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First Author: V.Surong INDIA
Co Author(s): D. Patel S. Saikia
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Childhood blindness is among the most important disabilities due to the high number of blind years that affect individuals as well society at large.. The study aim was to determine, for the first time in Meghalaya, the main causes of severe visual impairment (SVI) and blindness among children (<16 yrs) which would then enable us to plan and develop appropriate eye care services.
Mission trust and B. Nethralaya,Shillong, Meghalaya,India.
The study was conducted in July 2011 using two sources to identify the blind children in this region, which is a mainly tribal population and difficult access: Children from the two integrated schools for the blind in Meghalaya,were included in the study and also blind children identified using an ongoing house to house CBR disability detection programme in the districts of Jaintia hills and West Khasi hills. Examination of all identified blind/SVI children was done and recorded on a modified WHO childhood blindness records form.
87 children (from the schools for the blind) and 35 children (CBR program) with visual disability were identified . In the blind schools, 89.65% were blind and 9.20% had SVI; whereas in the community, 77.15% were blind and 11.42% had SVI. The anatomical sites of blindness were 1) Blind school : cornea (54.02%), lens related (6.90%), whole globe (13.80%) and 2) Community: cornea (34.28%), lens related (25.72%) and glaucoma/buphthalmos (17%). These differences between school and community were not statistically significant (p=0.1). In the majority the aetiology was unknown (community=51.44%, school=40.23%), but most causes were acquired in childhood (community=34.28%, blind schools=51.72%). The estimated prevalence extrapolated from the data was 1.2/1000 children. CBR method was effective in identifying the under 5 year age group, who were also too young for enrolment at the schools for the blind. Early detection in many cases may allow us to provide appropriate services especially in corneal and lens related causes , regular follow-up services and health awareness on maternal and child health.
Blindness/SVI from acquired/avoidable causes reflects the importance of primary prevention, e.g., of corneal blindness, by means of total measles immunization coverage, Vitamin A supplement, health and nutrition education (RCH programs). There is an urgent need to strengthen paediatrics eye care delivery services incl. surgical services. The CBR program holds promise for detecting blind children in the community, provides rehabilitation services and addresses issues of barriers faced by the community.