Causes of severe visual impairment and blindness in Bangladesh: a study of 1935 children.
OBJECTIVE
To identify the anatomical site and underlying aetiology of severe visual impairment and blindness (SVI/BL) in children in Bangladesh.


METHODS
A national case series.


METHODS
Children were recruited from all 64 districts in Bangladesh through multiple sources. Causes were determined and categorised using standard World Health Organization methods.


RESULTS
1935 SVI/BL children were recruited. The median age was 132 months, and boys accounted for 63.1% of the sample. The main site of abnormality was lens (32.5%), mainly unoperated cataract, followed by corneal pathology (26.6%) and disorders of the whole eye (13.1%). Lens-related blindness was the leading cause in boys (37.0%) compared with corneal blindness in girls (29.8%). In 593 children, visual loss was due to childhood factors, over 75% being attributed to vitamin A deficiency. Overall 1338 children (69.2%) had avoidable causes. Only 2% of the country's estimated SVI/BL children have access to education and rehabilitation services.


CONCLUSIONS
This is the first large-scale study of SVI/BL children in Bangladesh over two-thirds of whom had avoidable causes. Strategies for control are discussed.
Muhit
M A
MA
International Centre for Eye Health, Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. Mohammad.Muhit@Lshtm.ac.uk
Shah
S P
SP
Gilbert
C E
CE
Foster
A
A
D000293:Adolescent; D001459:Bangladesh / Q000453:epidemiology; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012423:Rural Health; D014504:Urban Health; D015354:Vision, Low / Q000453:epidemiology / Q000209:etiology*; D014792:Visual Acuity; D014802:Vitamin A Deficiency / Q000150:complications