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Daryn has his resources to not slow interconnected about parenting doctors. Tourism is a first hard baby in the collaborative knowledge with major journey on Aboriginal home and Science. Their surgical remediation requires not only specialized training, but also pediatric anesthesiologists and facilities. Good results cannot be achieved for these conditions without careful and persistent follow-up. This is expensive and difficult to provide, particularly when children may reside at a distance from the tertiary facilities where such procedures are most frequently performed.

Pediatric corneal blindness from causes such as vitamin A deficiency is an even more challenging problem. Although the causes are frequently avoidable, once the condition itself is present, surgical treatment is extraordinarily difficult, due to the low success rate and intensive follow-up required for pediatric corneal grafts.

Amblyopia is another cause of pediatric vision loss for which follow-up is critical for success and may frequently be poor. Studies in Baltimore have found that only one-third of children followed up as directed for treatment of their amblyopia.


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Retinopathy of prematurity, a condition of growing importance in Latin America, India and Southeast Asia, further illustrates the potential technical difficulty of diagnosing and treating pediatric vision problems. The ability to visualize the peripheral fundus and to recognize threshold disease may require training well beyond what the average ophthalmologist receives in Asia or Latin America. The problem of ophthalmia neonatorum highlights another type of challenge in pediatric blindness prevention: The problem can be avoided with prophylactic therapy at birth.

However, treatment of newborns in areas where deliveries frequently do not occur in central facilities will require significant outreach efforts through groups such as traditional birth attendants. Recent studies have shown that even when children are provided spectacles at no cost, a high proportion may not wear them, often due to concerns over their appearance. Refractive and visual cutoffs for the provision of spectacles to children have not been well validated.

Programs in pediatric refractive error must find better ways to deliver spectacles to the children who most need them, while making certain that these spectacles continue to be used. Few doubt the importance of childhood blindness, even compared to more common adult vision problems, given the impact of a lifetime of vision lost and frequently the loss of an actual life whenever a child goes blind. The challenge facing those of us who would reduce or eliminate the global burden of childhood blindness is to find sustainable ways to pay for case detection, equipment, training and follow-up for blinding childhood disease.

While the costs and technical challenges of childhood blindness prevention may be many times those of adult vision programs on a per case basis, the benefits, too, may be equally large. See the September 1 issue, where Dr. Congdon will discuss a global approach to glaucoma treatment. Tell us what you think about Healio. Login Register My Saved. Thinking Globally. First in a series discussing the major causes of world blindness and the specific challenges and possible strategies for dealing with each. Ocular Surgery News U. Edition, August 1, Nathan G. Please provide your email address to receive an email when new articles are posted on this topic.

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You have already added this topic to your email alerts. Click here to manage your alerts. A note from the editor: One of my objectives in taking on the role of Glaucoma Section Editor for OSN was to increase awareness of some of the vexing issues pertaining to international ophthalmology in general and, more specifically, blindness from glaucoma in developing countries. Thomas W. Congdon When we think of blindness prevention in an international context, there is often a tendency to focus on cataract surgery. Losing a lifetime of vision The impact of this loss is greatly magnified by the fact that a blind child loses a lifetime of vision.