Abstract
Objective: To identify the major causes of severe visual impairment and blindness among children
attending the schools for the blind with the view of offering treatment to those with remediable visual
impairment and blindness.
Design: Cross sectional study.
Study site: Four schools for the blind in the districts of Gulu, Kitgum and Arua (Uganda).
Methods: Pupils in Gulu Primary (Gulu), St Thereza Girls (Kitgum), Ediofe Girls (Arua) and Mvara Boys
(Arua) schools had complete ophthalmic examination from their respective schools. All findings were
documented on the WHO standard forms for recording causes of SVI/ blindness in children. Consent
was obtained from the school authority/ teachers.
Results: A total of 53 children were examined; Males 35 (66%) and females 18 (34%). The onset of visual
loss among the children was as follows: at birth 16 (30%), Infancy 5 (10%), onset between 1-15 years 25
(47%) and unknown onset 7 (13%). Visual impairment was observed in 98% and categorized as: blind
39 (75%), severe visual impairment 10 (19%), low vision 3 (6%) and normal vision 1 (2%). Anatomically,
the major sites of abnormality leading to visual loss were: whole Globe 27%, cornea 21%, lens 21%,
optic nerve 13.4% and retina 9.6%. The etiology of conditions that led to visual loss was found to be
as follows: unknown (63%), post natal causes (27%), hereditary (4%), peri-natal factors (4%) and intra
uterine causes (2%). The criteria for admission in the school was as follows: those recommended and
referred by health workers were 27 (51%), while 20 (38%) were taken by parents or guardians and 5
(11%) by the District Education Office.
Conclusion: Sixty seven percent of the causes of visual impairment were avoidable.
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