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BMJ Open Ophthalmol. 2019 Feb 27;4(1):e000240. doi: 10.1136/bmjophth-2018-000240. eCollection 2019.

Prevalence and causes of childhood blindness in Huidong County, South China, primary ascertained by the key informants.

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Outpatients Department, Affiliated Eye Hospital of Nanchang University, Nanchang, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
The International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.



The aim of this study is to ascertain the prevalence and causes of childhood blindness and severe visual impairment (BL/SVI) in Huidong, South China.


This cross-sectional study was conducted in early 2017 in areas of 139 816 children at the age of 0-15 as the study subjects. We used the trained key informants (KIs) to do preliminary visual test in the communities and refer those children suspected with blindness or unable to count fingers with both eyes at 5 m to hospital for further examination by paediatric ophthalmologist for causes. The WHO's definition of BL/SVI was used, as blindness is best-corrected visual acuity worse than 0.05 in better eye and SVI is equal to or better than 0.05 but worse than 0.1 in better eye.


Three hundred and fourteen KIs were trained. In total, 42 children with BL/SVI were found, and among them over half (22, 52.4%) were due to posterior segment disorders by anatomic site and 18 (42.9%) children were potentially preventable; these included BL/SVI caused by factors at children's development in intrauterine and after birth. This established the prevalence of BL/SVI was at 0.31/1000 (95% CI 0.28 to 0.34/1000).


A low prevalence of childhood blindness was documented in this study. Establishment of surveillance system for disabled children including those with BL/SVI and better health education on eye care to the public according to the surveillance outcomes would help to reduce avoidable children's BL/SVI further in China.


causes; childhood blindness and severe visual impairment; key informants; prevalence

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