title: [Visual impairment and blindness in children in a Malawian school for the blind].
abstract: OBJECTIVE
  The aim of this study was to determine the anatomic sites of severe visual impairment and blindness in children in an integrated school for the blind in Malawi, and to compare the results with those of previous Malawian blind school studies.
  
  
  METHODS
  Children attending an integrated school for the blind in Malawi were examined in September 2011 using the standard WHO/PBL eye examination record for children with blindness and low vision. Visual acuity [VA] of the better eye was classified using the standardised WHO reporting form.
  
  
  RESULTS
  Fifty-five pupils aged 6 to 19 years were examined, 39 (71 %) males, and 16 (29 %) females. Thirty eight (69%) were blind [BL], 8 (15 %) were severely visually impaired [SVI], 8 (15 %) visually impaired [VI], and 1 (1.8 %) was not visually impaired [NVI]. The major anatomic sites of visual loss were optic nerve (16 %) and retina (16 %), followed by lens/cataract (15 %), cornea (11 %) and lesions of the whole globe (11 %), uveal pathologies (6 %) and cortical blindness (2 %). The exact aetiology of VI or BL could not be determined in most children. Albinism accounted for 13 % (7/55) of the visual impairments. 24 % of the cases were considered to be potentially avoidable: refractive amblyopia among pseudophakic patients and corneal scaring.
  
  
  CONCLUSIONS
  Optic atrophy, retinal diseases (mostly albinism) and cataracts were the major causes of severe visual impairment and blindness in children in an integrated school for the blind in Malawi. Corneal scarring was now the fourth cause of visual impairment, compared to being the commonest cause 35 years ago. Congenital cataract and its postoperative outcome were the commonest remedial causes of visual impairment.
authors: Augenheilkunde, Universitätsaugenklinik Tübingen. mssoculus@web.de
authors: M
authors: M
authors: Schulze Schwering
authors: M
authors: M
authors: Nyrenda
authors: M S
authors: MS
authors: Spitzer
authors: K
authors: K
authors: Kalua
mesh_terms: D000293:Adolescent; D015984:Causality; D002648:Child; D015897:Comorbidity; D003316:Corneal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007905:Lens Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008295:Malawi / Q000453:epidemiology; D008297:Male; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012164:Retinal Diseases / Q000453:epidemiology*; D012307:Risk Factors; D013334:Students / Q000706:statistics & numerical data*; D014603:Uveal Diseases / Q000175:diagnosis / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D055815:Young Adult