Pediatric and adolescent population with visual impairment: study of 385 cases.

Objective: To analyze data on the pediatric population attending the Ophthalmologic Clinic's Low Vision Service at the São Paulo University Medical School.

Methods: Low vision ophthalmologic assessment, from April 1998 to December 2003, of 385 children and adolescents with mean age of 7 years; 51.7% males and 48.3% females. The main data analyzed were age, diagnosis, anatomic site of the ocular injury, visual acuity, and prescription of optical aids.

Results: 45.4% were below 6 years, and 54.6% were between 6 and 16 years. 35.5% experienced moderate visual impairment, 26% had severe visual impairment, 8.6% had profound visual impairment, 10.6% were near blind, and 1.6% were blind. The main causes of visual impairment included congenital glaucoma (30.6%), macular retinochoroiditis due to congenital toxoplasmosis (16.7%), congenital cataract (12.8%), retinal and macular inherited disorders (11.7%), and optic atrophy (9.8%). Among school-age children, 52.9% received a prescription of optical aids. The most widely used optical aids for distance were 2.8 X 26 (34.4%); 4.2 X 12 (30.3%); and 6 X 17 (26.8%) telescopic systems. The most frequently prescribed optical aid for near vision was the 2x magnifying bar (33.3%).

Conclusions: There is a need for prevention of primary (congenital infections), secondary (congenital glaucoma and retinopathy of prematurity), and tertiary (congenital cataract) visual impairment. The prescription of optical aids for school-age children will help them perform better at school and contribute to their social inclusion.