Globally, 1.4 million children are blind and don’t have the opportunities available to most children in Hong Kong. This is inexcusable, when almost half the conditions that cause childhood blindness can be prevented or treated.
Fortunately, vision loss from eye disease in children isn’t very common and most begin life with excellent sight. However, some hereditary, juvenile or inherited diseases can cause visual loss or even blindness early in life. This is a significant problem in developing countries because many families don’t have access to health care and eye health services.
Sadly, the most marginalised people such as the victims of large-scale disasters and displaced people living in makeshift homes suffer the risk of children dying within a few years of going blind, either from the condition that caused them to go blind or because they live in poverty. But even for the children who do survive with vision loss, life can often be hard if their families aren’t able to look after them properly and access the services they need.
What are the childhood eye diseases we work with?
The common eye diseases that affect children or cause vision loss often depend on the development status of a country. In developing countries, blindness is caused by a number of reasons: corneal scarring from measles, Vitamin A deficiency, retinopathy of prematurity, trachoma and cataract. The Foundation concentrates on working with our partners to help prevent or treat vision loss in children that suffer from conditions such as:
Cataract: a condition that is important to detect and treat early in childhood to minimise the impact of vision loss on the child’s development. It’s a rare condition, but can be treated successfully by a paediatric ophthalmologist – although the surgery is more complex than for adult cataract. Post-operative visual rehabilitation is an important component of care.
Trachoma: an infection often acquired in childhood, particularly in dusty poverty stricken areas, where water is scarce and sanitation is poor. The WHO approved SAFE strategy is a comprehensive approach to deal with trachoma through eyelid Surgery, Antibiotic distribution together with targeted activities to improve Facial cleanliness and Environmental interventions to improve water supply and sanitation.
Retinopathy of prematurity (ROP): when a baby is born very prematurely, the retina and its blood vessels are not fully developed. These infants fight for their lives in a neonatal ICU, usually with supplementary oxygen. This helps the child to survive, but can seriously damage the developing blood vessels of the retina. Scarring in the retina, usually in both eyes, follows this damage and can cause blindness.
The Fred Hollows Foundation also works to improve refractive error in some area. Learn more on the topic and what we are doing.
How can we prevent these diseases?
Early intervention for diseases like cataract and trachoma is critical to correct vision loss in children. But even if the structure and function of the eye are restored to near normal through appropriate glasses or surgery, the capacity to see can’t always be restored. This is because a child whose brain development has almost been completed (usually by 10 years of age) with poor vision, the lack of normal visual stimulation limits the brain’s ability to ever process visual stimuli. To combat the devastating effects of vision loss in children, early detection and appropriate specialist care is essential.
In terms of retinopathy of prematurity, the significantly better basic care in local and regional hospitals in developing countries means preterm babies have a good chance of survival. However, many neonatal units are not equipped to screen babies for ROP, so even if they survive, they often have vision loss. We support work in this area through training, and empowering nurses to provide the appropriate oxygen therapy in the incubators and ventilators while the baby is in the ICU. We’re also working to increase awareness within hospitals for the need to have an eye specialist examine and treat babies even while they are in the ICU.