New trends in childhood vision impairment in a developed country.

Background: The Education Vision Assessment Clinic (EVAC) is a unique statewide service that reviews school children 4-18 years of age with low vision in Victoria, Australia, to determine their eligibility for educational support. The purpose of this study was to identify causes of vision impairment in students in Victoria using data from the EVAC.

Methods: Data collected from students who attended the EVAC at the Royal Victorian Eye and Ear Hospital, Melbourne, between the years 2003 and 2012 inclusive, were analyzed retrospectively. Participants were identified through the EVAC schedule of medical appointments. Medical records were reviewed for clinical and demographic information, including diagnosis of vision impairment and best-corrected visual acuity and/or visual fields.

Results: Of 543 students, 355 (65%) were eligible for educational assistance. Of those, 249 (70%) had best-corrected visual acuity between 20/60 and 20/200 and/or a field of vision of <20° to 10°, and 106 (30%) had a best-corrected visual acuity worse than 20/200 and/or a field of vision of <10°. Common causes of vision impairment were retinal dystrophies (24%), optic nerve pathology (14%), albinism (14%), and infantile motor nystagmus (10%).

Conclusions: Treatable and potentially preventable causes of vision impairment, such as retinopathy of prematurity and cataract, caused <10% of vision impairment cases in Victorian school children. Analysis of demographic trends is essential to supporting efforts to ensure that students with low vision, from any socioeconomic background, receive specialist teaching services.