Causes of Visual Impairment in Children: A Study of 3,210 Cases

PURPOSE To determine causes of visual impairment in children at the Low Vision Service of the Ophthalmic Clinic at the University of São Paulo and at the Brazilian Association for the Visually Impaired People (Laramara), located in São Paulo, Brazil. PATIENTS AND METHODS This study evaluated 3,210 visually impaired children (49% female, 51% male; average age, 5.9 years). Visual impairment was present in 57% (visually impaired group) and 43% presented another associated disability (multiple disability group). RESULTS The main causes of visual impairment in the visually impaired group were toxoplasmic macular retinochoroiditis (20.7%), retinal dystrophies (12.2%), retinopathy of prematurity (11.8%), ocular malformation (11.6%), congenital glaucoma (10.8%), optic atrophy (9.7%), and congenital cataracts (7.1%). The main causes of visual impairment in the multiple disability group were optic atrophy (37.7%), cortical visual impairment (19.7%), toxoplasmic macular retinochoroiditis (8.6%), retinopathy of prematurity (7.6%), ocular malformation (6.8%), congenital cataracts (6.1%), and degenerative disorders of the retina and macula (4.8%). The retina was the most frequently affected anatomic site in the visually impaired group (49.2%) and the optic nerve in the multiple disability group (39%). CONCLUSION Primary, secondary, and tertiary prevention efforts for childhood blindness and visual rehabilitation must be considered in Latin America. <cite>J Pediatr Ophthalmol Strabismus</cite> 2007;44:232-240. AUTHORS Drs. Haddad, Sampaio, and Kara-José are from the University of São Paulo Medical School, São Paulo, Brazil. Dr. Sei is from the Brazilian Association for the Visually Impaired People, São Paulo, Brazil. Originally submitted January 11, 2006. Accepted for publication February 26, 2006. Address correspondence to Maria Aparecida Onuki Haddad, MD, Rua da Consolação, 2779 apartamento 11, Cerqueira César, CEP 01416-001, São Paulo – SP, Brasil.