N M Flanagan¹, A J Jackson², A E Hill3
¹Royal Belfast Hospital for Sick Children, Paediatrics - Musgrave Ward, Belfast, United Kingdom; ²Royal Victoria Hospital, Ophthalmology, Belfast, United Kingdom; 3South & East Belfast Health & Social Services Trust, Community Paediatrics, Belfast, United Kingdom
Background The concept of what constitutes visual impairment in childhood has changed dramatically over the last 30 years. In this project, the aim of which was to develop a register of visually impaired children living in South and East Belfast, we profile the current extent and nature of paediatric visual impairment.
Methods Children between the ages of 2 and 19 years with a visual impairment (best binocular corrected visual acuity of <6/18 or significant field loss) were identified from multiple sources including hospital and community based clinical attendance records, blind and partially sighted registers, a computerised child health database, records held by social services teams for those with sensory impairment and peripatetic educational service records. Data on visual status, ophthalmic diagnosis, the use of spectacles, contact lenses and low vision aids and on medical and neurological status were acquired.
Results Seventy-four children with a visual impairment were identified, the childhood prevalence rate being 1.64 per 1000. Twenty-four children (33%) had a normal pattern of development, whereas 32 (43%) exhibited global delay with severe level of disability. Cortical visual impairment was diagnosed in 33 cases (45%), of which 25 had cerebral palsy (34%). Isolated ophthalmic pathology including congenital nystagmus (6), albinism (6), optic atrophy (5) and retinitis pigmentosa (4) occurred in 16 patients (22%). Only 17 children were officially registered as blind or partially sighted.
Conclusion The majority of visually impaired children have been identified as having additional impairments, cortical visual impairment accounting for a high proportion of childhood visual impairment. The prevalence rate is 0.16%, higher than previously estimated.
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