Here’s what you need to know about childhood blindness and its prevention

From the time of birth to early childhood and adolescence, eye care for children must be prioritised

We often take our eyes for granted, not realising they are the windows to the world. Any damage to these vital organs — especially at a young age — can cause a lifetime of misery and dependence.

“From the time of birth to early childhood and adolescence, eye care for children must be a special focus for families and paediatricians. Yet, India has the dubious distinction of not only having the largest number of blind in the world, but also possibly the largest number of blind children with estimates ranging between 1.6 to 2 million,” Dr Smita Kapoor Grover, Consultant Paediatric Ophthalmology, Vision Eye Centres, New Delhi, tells

Causes of blindness in children

Dr Grover points out that corneal clouding and scarring were considered to be the most common causes of childhood blindness in India. “Studies in the early 2000s concluded refractive errors constituted the biggest cause of childhood blindness, followed by retinal degenerations, corneal opacities, congenital eye anomalies and amblyopia.”

It is to be noted at least 1/6th of the cases could have been prevented if causes such as vitamin A deficiency were taken care of. The remaining cases of childhood blindness were found to happen because of congenital eye anomalies and retinal degeneration. “Research in the last few suggests that globe abnormalities in terms of childhood blindness have been attributed to genetic mutations as well as usage of drugs and alcohol and exposure to pesticides or fertilizers during pregnancy,” the doctor says.

Importance of vitamin A

Timely introduction of corrective glasses to children depending on the degree of severity can go a long way in preventing blindness. Not only that, nutritional blindness among children can be prevented by properly administering vitamin A doses according to their age. “Deficiency of Vitamin A can lead to a range of eye conditions: from xerophthalmia (incapacity to produce tears) to severe dryness of the cornea, and conjunctiva and nyctalopia (night blindness) to keratomalacia (clouding and softening of the cornea), which can lead to corneal rupture and permanent blindness,” says Dr Grover.

Deficiency of vitamin A can also lead to measles in children which, in turn, leads to measles keratitis. “In this, the child while developing an infection in the cornea, may tend to produce excessive tears while also evincing extreme sensitivity to light. The infection can lead to corneal swelling or scarring which could cause permanent blindness.”

Additionally, if the mother contracts measles during pregnancy it becomes hazardous for the baby who may lose their vision because of corneal and retinal complications. An encouraging fact is measles in children under five has shown a demonstrable decline over the years in India, says the doctor.

Addressing the problem

Parents must identify early signs of a disorder — children with uncoordinated eyes or cross-eyes at birth. “This is because it takes time for coordination between eyes. However, if there is the persistence of cross-eyes, parents must visit a paediatric ophthalmologist,” suggests Dr Grover.

Ensure timely preventive treatment is offered by offering supplements of vitamin A to expecting mothers and new-born babies. “Food rich in vitamin A, leafy vegetables and milk must be consumed. Also, it is better to avoid any home treatment without consulting an ophthalmologist. The guidelines by WHO on screen time for children of different age groups must be strictly adhered to.”

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