title: Changing pattern of childhood blindness in Maharashtra, India.
abstract: OBJECTIVE
  To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India.
  
  
  METHODS
  Children aged <16 years with a visual acuity of <6/60 in the better eye, attending 35 schools for the blind were examined between 2002 and 2005, and causes were classified using the World Health Organization's system.
  
  
  RESULTS
  1985 students were examined, 1778 of whom fulfilled the eligibility criteria. The major causes of visual loss were congenital anomalies (microphthalmos or anophthalmos; 735, 41.3%), corneal conditions (mainly scarring; 395, 22.2%), cataract or aphakia (n = 107, 6%), and retinal disorders (mainly dystrophies; n = 199, 11.2%). More than one third of children (34.5%) were blind from conditions which could have been prevented or treated, 139 of whom were referred for surgery. Low vision devices improved near-acuity in 79 (4.4%) children, and 72 (4%) benefited from refraction. No variation in causes by sex or region was observed.
  
  
  CONCLUSIONS
  Congenital anomalies accounted for 41% of blindness, which is higher than in a similar study conducted 10 years ago. Corneal scarring seems to be declining in importance, low vision and optical services need to be improved, and research is needed to determine the aetiology of congenital anomalies.
authors.affiliation: H.V., Desai Eye Hospital,Survey number 93, Tarawade Vasti, Mohammadwadi, Hadapsar, Pune 411028, India. parikshitgogate@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Gogate
authors.forename: M
authors.initials: M
authors.lastname: Deshpande
authors.forename: S
authors.initials: S
authors.lastname: Sudrik
authors.forename: S
authors.initials: S
authors.lastname: Taras
authors.forename: H
authors.initials: H
authors.lastname: Kishore
authors.forename: C
authors.initials: C
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D001035:Aphakia / Q000453:epidemiology; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D002386:Cataract / Q000453:epidemiology; D002648:Child; D003316:Corneal Diseases / Q000453:epidemiology; D005124:Eye Abnormalities / Q000453:epidemiology; D005139:Eyeglasses; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012164:Retinal Diseases / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology*; D014792:Visual Acuity / Q000502:physiology