-48 and LV VFQ-20 in Low Vision Rehabilitation. Optom Vis Sci 2007; 84(8):705–9.
  21. Stelmack J, Moran D, Dean D, Massof R. Short- and Long-Term Effects of an Intensive Inpatient Vision Rehabilitation Program. Arch Phys Med Rehabil 2007; 88(6):691–5.
  22. Ryan B, Khadka J, Bunce C, Court H. Effectiveness of the Community-based Low Vision Service Wales: A Long-term Outcome Study. Br J Ophthalmol 2013; 97(4):487–91.
  23. Stelmack J, Tang X, Wei Y, Massof R, Low-Vision Intervention Trial Study Group. The Effectiveness of Low-vision Rehabilitation in 2 Cohorts Derived from the Veteran’ Affairs Low-vision Intervention Trial. Arch Ophthal 2012; 130(9):1162.
  24. Scott I, Smiddy W, Schiffman J, Feuer W, Pappas C. Quality of Life of Low-vision Patients and the Impact of Low-vision Services. Am J Ophthalmol (Online) 1999; 128(1):54–62. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10482094
  25. Reeves B. Enhanced Low Vision Rehabilitation for People with Age Related Macular Degeneration: a Randomised Controlled Trial. Br J Ophthalmol 2004; 88(11):1443–9.
  26. de-Boer M, Twisk J, Moll A, Volker-Dieben H, Vet H, Rens G. Outcomes of Low-vision Services Using Optometric and Multidisciplinary Approaches: A Non-randomized Comparison. Ophthalmic Physiol Opt 2006; 26(6):535–44.
  27. Gyawali R, Moodley VR. Causes of Childhood Vision Impairment in the School for the Blind in Eritrea. Optom Vis Sci 2017; 94(12):1138–44.
  28. Baarah B, Shatnawi R, Khatatbeh A. Causes of Permanent Severe Visual Impairment and Blindness among Jordanian Population. Middle East Afr J Ophthalmol 2018; 25(1):25.
  29. Fierson W. Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics 2018; 142(6):e20183061.
  30. Islam M, Ababneh F, Akter T, Khan H. Prevalence and Risk Factors for Low Birth Weight in Jordan and its Association with under-five Mortality: A population-based Analysis. East Mediter Health J 2020; 26(10):1273–84.
  31. Gharaibeh A, Khriesat W, Migdadi Y, Khassawneh M, Alkhatib S. Adopting Western Retinopathy of Prematurity Screening Programs in Eastern Countries, are we Screening Properly? Middle East Afr J Ophthalmol 2011; 18(3):209.
  32. Ababneh L, Khriesat W, Abu-Dalu S, hanania R, Ababneh B, Bany-Amer N, Jahmanic T. Knowledge of and Attitude to Eye disorders among Pediatricians in North Jordan. Ann Med Surg (Online) 2021 Jul 1 [cited 2022 Jul 10]; 67:102430. Available from: https://www.sciencedirect.com/science/article/pii/S2049080121003800
  33. Furtado J, Lansingh V, Carter M, Milanese M, Pena B, Ghersi H, Bote PL, Nano ME, Silva JC. Causes of Blindness and Visual Impairment in Latin America. Surv Ophthalmol (Online) 2012 Mar 1 [cited 2022 Jun 13]; 57(2):149–77. Available from: https://www.sciencedirect.com/science/article/pii/S0039625711001639?casa_token=cakb9Gh_zAoAAAAA:2de4QIxll_YzXey6CnY9kV5h8xhkG-TshKEA7-A2XJV-1xU0RXC9dHMTPNQUTr6X-e84KTBUY7w
  34. Lin JY, Kang EY, Banker AS, Chen KJ, Hwang YS, Lai CC, Huang JL, Wu WC. Comparison of RetCam and Smartphone-Based Photography for Retinopathy of Prematurity Screening. Diagnostics (Basel). 2022; 12(4):945. Published 2022 Apr 10. Doi: 10.3390/diagnostics12040945
  35. Wang SK, Callaway NF, Wallenstein MB, Henderson MT, Leng T, Moshfeghi DM. SUNDROP: six years of screening for retinopathy of prematurity with telemedicine. Can J Ophthalmol. 2015; 50(2):101-106. doi:10.1016/j.jcjo.2014.11.005
  36. Vinekar A, Jayadev C, Mangalesh S, Shetty B, Vidyasagar D. Role of tele-medicine in retinopathy of prematurity screening in rural outreach centers in India - a report of 20,214 imaging sessions in the KIDROP program. Semin Fetal Neonatal Med. 2015;20(5):335-345. doi:10.1016/j.siny.2015.05.002
  37. Solebo A, Teoh L, Rahi J. Epidemiology of Blindness in Children. Archives of Disease in Childhood (Online) 2017; 102(9):853–7. Available from: https://adc.bmj.com/content/102/9/853
  38. Jordan Country Reclassification - Questions and Answers. World Bank (2017).

https://www.worldbank.org/en/country/jordan/brief/qa-jordan-country-reclassification. Accessed September 20, 2022.

  1. De-Paula C, Vasconcelos G, Nehemy M, Granet D. Causes of Visual Impairment in Children Seen at a University-based Hospital Low Vision Service in Brazil. J AAPOS (Online) 2015 [cited 2022 Jul 10]; 19(3):252–6. Available from: https://pubmed.ncbi.nlm.nih.gov/26059672/
  2. Rice M, Sandoval M, Castleberry K, Schwartz T. Physician Prescribing and Referral Patterns in Children with Cerebral Visual Impairment. Optom Vis Sci 2021; 98(9).
  3. Al-dolat W, Alqudah N, Atoum D, Al-Omari R, Khatatbeh M. Preferred Surgical and Anesthesia Techniques for Cataract Surgery in Jordan. Clin Ophthalmol 2021; 15:4259–67.
  4. Gogate PM, Chottopadhyay T, Kaur H, Narayandas S, Phadke S, Kharat M, Dhangar A, Inamdar M, Badkere A, Khanna RC. Making Blind Children See: Impact of Correcting Moderate and Severe Visual Impairment in Schools for the Blind. Middle East Afr J Ophthalmol 2019; 26(4):216.
  5. John D, Jacob C, Paul P, Abraham, Kuriakose T. Low Vision Device Requirements among Children from Two Schools for the Blind in Tamil Nadu. Indian J Ophthalmol 2021; 69(1).
  6. Gyawali R, Moodley V. Need for Optical Intervention in Children Attending a School for the Blind in Eritrea. Clin Exp Optom 2017; 101(4):565–70.
  7. The 10-Year Strategy for Inclusive Education Developed jointly with the Ministry of Education (2017). https://moe.gov.jo/sites/default/files/the_10-year_strategy_for_inclsuive_education_0_0.pdf. Accessed September 20, 2022.
  8. Okashah A. The prescribing and use of pocket and portable electronic low vision aids for patients with visual impairment. PhD. Dissertation. Cardiff, UK: Cardiff University, 2015. https://www.semanticscholar.org/paper/The-prescribing-and-use-of-pocket-and-portable-low-Okashah/24a3d5d49480c90ff1af6bd330db04a1492073ad. Accessed September 20, 2022.
  9. Loh AR, Chiang MF. Pediatric Vision Screening. Pediatr Rev. 2018; 39(5):225-234. doi:10.1542/pir.2016-0191
  10. Wallace DK, Morse CL, Melia M, Sprunger DT, Repka MX, Lee KA, Christiansen SP, American Academy of Ophthalmology Preferred Practice Pattern Pediatric Ophthalmology/Strabismus Panel. Pediatric Eye Evaluations Preferred Practice Pattern®: I. Vision Screening in the Primary Care and Community Setting; II. Comprehensive Ophthalmic Examination. Ophthalmology. 2018; 125(1):P184-P227. doi:10.1016/j.ophtha.2017.09.032
  11. Mousa AM, Suha AE. Eye diseases in children in Jordan. J Pak Med Assoc. 2014; 64(1):13–15.
  12. Al-Salem KM, Saleem MS, Ereifej I, Alrawashdeh HM, Hussein Obeidat RF, Abdlmohdi AA, Al-Momani RZ, Hammad LM, Al-Habahbeh OA, Assassfeh YM, Najib Al-Qsous LR, Adeeb Nasraween AH, AlMaaitah TA, Hasan Aqeel DAM, Awad Alabdulrazzg IE, Mohammad Murad AM, Faleh Al-Zurqan AJ, Mohammad Jaradat EJ, Suliman Aldhoon SE, Dmour AM, Asassfeh AT, Halaseh JA, Ammar Daoud AA, Alkasasbeh WA, Matar KG. Amblyopia screening for first and second-grade children in Jordan. Int J Ophthalmol. 2022; 15(2):352-356. Published 2022 Feb 18. doi:10.18240/ijo.2022.02.24
International Journal of Pediatrics
Volume 11, Issue 5
May 2023
Pages 17685-17697
Files
Share
How to cite
Statistics