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Visual impairment in children in middle- and lower‑income countries
  1. Paul Courtright1,2,
  2. Amy K Hutchinson2,
  3. Susan Lewallen1,2
  1. 1Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
  2. 2Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
  1. Correspondence toDr Paul Courtright, Kilimanjaro Centre for Community Ophthalmology, Good Samaritan Foundation, PO Box 2254, Moshi, Tanzania; pcourtright{at}


Reducing visual impairment and blindness in children in resource-poor countries is one of the key components of the major global prevention of blindness initiative, VISION 2020 the Right to Sight. Although visual impairment and blindness among children is much less common than among adults, the potential lifespan of a child means that the lifelong impact of such impairment is very large. Over 10 years ago, it was estimated that, globally, 1.4 million children were blind. Much has changed in the past 10–20 years and there is a need to reassess both the magnitude and causes of global childhood blindness and visual impairment. While the widespread implementation of vitamin A supplementation and measles immunisation programmes have led to a reduction in vitamin A deficiency-related blindness in many poor countries, retinopathy of prematurity is now undergoing a third wave of endemicity, particularly in newly industrialising countries in Latin America and Asia. Childhood cataract is better recognised as an important potentially avoidable problem, as is paediatric glaucoma and refractive error in some populations. Trained paediatric ophthalmologists, although still too few, are growing in number in poor countries. A programmatic approach with a multidisciplinary team is essential to reducing childhood blindness. The elements of such programmes and the need for planning are discussed.

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  • Funding We acknowledge an unrestricted grant from Research to Prevent Blindness to Emory University Department of Ophthalmology and financial support from Dark & Light Blind Care, Light for the World and Seva Canada to the Kilimanjaro Centre for Community Ophthalmology.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.