Paediatric severe low vision (SLV) can have a serious impact on child development and access to education if low vision services are not provided. Data on the causes of SLV in children is essential for planning appropriate paediatric low vision services.
Objective The objective of this study is to analyse and describe the epidemiology of paediatric SLV in Bangladesh.
Methods Children aged <16 years with SLV (visual acuity <6/60 to light perception, in the better eye; due to incurable causes) were recruited. Causes were determined and categorised by an ophthalmologist and data recorded using the WHO methodology.
Results A total of 859 children was diagnosed with SLV; among them, 9.4% were aged 0–5 years and 30.2% 6–10 years. Boys accounted for 59.4% and 95.2% were from rural residence. The main anatomical site of abnormality was corneal diseases, mainly due to xerophthalmia (37.7%), retinal diseases (21.4%), whole globe and congenital eye anomalies (11.5%), SLV due to dense amblyopia, pseudophakia and aphakia after cataract surgery (10.9%) and optic nerve diseases (9.4%). The commonest underlying aetiology was childhood aetiologies (44%) followed by familial or genetic conditions (13.2%). There was no significant difference in causes of SLV among boys and girls. 23% of SLV children had a near vision of N30 or better.
Conclusion There is an urgent need to develop paediatric low vision services in Bangladesh. Large proportions of SLV children have useful residual vision. Preventive strategies need to be enhanced to reduce the burden of SLV in children due to corneal blindness.