The Indian Journal of Pediatrics

, Volume 84, Issue 12, pp 924–929 | Cite as

Magnitude and Temporal Trends in Avoidable Blindness in Children (ABC) in India

  • Venkata S. Murthy Gudlavalleti
Review Article


The World Health Organization estimates that 19 million children are visually impaired, among whom, 1.4 million are blind. Childhood blindness is an excellent indicator of the state of child health and primary care services in a country. Childhood blindness is important not just due to the number of children blind but also because the number of years that the surviving child has to live with blindness (blind years lived). Childhood blindness is next only to adult cataract in terms of the number of blind person years lived. Under-five mortality rates have been used as a proxy measure to compute the prevalence of childhood blindness in low and middle income countries due to limitations of other methods of data collection. In India, it is estimated that there are 0.8 blind for 1000 children. Whole globe lesions, corneal scarring, retinal pathology and afflictions of the lens are important anatomical sites in children. Causes operating in childhood and hereditary causes are important in etiology of childhood blindness. In 38.2%–68.4% cases across the region, a specific cause of blindness could not be identified in South Asia. The proportion of blindness that can be prevented or treated (avoidable) in children is less than 50%. Therefore a comprehensive eye care system needs to be in place to cater to the needs of children with avoidable and those with incurable blindness. Early detection and prompt management are critical for success of programs targeting avoidable blindness in children.


Blindness Childhood India Prevalence Vision disability 


Compliance Ethical Standards

Conflict of Interest


Source of Funding



  1. 1.
    Gilbert C, Foster A. Blindness in children: control priorities and research opportunities. Br J Ophthalmol. 2001;85:1025–7.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96:614–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Dandona L, Williams JD, Williams BC, Rao GN. Population-based assessment of childhood blindness in southern India. Arch Ophthalmol. 1998;116:545–6.PubMedGoogle Scholar
  4. 4.
    Solebo AL, Rahi J. Epidemiology, aetiology and management of visual impairment in children. Arch Dis Child. 2014;99:375–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Gilbert C, Foster A. Childhood blindness in the context of vision 2020 – the right to sight. Bull World Health Organ. 2001;79:227–32.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Pizzarello L, Abiose A, Ffytche T, et al. VISION 2020: the right to sight – a global initiative to eliminate avoidable blindness. Arch Ophthalmol. 2004;122:615–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Gilbert C. Changing challenges in the control of blindness in children. Eye. 2007;21:1338–43.CrossRefPubMedGoogle Scholar
  8. 8.
    Bodeau-Livinec F, Surman G, Kaminski M, Wilkinson AR, Ancel P-Y, Kurinczuk JJ. Recent trends in visual impairment and blindness in the UK. Arch Dis Child. 2007;92:1099–104.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Rahi JS, Cumberland PM, Peckham CS; British Childhood Visual Impairment Interest Group. Improving detection of blindness in childhood: the British childhood vision impairment study. Pediatrics. 2010;126:3895–903.Google Scholar
  10. 10.
    Muhit MA, Shah SP, Gilbert CE, Hartley SD, Foster A. The key informant method: a novel means of ascertaining blind children in Bangladesh. Br J Ophthalmol. 2007;91:995–9.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Husain L. Using the key informant method to investigate childhood blindness related to vitamin A deficiency disorder in six rural sub-districts in Bangladesh. Community Eye Health. 2007;20:7–8.Google Scholar
  12. 12.
    Chipalo-Mutati G. A survey of childhood blindness in three schools for the blind in Zambia. Community Eye Health. 2007;20:7.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Kalua K. Use of key informants in determining the magnitude and causes of childhood blindness in Chikwawa district, southern Malawi. Community Eye Health. 2007;20:8.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Muhammad N, Maishanu NM, Jabo AM, Rabiu MM. Tracing children with blindness and visual impairment using the key informant survey in a district of north-western Nigeria. Middle East Afr J Ophthalmol. 2010;17:330–4.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Jose R, Sachdeva S. School eye screening and the National Program for control of blindness. Indian Pediatr. 2009;46:205–8.PubMedGoogle Scholar
  16. 16.
    Nirmalan PK, Vijayalakshmi P, Sheeladevi S, Kothari MB, Sundaresan K, Rahmathullah L. The Kariapatti pediatric eye evaluation project: baseline ophthalmic data of children aged 15 years or younger in southern India. Am J Ophthalmol. 2003;136:703–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Dandona R, Dandona L. Childhood blindness in India: a population based perspective. Br J Ophthalmol. 2003;87:263–5.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Murthy GV, Gupta SK, Ellwein LB, et al. Refractive error in children in an urban population in New Delhi. Invest Ophthalmol Vis Sci. 2002;43:623–31.PubMedGoogle Scholar
  19. 19.
    Dandona R, Dandona L, Srinivas M, et al. Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci. 2002;43:615–22.PubMedGoogle Scholar
  20. 20.
    Dorairaj SK. Bandrakalli P, Shetty C, RV, Misquith D, Ritch R. Childhood blindness in a rural population of southern India: prevalence and etiology. Ophthalmic Epidemiol. 2008;15:176–82.Google Scholar
  21. 21.
    Kemmanu V, Hegde K, Giliyar SK, Shetty BK, Kumaramanickavel G, McCarty CA. Prevalence of childhood blindness and ocular morbidity in a rural pediatric population in southern India: the Pavagada pediatric eye disease study-1. Ophthalmic Epidemiol. 2016;23:185–92.CrossRefPubMedGoogle Scholar
  22. 22.
    Murthy GV, Mactaggart I, Mohammad M, et al; Bangladesh KIM study group. Assessing the prevalence of sensory and motor impairments in childhood in Bangladesh using key informants. Arch Dis Child. 2014;99:1103–8.Google Scholar
  23. 23.
    Gilbert C, Foster A, Negrel AD, Thylefors B. Childhood blindness: a new form for recording causes of visual loss in children. Bull World Health Organ. 1993;71:485–9.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Rahi JS, Sripathi S, Gilbert CE, Foster A. Childhood blindness in India: causes in 1318 blind school students in nine states. Eye (Lond). 1995;9:545–50.Google Scholar
  25. 25.
    Hornby SJ, Adolph S, Gothwal VK, Gilbert CE, Dandona L, Foster A. Evaluation of children in six blind schools of Andhra Pradesh. Indian J Ophthalmol. 2000;48:195–200.PubMedGoogle Scholar
  26. 26.
    Titiyal JS, Pal N, Murthy GVS, et al. Causes and temporal trends of blindness and severe visual impairment in children in schools for the blind in North India. Br J Ophthalmol. 2003;87:941–5.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Bhattacharjee H, Das K, Borah RR, et al. Causes of childhood blindness in the northeastern states of India. Indian J Ophthalmol. 2008;56:495–9.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Muhit MA, Shah SP, Gilbert CE, Foster A. Causes of severe visual impairment and blindness in Bangladesh: a study of 1935 children. Br J Ophthalmol. 2007;91:1000–4.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Gogate P, Deshpande M, Sudrik S, Taras S, Kishore H, Gilbert CE. Changing pattern of childhood blindness in Maharashtra, India. Br J Ophthalmol. 2007;91:8–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Gogate P, Kishore H, Dole K, et al. The pattern of childhood blindness in Karnataka, South India. Ophthalmic Epidemiol. 2009;16:212–7.Google Scholar
  31. 31.
    Muecke J, Hammerton M, Aung YY, et al. A survey of visual impairment and blindness in children attending seven schools for the blind in Myanmar. Ophthalmic Epidemiol. 2009;16:370–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Gao Z, Muecke J, Edussuriaya K, et al. A survey of severe visual impairment and blindness in children attending thirteen schools for the blind in Sri Lanka. Ophthalmic Epidemiol. 2011;18:36–43.CrossRefPubMedGoogle Scholar
  33. 33.
    Krishnaiah S, Rao BS, Narasamma KL, Amit G. A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India. Eye. 2012;26:1065–70.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Shrestha JB, Gnyawali S, Upadhyay MP. Causes of blindness and visual impairment among students in integrated schools for the blind in Nepal. Ophthalmic Epidemiol. 2012;19:401–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Kapil U, Gupta A. Low quality scientific evidence for the continuation of universal vitamin A supplementation among under 5 children in India. Indian J Public Health. 2016;60:176–80.Google Scholar
  36. 36.
    International Institute for Population Sciences. National Family Health Survey-4 2015–16: India Fact Sheet. Government of India, Ministry of Health & Family Welfare, New Delhi, India, 2016: 1–6. Available at: Accessed on 20th March 2017.
  37. 37.
    Deorari A, Gilbert C. Controlling visual loss from retinopathy of prematurity in India. Indian Pediatr. 2016;53:S73–5.PubMedGoogle Scholar
  38. 38.
    Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379:2162–72.CrossRefPubMedGoogle Scholar
  39. 39.
    Blencowe H, Moxon S, Gilbert C. Update on blindness due to retinopathy of prematurity globally and in India. Indian Pediatr. 2016;53:S89–92.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  1. 1.Indian Institute of Public HealthHyderabadIndia
  2. 2.International Centre for Eye Health, Department of Clinical Research, Faculty of Infectious & Tropical DiseasesLondon School of Hygiene & Tropical MedicineLondonUK
  3. 3.HyderabadIndia

Personalised recommendations