The currently most common causes of childhood blindness in Kinshasa (d. R. Congo)

BACKGROUND: 90 % of blind children live in the developing world. Only limited data are available on the prevalence and causes of blindness. PURPOSE AND METHODS: In order to identify the commonest causes of childhood blindness in the Democratic Republic of Congo, a study was conducted in 81 children (< 16 years old) attending schools for the blind in the capital city Kinshasa. RESULTS: According to WHO criteria, 53 (65.4 %) of the 81 children were classifiable as blind (visual acuity < 3/60), 11 (13.6 %) as visually impaired (visual acuity < 1/18) and 17 (21.0 %) as not impaired. On anatomic and functional classifications the commonest causes of blindness were: corneal opacity/scarring (20.0 %), phthisis bulbi (15.2 %), refractive anomalies (11.0 %), optic nerve atrophy (9.0 %), retinal disorders (7.6 %), glaucoma/buphthalmos (7.6 %), cataract (6.9 %), microphthalmos (3.5 %), vitreous opacity (2.8 %) and aphakia (2.1 %). The aetiology of blindness could not be determined in most of the children. Trauma, measles in conjunction with vitamin A deficiency, and the use of traditional eye medications are presumed to be the commonest causes of corneal opacity/scarring and of resultant phthisis bulbi. CONCLUSION: Childhood blindness would be potentially avoidable in 60 % of cases, either by surgery (for cataract [~6.9 %]) or by preventive measures (corneal opacity/scarring, phthisis bulbi, glaucoma, refractive anomalies [~53.0 %]).