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J. E. Keeffe, A. T. Cama, T. B. Sikivou; The Prevalence and Causes of Low Vision and Blindness in Children in Fiji. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3156. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To establish the prevalence and causes of low vision and blindness in children in Fiji using existing data from the eye clinic, school for the blind and an outreach service with new data provided by key informants and from surveys.
Childhood vision impairment was defined as visual acuity <6/18, low vision as <6/18 - 3/60 and blindness <3/60. The study was undertaken in Fiji's Central Medical Division (CMD) with a population of 102,706 children aged 0-15 years. Data were obtained from existing records at CMD's only hospital eye clinic, the school and an outreach service for ‘blind’ children, primary school screening records, and all referrals to a low vision clinic during a 12 month period. Surveys were also conducted in high schools and schools for children with hearing, physical or intellectual disabilities. Causes were ascertained from an eye exam or clinic records. Prevalence was calculated for vision impairment for each 5 year age group, and for low vision and blindness. Sensitivity analysis was used to re-calculate prevalence based on age of onset of vision impairment.
A total of 74 children were identified giving a crude prevalence rate of 0.072 (CI 0.070, 0.073) or 7.2 per 10,000. Even though congenital causes of vision impairment predominated, only 9.4% of children identified were aged 0-5 years. Sensitivity analysis calculated the probable prevalence of vision impairment per 10,000 of 0-15 year olds would be 11.68 (CI 11.48, 11.88) with 7.69 (CI 7.53, 7.85) with low vision and 3.99 (3.87, 4.11) blind. For those where a definitive cause was established (n=58), 69% had unavoidable causes of vision loss mainly related to retinal (39.7%) and cortical (15.5%) origin with avoidable causes of vision loss - cataract (15.5%), retinopathy of prematurity (6.9%) and cornea (1.7%) and others (6.9%) contributing a relatively small proportion.
Low to moderate prevalence and mainly unavoidable causes of low vision and blindness indicate that Fiji, a developing country, has prevalence and causes of vision impairment similar to the more resourced, industrialised countries.
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