Abstract

DO.26.06

Pediatric Ophthalmology in Developing Countries

Martin M. Nentwich, Ulrich C. Schaller, Volker Klauß

Augenklinik der Ludwig-Maximilians Universität München

Objective
In the year 2000, there were 45 million blind people worldwide – 1.4 million of these were children, mainly in newly industrialised and developing countries. The highest rates of childhood blindness are found in the poorest countries in Asia and Africa. The main focus of this summary is the discussion of the present situation of pediatric ophthalmology in developing countries and of the progress in some of the avoidable causes of blindness such as Vitamin A deficiency, congenital cataract, retinopathy of prematurity (ROP) and refractive errors.
Methods
Summary of recent publications on the topic of pediatric ophthalmology in developing countries.
Results
The important role of pediatric ophthalmology can be recongnized, if one looks at the high mortality rate of up to 50% of children in the first year after having become blind. The surviving children spend their life without vision, 90% of them do not attend school.
The causes of blindness significantly differ between different regions. In industrialised nations these are (in decreasing number of frequency): ROP, teratogens, cataract and glaucoma; in newly industrialised countries cataract, ROP, glaucoma, teratogens; in developing countries corneal opacities, cataract, glaucoma, optic atrophy.
Concerning Vitamin A deficiency, a supplementation with 200.000 IU vitamin A twice a year, with therapeutic costs of about 1 US$ could significantly reduce corneal childhood blindness together with childhood mortality itself.
Pediatric cataract not only poses a surgical challenge, also postoperative amblyopia due to insufficient follow-up and the absence of occlusion therapy is an important factor preventing good functional outcomes.
In newly industrialised countries, ROP increasingly becomes a problem due to higher survival rates of small premature babies without sufficient ophthalmologic examinations.
During the last years, the protocol of the “Refractive Error Study in Children“ (RESC) collected first comparable, popultion-based, raliable data on the prevalence of refractice errors in children.
Conclusions
After ten years of Vision 2020, some progress in identifying and treating some of the major causes of childhood blindness has been made. However, ophthalmologic care and alimentation for children still need to be improved.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.