Introduction: Severe impairment of visual function and total vision loss are particularly important public health issues worldwide. The issue is even more sensitive when children are involved, because the ability to see plays a key role in the process of perceiving the world around us and its loss has severe consequences on all aspects of a child’s development.
Aim: The aim of this article is to report causes of severe visual impairment and blindness among students from Prof. Dr. Ivan Shishmanov Specialized School for Students with Visual Impairment in Varna, as well as to describe the place of the retinopathy of prematurity (ROP) among them.
Materials and Methods: The current study included a sample of 143 persons, 88 boys (61.5%) and 55 (38.5%) girls. The included students were between 6 and 20 years of age, and the mean age for the whole cohort was 12.5 ± 3.7 years. The study was conducted in the period August 2022–November 2022 among the students in the Prof. Dr. Ivan Shishmanov Specialized School for Students with Visual Impairment after received permission from the school principal.
Results: Atrophy of the optic nerve has been determined as a leading cause for vision loss with a rate of 74.8% of all cases. Retinopathy of prematurity took second place with a rate of 8.4%, followed by cortical visual impairment (5.6%) and other, unclassified reasons (5.6%). Among children with visual impairment due to ROP, the mean birth weight was 1033 ± 352 g, and the mean gestational age was 34.4 ± 1.44 weeks. The boys-to-girls ratio was 2:1. In most cases treatment for ROP had been conducted—cryotherapy in 5 cases (41.7%) and surgical treatment in 5 cases (41.7%). Almost all children (91.7%) were with neurodevelopmental delay, and hearing problems were diagnosed among 41.7% of them.
Conclusion: Diseases of the optical nerve and retina were the main reason for severe visual impairment among the students from the Prof. Dr. Ivan Shishmanov Specialized School for Students with Visual Impairment in Varna.
Abdulhussein D, Abdul Hussein M. WHO Vision 2020: Have we done it? Ophthalmic Epidemiol. 2023;30(4):331–9 doi: 10.1080/09286586.2022.2127784.
Solebo AL, Teoh L, Sargent J, Rahi JS, British Childhood Visual Impairment and Blindness Study Interest Group. Avoidable childhood blindness in a high-income country: findings from the British Childhood Visual Impairment and Blindness Study 2. Br J Ophthalmol. 2022;bjophthalmol-2022-321718. doi: 10.1136/bjo-2022-321718.
Gilbert C, Bowman R, Malik AN. The epidemiology of blindness in children: changing priorities. Community Eye Health. 2017;30(100):74-7.
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020--the right to sight. Bull World Health Organ. 2001;79(3):227–32.
Gilbert C. Changing challenges in the control of blindness in children. Eye Lond Engl. 2007;21(10):1338–43 doi: 10.1038/sj.eye.6702841.
Borțea CI, Stoica F, Boia M, Iacob ER, Dinu M, Iacob R, et al. Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants. Med Kaunas Lith. 2021;57(5):420 doi: 10.3390/medicina57050420
Kulkarni S, Gilbert C, Giri N, Hankare P, Dole K, Deshpande M. Visual impairment and blindness among children from schools for the blind in Maharashtra state, India: Changing trends over the last decade. Indian J Ophthalmol. 2022;70(2):597–603. doi: 10.4103/ijo.IJO_1930_21.
World Health Association [Internet]. Vision impairment and blindness [cited 2023 Jul 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment.
Zepeda-Romero LC, Barrera-de-Leon JC, Camacho-Choza C, Gonzalez Bernal C, Camarena-Garcia E, Diaz-Alatorre C, et al. Retinopathy of prematurity as a major cause of severe visual impairment and blindness in children in schools for the blind in Guadalajara city, Mexico. Br J Ophthalmol. 2011;95(11):1502–5. doi: 10.1136/bjophthalmol-2011-300015.
Kocur I, Kuchynka P, Rodný S, Baráková D, Schwartz EC. Causes of severe visual impairment and blindness in children attending schools for the visually handicapped in the Czech Republic. Br J Ophthalmol. 2001;85(10):1149–52. doi: 10.1136/bjo.85.10.1149.
Rohrschneider K, Mackensen I. Causes of blindness in students at the school for blind children in Ilvesheim. Changes between 1885 and 2008. Ophthalmol Z Dtsch Ophthalmol Ges. 2013;110(4):331–8 (in German) doi: 10.1007/s00347-012-2708-7.
Mezer E, Chetrit A, Kalter-Leibovici O, Kinori M, Ben-Zion I, Wygnanski-Jaffe T. Trends in the incidence and causes of severe visual impairment and blindness in children from Israel. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 2015;19(3):260-5 doi: 10.1016/j.jaapos.2015.04.002.
Gilbert C, Rahi J, Eckstein M, O’Sullivan J, Foster A. Retinopathy of prematurity in middle-income countries. Lancet Lond Engl. 1997;350(9070):12–4. doi: 10.1016/S0140-6736(97)01107-0.
Mutlu FM, Sarici SU. Treatment of retinopathy of prematurity: a review of conventional and promising new therapeutic options. Int J Ophthalmol. 2013;6(2):228–36. doi: 10.3980/j.issn.2222-3959.2013.02.23.
Mintz-Hittner HA. Retinopathy of Prematurity: Intravitreal injections of bevacizumab: timing, technique, and outcomes. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 2016;20(6):478–80. doi: 10.1016/j.jaapos.2016.10.002.
Aghaji A, Okoye O, Bowman R. Causes and emerging trends of childhood blindness: findings from schools for the blind in Southeast Nigeria. Br J Ophthalmol. 2015;99(6):727–31. doi: 10.1136/bjophthalmol-2014-305490.
Kello AB, Gilbert C. Causes of severe visual impairment and blindness in children in schools for the blind in Ethiopia. Br J Ophthalmol. 2003;87(5):526–30. doi: 10.1136/bjo.87.5.526.
Email this article (Login required) 
