In developed areas, the main causes of pediatric blindness are
ROP, perinatal hypoxic brain injury, optic nerve hypoplasia, inherited
retinal dystrophies, congenital anomalies, cataract, and glaucoma.
These disorders are largely not preventable, but some are treatable.
Geographically, 90% of all pediatric blindness (1,300,000)
occurs in developing countries with 24% in Africa, 20% in
India, and 29% in the rest of Asia (Fig.
582-1). In these areas, the major causes of childhood blindness
are vitamin A deficiency, trachoma, ophthalmia neonatorum, measles
infection, harmful traditional medicines, and trauma. All these
conditions are largely the result, directly or indirectly, of malnutrition,
lack of sanitation, or infection, and most of these factors cause
blindness primarily through corneal scarring. All of these conditions
are preventable or treatable. Blindness in children due to uncorrected
major refractive errors occurs in 0.6% to 2.6% of
children in developing areas. In China, it is thought that nearly
6 millions children are visually impaired simply because they are
in need of glasses that they may never receive.3