Article Text

Download PDFPDF
Causes and temporal trends of childhood blindness in Indonesia: study at schools for the blind in Java
  1. R S Sitorus1,2,
  2. M Sulaiman Abidin1,2,
  3. Joedo Prihartono1,3
  1. 1
    University of Indonesia, Department of Ophthalmology, Department of Community Medicine, Jakarta, Indonesia
  2. 2
    Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
  3. 3
    Department of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
  1. R S Sitorus, Department of Ophthalmology Faculty of Medicine University of Indonesia. Jakarta. Salemba 6, Jakarta-10430. Indonesia; ritasito{at}; ritass{at}


Aims: To ascertain the causes of blindness and severe visual impairment (BL/SVI) in schools for the blind in Java, to identify preventable and treatable causes and to evaluate temporal trends in the major causes.

Methods: From a total of 504 students, 479 were examined. Data was collected using a modified World Heath Organization Prevention of Blindness (WHO/PBL) eye examination record for children.

Results: The majority of the students (95%) were blind and 4.6% were severely visually impaired. The major anatomical site of BL/SVI was whole globe in 35.9%, retina in 18.9%, lens in 16.4% and cornea in 16.1%. The major underlying aetiology of BL/SVI was undetermined/unknown in 32.7% (mainly microphthalmia, anterior segment dysgenesis and cataract), hereditary factors 31.9% (mainly retinal dystrophies), and childhood disorders 28.5%.

Avoidable causes of BL/SVI accounted for 59.9% of the total students, whereas measles blindness was the underlying condition for 23.1% of the preventable causes; cataract and glaucoma accounted for 15.5% and 8.2% of the treatable causes, respectively. Exploration on trends of SVI/BL among two different age groups <16 years and ⩾16 years suggested that childhood disorders and corneal factors have declined, while hereditary disorders have increased. Optic nerve disorder, although not counted as a major cause of blindness, seems to be on the increase.

Conclusions: More than half of the BL/SVI causes are potentially avoidable. Cataract and corneal disorders related to measles or vitamin A deficiency were the major treatable and preventable causes. Declining proportions of childhood factors and corneal disorders over a period of 10–20 years could reflect improved vitamin A supplementation and measles vaccination coverage in Indonesia. This finding, and the increased proportion of hereditary disease causes, could suggest improving levels of socioeconomic development and health care services.

View Full Text

Statistics from


  • Competing interests: None declared.

  • Abbreviations:

    anterior segment dysgenesis




    Leber’s congenital amaurosis


    retinopathy of prematurity


    severe visual impairment


    World Heath Organization Prevention of Blindness

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.