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Avoidable childhood blindness in a high-income country: findings from the British Childhood Visual Impairment and Blindness Study 2
  1. Ameenat Lola Solebo1,2,3,4,
  2. Lucinda Teoh1,4,
  3. Jenefer Sargent5,
  4. Jugnoo S Rahi1,2,3,4
  5. on behalf of the British Childhood Visual Impairment and Blindness Study Interest Group
  1. 1Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
  2. 2NIHR Moorfields Biomedical Research Centre, London, UK
  3. 3Ophthalmology Department, Great Ormond Street Hospital, London, UK
  4. 4Ulverscroft Vision Research Group, London, UK
  5. 5Wolfson Neurodisability Service, Great Ormond Street Hospital For Children NHS Trust, London, UK
  1. Correspondence to Professor Jugnoo S Rahi, Population, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK; j.rahi{at}ucl.ac.uk

Abstract

Background/aims Addressing childhood visual disability is an international priority, with data on causes needed to plan, implement and evaluate public health and clinical care. We have examined the contribution of ‘avoidable’ blinding disorders to childhood visual impairment, severe visual impairment and blindness (VI/SVIBL) in the UK.

Methods National prospective observational longitudinal study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), of children (aged 18 years or under) newly diagnosed with vision worse than 0.48 logMAR (logarithm of the minimum angle of resolution) or equivalent in both eyes. Proportions of children with an ‘avoidable’ disorder comprising either a potentially preventable (isolated disorders with an effective intervention which reduces disease incidence) or treatable (isolated eye or vision disorders for which there are routinely available effective interventions able to improve vision or halt progressive visual loss) are reported.

Results Of the 784 children within BCVIS2, isolated potentially preventable disorders were present in only 17% (132/784) and treatable disorders in an additional 13% (99/784). The most common treatable causes were cataract, retinopathy of prematurity and glaucoma. Of the 132 children with potentially preventable disease, 64 had hypoxic–ischaemic encephalopathy. Non-accidental injury accounted for almost two-thirds (11/16, 69%) of those with VI/SVIBL due to injury.

Conclusion Despite significant progress in the past decades in high-income countries, there remains a need to be vigilant about implementing preventive strategies and treatments. Attention to disorders that are currently neither preventable nor treatable remains a priority in these settings and will become increasingly important in lower-income and middle-income countries undergoing economic transition.

  • epidemiology
  • visual pathway
  • child health (paediatrics)

Data availability statement

No data are available. Current ethics and research governance approvals in place (including Section 251 exemption approval granted by HRA Confidential Advisory Group for use of unconsented patient data) do not permit sharing of individual level data.

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Data availability statement

No data are available. Current ethics and research governance approvals in place (including Section 251 exemption approval granted by HRA Confidential Advisory Group for use of unconsented patient data) do not permit sharing of individual level data.

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Footnotes

  • Twitter @Rahi_Eye_Vision

  • Collaborators British Childhood Visual Impairment Study Group (members in supplementary document)

  • Contributors Study design: ALS and JSR. Study conduct, provision of materials, data analysis/interpretation, and drafting and proofing of the manuscript: all authors. Study co-guarantors: ALS and JSR

  • Funding This work was funded directly by a Fight for Sight grant (1525/26) and was supported by funding from the Ulverscroft Foundation for the Ulverscroft Vision Research Group. ALS received support from the National Institute for Health Research Biomedical Research Center (NIHR BRC) based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, and an NIHR Lectureship, and is supported by an NIHR Clinician Scientist award (CS-2018-18-ST2-005). JSR is supported in part by the NIHR BRC based at Moorfields Eye Hospital NHS Foundation Trust and by the UCL Institute of Ophthalmology, and an NIHR Senior Investigator award (NF-SI-0617-10031). This work was undertaken at UCL Institute of Child Health/Great Ormond Street Hospital for children which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centers funding scheme. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.