Eye conditions and blindness in children: Priorities for research, programs, and policy with a focus on childhood cataract

• Main Authors: Clare Gilbert, Mohammed Muhit
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Diabetes-related blindness; diabetic retinopathy; key informant; rapid assessment of avoidable blindness; retinopathy of prematurity; tele-ophthalmology; Blindness; disability; equity; health economics; health policy; health and development; social exclusion; Community eye health; prevention of blindness; ophthalmogical residency; VISION 2020; Visual impairment; blindness; inequality; social class; income; educational status; gender and ethnic groups; Advocacy; effective service delivery; enabling environment; stakeholders; resources; Avoidable blindness and visual impairment; impact; scaling up; Global blindness; prevalence; visual impairment; visual acuity; Comprehensive eye care; eye care model; pyramidal model; optometrist; optometry regulation; eye health; India; Economics; market; government; cost; Millennium development goals; Vision 2020 the Right to Sight; eye care services; planning rapid assessment methods; Avoidable blindness; cataract surgical rate; corneal blindness; Compliance; services; Human resource development; service delivery; social entrepreneurship; uncorrected refractive error; cataract extraction; cataract; coverage; data aggregation; population; Case detection; comprehensive eye examination; developing countries; glaucoma; integrated approach; training requirements; Child health policy; childhood blindness; social determinants of eye health
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2012;volume=60;issue=5;spage=451;epage=455;aulast=Gilbert

The major causes of blindness in children encompass intrauterine and acquired infectious diseases, teratogens and developmental and molecular genetics, nutritional factors, the consequences of preterm birth, and tumors. A multidisciplinary approach is therefore needed. In terms of the major avoidable causes (i.e., those that can be prevented or treated) the available evidence shows that these vary in importance from country to country, as well as over time. This is because the underlying causes closely reflect socioeconomic development and the social determinants of health, as well as the provision of preventive and therapeutic programs and services from the community through to tertiary levels of care. The control of blindness in children therefore requires not only strategies that reflect the local epidemiology and the needs and priorities of communities, but also a well functioning, accessible health system which operates within an enabling and conducive policy environment. In this article we use cataract in children as an example and make the case for health financing systems that do not lead to ′catastrophic health expenditure′ for affected families, and the integration of eye health for children into those elements of the health system that work closely with mothers and their children.