Prevalence and causes of visual impairment and blindness among primary schoolchildren in Herat, Afghanistan

Abstract

Childhood visual impairment and blindness (VI&B) significantly affects socioeconomic status and health of an individual in adult age. The prevalence and etiology of VI&B in children varies considerably around the world and across different studies. This study aims to identify the prevalence and causes of VI&B among schoolchildren in Herat, Afghanistan. This school-based cross-sectional study was conducted through a stratified cluster sampling on schoolchildren of both sexes aged between 7 and 15 years, between September and December 2021. Visual acuity of study participants was assessed using standard Snellen chart. Participants with VI&B were further assessed for identification of etiology. Data was analyzed in IBM SPSS Statistics (version 27). A total of 8930 schoolchildren, comprising 4366 (48.9%) boys and 4564 (51.1%) girls with a mean age of 10.1 ± 2.3 years were examined. The prevalence of VI&B in the worst eye was 5.2% (5.0% VI and 0.2% blindness). Of the 4366 boys in this study, 228 (5.2%) had VI, while 17 (0.4%) had blindness, while of the 4564 girls in this study, 211 (4.6%) had VI and 4 (0.1%) had blindness in the worst eye. Refractive error was the principle cause of VI&B in 334 (72.6% of the visually-impaired and 3.6% of the overall sample population). This is the first comprehensive study that reports the prevalence and causes of VI&B in schoolchildren in Afghanistan. The prevalence of VI&B among participants was high in Herat, and the principle cause was uncorrected refractive error.