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Clinical science
Distribution and causes of blindness and severe visual impairment in children at a tertiary referral centre in Rwanda
  1. Sylvain El-Khoury1,2,
  2. Sophia Strittmatter3,
  3. Theophile Tuyisabe1,
  4. Paul-Rolf Preussner3,
  5. Youssef Abdelmassih4
  1. 1Eye Unit, Kabgayi Hospital, Muhanga, Rwanda
  2. 2Department of Ophthalmology, Centre Hospitalier de Grasse, Grasse, France
  3. 3Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
  4. 4Pediatric Ophthalmology, The Fondation Adolphe de Rothschild Hospital, Paris, France
  1. Correspondence to Dr Sylvain El-Khoury, Department of Ophthalmology, Centre Hospitalier de Grasse, Grasse, France; s.el_khoury{at}ch-grasse.fr

Abstract

Aim To determine the prevalence and the causes of severe visual impairment and blindness (SVI/BL) in children at a tertiary referral centre in Rwanda.

Methods In this retrospective study, files of all patients <18 years presenting during the year 2019 at the Kabgayi Eye Unit in Rwanda with SVI/BL (presenting visual acuity of <6/60 Snellen or lack of preferential looking behaviour) in at least one eye were analysed for age, sex, laterality, province of origin and cause of SVI/BL. Causes were categorised according to WHO standard classification.

Results Out of 3939 children presenting to the clinic, 428 (10.9%) had SVI/BL in at least one eye. 165 (4.2%) patients had bilateral and 263 (6.7%) had unilateral condition. Of patients with BL/SVI, 36.7% were below the age of 6 years. In bilateral BL/SVI, the main causes were cataract (18%), refractive error (18%), keratoconus (13%), congenital eye anomaly (9%), glaucoma (8%), cortical blindness (8%) and retinoblastoma (6%). In unilateral BL/SVI it was trauma (46%), cataract (8%), keratoconus (8%), infectious corneal disease (7%) and retinoblastoma (7%). In preschool children, retinopathy of prematurity accounted for 7% of bilateral BL/SVI. Avoidable BL/SVI accounted for 87% of all cases.

Conclusion The high number of avoidable causes for SVI/BL may be reduced through several cost-effective ways.

  • Child health (paediatrics)
  • Epidemiology
  • Public health

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

http://dx.doi.org/10.1136/bjo-2022-321522

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Contributors P-RP, TT, SS, YA and SE-K contributed to the conception of the work and the analysis, the interpretation of data and critically revised the manuscript. SE-K wrote the manuscript with support from SS, YA and TT. P-RP and YA statistically analyzed the data. P-RP and TT supervised the research. Nsabimana Faustin and Munyaneza Celestin collected the data. SE-K is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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