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G.A. Gole, J. Bevan, A. Blaikie, P. Cranstoun, M. Forrest, A. Lamont, B. Hein; The Causes of Paediatric Low Vision the State of Queensland, Australia Over a 30 Year Period . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3475.
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To report the changing causes of paediatric low vision (PLV) in an Australian population over a 30 year period.
The Paediatric Low Vision Clinic is based in the Education Dept of the State of Queensland , Australia (pop 4m). It provides support from infancy to school departure. Assessment is multidisciplinary. Referral is from ophthalmologists, optometrists, parents and teachers. Records of diagnoses have been prospectively collected since 1974 (n=2513).
(abbreviated) Cerebral vision impairment has increased from 2.4% to 25.2% of cases and has been the commonest cause of PLV since the late 1980's. Retinopathy of Prematurity had a peak in the early 1990's (9.0%) but has fallen to 3.0% of cases. Optic nerve hypoplasia has steadily increased as a cause of PLV. Congenital cataract has fallen from 15.8% to 3.0%. Congenital rubella has not been recorded as a diagnosis since 1992. Congenital (idiopathic) nystagmus (CIN) as a diagnosis has fallen from 16.5% to 1.5% of cases.
Cerebral vision impairment has been the commonest cause of PLV for nearly two decades largely due to increasing survival of premature infants. Clearly, more research effort needs to be made in this area. Despite a marked increase in survival of premature infants, ROP blindness is not a common cause of PLV in this population probably due to aggressive laser treatment of proliferative ROP. Better management of congenital cataracts with early surgery and visual rehabilitation has caused a marked fall in in PLV from this cause. The falling prevalence of CIN in our dataset is probably artefactual and due to more precise diagnosis of children with infantile onset nystagmus.
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