Background: To determine the causes of blindness among children in rural Malawi.
Methods: This was a cross-sectional study of children in communities of Chikwawa district, Malawi. Children were identified through trained, community-based key informants. All identified children were examined by an ophthalmologist and the cause of blindness determined.
Results: In total, 151 children were identified, of whom 37 (25%) were blind. Among the blind, 21 (60%) were girls and 16 (40%) were boys. Cataract (congenital/developmental) was the leading cause of blindness (35%), followed by corneal conditions (22%).
Interpretation: In an area once noted for vitamin A deficiency in children, cataract is now the leading cause of blindness in children, replacing cornea blindness. Priorities for early cataract detection and intervention need to be considered for restoration of sight in children.