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Three things you need to know about child eye health

A snapshot of key issues, messages, and resources to help you drive action in child eye health.

Author: Jissa James, IAPB Knowledge Team, August 2022

Children around the world continue to experience and bear the consequences of vision loss, when most could be prevented.

The number of children who need attention, treatment and care will continue to grow significantly by 2050, making it extremely difficult to ‘leave no one behind’, keep ‘2030 In Sight’ and achieve the Sustainable Development Goals.

Solutions are available, but we need significant interventions, innovative approaches, strategic collaborations, and effective monitoring & evaluation.

 

1) 32 million children and adolescents have severe vision loss or blindness

2 children in Yemen with Esotropia, which corrected by eyeglasses Over 32 million children (defined as 0-14 years) and adolescents (defined as 15-19 years) have severe vision loss or blindness.1 Of those:

  • 2.1 million are blind, including 1.4 million children
  • 22 million children and 8 million adolescents have moderate to severe vision loss.

Unfortunately, we lack comprehensive data on visual impairment in children. However, it is estimated that 40% of children are blind from eye conditions that could have been prevented or could be managed if the child had access to eye care services.2

We also know the leading causes of blindness and moderate-severe vision loss among children include uncorrected refractive error, cataract, retinopathy of prematurity, congenital ocular anomalies, corneal scarring, and cerebral visual impairment.3

The good news is that if refractive error is excluded, the number of children who are blind from eye conditions is falling in all regions, due to the reduction of corneal blindness due to vitamin A deficiency and measles.4

However, the prevalence of myopia in children is rapidly increasing in many parts of the world. The COVID-19 pandemic has accelerated this – myopia progression among older schoolchildren increased by 1.5 times since COVID-19 began.5 The rate of myopia varies considerably within and between regions6, but in 2020, 60% of children in Asia and 40% of children in Europe had myopia.7

2) Vision impairment in children can have lifelong consequences

Numerous studies have also shown that vision loss is often associated with various negative health outcomes and poor quality of life, with lifelong consequences8. For example, young children with early onset severe vision loss can experience delayed motor, language, emotional, social and cognitive development.9

If a child has vision loss, this can really impact their educational outcomes, contribute to low self-esteem and future socio-economic potential.10,11,12,13,14 The Lancet Global Health Commission on Global Eye Health15 reported that children with vision loss in low- and middle-income countries are up to five times less likely to be in formal education.16

 

A class of school children await their turn to have their eyes examined at a school screening event in Sierra Leone

3) We need to urgently scale up and strengthen child eye health services

the optometrist is providing the detailed explanation about the procedure of visual acuity assessment using the Snellen's Vision Chart and pinhole to the school students and teachers during a school eye screening program in NepalThere are several positive examples across the world from diverse settings that could guide our approaches to reducing unnecessary vision loss among our children.

The recent developments in global eye health advocacy, increased attention on child eye health in global bodies and technology advances in detecting eye disease and providing care offers hope for a brighter future for our children.

However, we need to urgently scale up and strengthen child eye health services. As a sector we need to:

  • Advocate for an enabling environment where every child has access to eye health screening from birth, examination as required and affordable solutions for their vision-related issues.
  • Improve access and provide comprehensive services at the community, primary, secondary, and tertiary level to increase reach and reduce vision loss in children.
  • Offer school eye health programmes that are integrated within educational policy, systems, and reporting.
  • Collaborate beyond the eye health sector.

Explore more:

  • The IAPB School Eye Health Workgroup has released School Eye Health Guidelines to help deliver standardised comprehensive eye health services to more than 700 million children attending schools around the world.
  • Focus on Child Eye Health engages some of the world’s best and brightest thought leaders throughout the year to share knowledge, inspire action, discuss ideas and push Child Eye Health to the forefront of pressing development issues.

 

  1. Bourne R, Steinmetz JD, Flaxman S, Briant PS, Taylor HR, Resnikoff S, et al. Trends in prevalence of blindness and distance and near vision loss over 30 years: an analysis for the Global Burden of Disease Study. The Lancet Global Health. 2021 Feb 1;9(2):e130–43. Unpublished supplementary data.
  2. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020 [Supplementary appendix 1]. The Lancet Global Health. 2021 Apr;9(4):e489–551.
  3. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. The Lancet Global Health. 2021 Apr;9(4):e489–551.
  4. Gilbert C, Bowman R, Malik AN. The epidemiology of blindness in children: changing priorities. Community Eye Health. 2017;30(100):74.
  5. Xu, L. et al. COVID-19 Quarantine Reveals Behavioral Changes Effect on Myopia Progression. Ophthalmology (2021) doi:10.1016/j.ophtha.2021.04.001.
  6. Sankaridurg P, Tahhan N, Kandel H, Naduvilath T, Zou H, Frick KD, et al. IMI Impact of Myopia. Investigative Ophthalmology & Visual Science. 2021 Apr 28;62(5):2.
  7. Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC ophthalmology. 2020 Dec;20(1):1-1.
  8. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Public Health Approaches to Reduce Vision loss and Promote Eye Health; Welp A, Woodbury RB, McCoy MA, et al., editors.
    Washington (DC): National Academies Press (US); 2016 Sep 15. https://www.ncbi.nlm.nih.gov/books/NBK402367/
  9. https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment
  10. Glewwe P, West KL, Lee J. The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida. J Policy Analysis Manage. 2018;37(2):265–300.
  11. Glewwe P, Park A, Zhao M. A better vision for development: Eyeglasses and academic performance in rural primary schools in China. Journal of Development of Economics. 2016 Sep 1;122:170–82.
  12. Hannum E, Zhang Y. Poverty and Proximate Barriers to Learning: Vision Deficiencies, Vision Correction and Educational Outcomes in Rural Northwest China. World Dev. 2012 Sep 1;40(9):1921–31.
  13. Ma X, Zhou Z, Yi H, Pang X, Shi Y, Chen Q, et al. Effect of providing free glasses on children’s educational outcomes in China: cluster randomized controlled trial. BMJ. 2014 Sep 23;349:g5740.
  14. Ma Y, Congdon N, Shi Y, Hogg R, Medina A, Boswell M, et al. Effect of a Local Vision Care Center on Eyeglasses Use and School Performance in Rural China: A Cluster Randomized Clinical Trial. JAMA Ophthalmol. 2018 Jul 1;136(7):731–7.
  15. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. The Lancet Global Health. 2021 Apr;9(4):e489–551.
  16. Kuper H, Dok AM, Wing K, Danquah L, Evans J, Zuurmond M, et al. The Impact of Disability on the Lives of Children; Cross-Sectional Data Including 8,900 Children with Disabilities and 898,834 Children without Disabilities across 30 Countries. PLOS ONE. 2014 Sep 9;9(9):e107300.

Photo Credits

Malek Al Menbary, Graham Coates, Sandeep Kandel