Changing Trends in Childhood Blindness in Schools for the Visually Impaired in India: A Structured Literature Review.

Abstract

Purpose: To provide insights for targeted public health interventions and future research. This review synthesizes recent evidence on the causes of childhood blindness in Indian schools for the visually impaired, highlighting emerging trends, regional disparities, and the role of socioeconomic and genetic factors.

Methods: A structured literature review of studies published from 2009 to 2023 was conducted across PubMed, Scopus, and IndMed. The review followed systematic literature search and study selection principles, with methodology aligned to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines where applicable. Eleven cross-sectional and observational studies conducted in blind schools across India were included, all employing World Health Organization/International Classification of Diseases criteria for classifying childhood blindness and severe visual impairment. Data on sample size, demographics, and anatomical/etiological causes of blindness were systematically extracted and compared.

Results: Across the included studies (a total of 3051 children), the proportion of preventable blindness has declined, whereas genetic and congenital causes have risen. Whole globe anomalies (22%-40%) are most common in socioeconomically disadvantaged regions, whereas optic nerve disorders (18%-24%) and retinal dystrophies (14%-19%) predominate in areas with high consanguinity. Corneal scarring has decreased to 8%-26% due to public health programs, but lens pathologies (up to 30%) and untreated refractive errors (9%-17%) remain significant. Retinopathy of prematurity accounts for up to 15% of cases in urban Maharashtra.

Conclusions: Childhood blindness in India is shifting from preventable to genetic and congenital causes, with clear regional patterns influenced by socioeconomic and cultural factors. Strengthening region-specific screening, genetic counseling, and early intervention programs is essential to further reduce the burden and meet VISION 2020 targets.