The Psychosocial Aspect of Managing a Child with Permanent Blindness: A Challenging Role for the Ophthalmologist

Abstract

The management of permanent blindness in a child is challenging, and the literature dealing with the psychosocial aspect of this condition is limited. We report a case of a child becoming blind after trauma and discuss the short term management of this condition. A 12-year-old girl had right eye perforation and left eye extensive corneo-scleral laceration after a motor vehicle accident. The postoperative outcome was non-perception of light in the right eye and perception of light in the left eye. The patient was unable to accept her eye condition and experienced extreme difficulty in adjusting to her visual impairment. Her family was counseled about her condition, and she was registered in the national blind registry. Psycho-social support was also provided in the ward, and she was emotionally stable upon discharge. She was followed up weekly. At about two months post trauma, the child became depressed, with suicidal ideation. After further psychological intervention, she was able to accept her condition. This case highlights the role of the ophthalmologist in assessing a child who experiences recent blindness. Psychological evaluation of the patient is essential, as is the assessment of the socio-economic circumstances of the family. Close follow-up and multidisciplinary management give the best outcome. Once she is considered not at risk of deliberate self-harm, the patient can be enrolled in a school for the blind, which will provide her with lifelong education and training.