Analysis of low vision and blindness in children consulted in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Ophthalmology Department in 2005-2006 and 2019-2020

Abstract

Objective: 1. To determine the prevalence of avoidable and unavoidable childhood blindness and low vision among children consulted in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Ophthalmology Department in 2019-2020. 2. To compare the current prevailing causes of childhood blindness and low vision with data from a study conducted at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Ophthalmology Department in 2005-2006. Methods: A retrospective analysis of medical records of children consulted in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Ophthalmology Department in 2019-2020. Children who met the ICD-10 criteria for blindness and low vision were included. The following data were collected: age, best corrected visual acuity, diagnosis and the cause of the visual impairment. The data obtained were compared with the same analysis performed in 2005-2006. Results: The study involved 179 children, 20% of them were blind and 80% had low vision. In 2005-2006 223 children were included. Unavoidable causes of blindness and low vision were identified in 61% of patients in the 2005-2006 study and in 79.9% of patients in 2019-2020. The most common causes of visual impairment in 2005-2006 were amblyopia (22%) and congenital cataract (18%), while in 2019-2020, the most common causes were optic nerve dysplasia/atrophy (29%) and retinal dystrophies (18.4%). According to the anatomical classification, the most frequent cause was retinal damage (30%) in 2005-2006 and optic nerve damage (30.7%) in 2019-2020. The cause of visual impairment was unknown in 41.7% of patients in the 2005-2006 study. In 2019-2020 55.3% of the causes were hereditary and caused by genetic changes and 22% were unknown. The most common cause of blindness in 2005-2006 was retinopathy of prematurity (ROP) (38.2%) and the most common cause of low vision was amblyopia (25%). In the 2019-2020 study 36.1% of patients were blind and 27.3% had low vision due to optic nerve damage. Conclusions: The prevalence of avoidable childhood blindness and low vision in Lithuania has significantly declined over 15 years. Early diagnosis of congenital cataract and visual outcomes have improved with the introduction of neonatal red reflex screening in 2012. Effective screening of premature newborns has reduced the prevalence of blindness due to ROP. New technologies such as optic coherence tomography have improved the diagnosis of optic nerve damage and retinal dystrophies, which have become the leading cause of childhood blindness and low vision.