Only a little endeavour can help visually impaired newborns see
Mahbuba Zannat
Only a little endeavour can help a good number of visually impaired newborn babies see their parents. But unfortunately, lack of awareness, neonatal care and trained community health workers have left them blind forever. Congenital cataract leads to blindness around 10000 children in the country that could be avoided if it is removed within two months of their birth, said a study conducted in 2001-03. According to Child Sight Foundation, 31percent of child blindness is caused by congenital and developmental cataracts. If a mother has rubella, viral diseases, malnutrition, dehydration or vitamin A deficiency during first trimester of her pregnancy, there lies a possibility of giving birth to a child with congenital cataract, experts said. Besides, some hereditary diseases, late pregnancy and intake of contraceptive pills also increase the risk of children's birth with congenital cataract. However, in 80 percent cases the main reason of cataract is unknown, said Dr Kazi Shabbir Anwar of Bangladesh Eye Hospital. He said cataract is seen mainly among the children of poor families and 95 percent of cataract children belong to lower class. If a child, diagnosed with congenital cataract, goes through a surgery within two months of his/her birth and gets postoperative care, there is a total possibility of getting back eyesight, said the experts. They said surgery is the only treatment of cataract among the children, and a delayed treatment increases the risk of amblyopia and irreversible visual impairment or blindness. Among the 52 million children in the country, a total of 40,000 are blind and 74 percent of all blindness is caused by cataract, according to Bangladesh Blindness Survey 2000. As people are quite unaware and still consider child blindness is a result of sin of their parents, they just sit idle blaming the God. The community health workers also ignore the matter due to lack of training in this field, said Associate Professor of Ophthalmology of Bangabandhu Sheikh Mujib Medical University Dr Shafiqul Islam. "The children do not get expected vision as they come to the doctors when it is too late and expected vision decreases as they grow older," he said. According to National Childhood Blindness Study conducted in 2001-03 by D M Muhit, Dr C Gilbert and Prof Allen Foster, cataract is the major cause of child blindness in Bangladesh. "There is lack of information about childhood cataract blindness and its management among the general public and professionals, lack of communication materials to generate awareness in the community and provide information to parents, key community members and health professionals," said Muhit, also a Clinical Research Fellow of International Centre for Eye Health. According to the experts, ten key activities could prevent child blindness. These include providing high dose of vitamin A supplements to mothers within one month of delivering a baby and high dose of vitamin A to children aged six months to five years in every six months, promoting breast feeding and immunization of young children particularly against measles. Besides, early detection of blind children within households and communities, eye examination of blind children and referral of children with cataract, good quality cataract surgery and optical correction as well as regular and long-term follow-up care could restore the eyesight of child with cataract, they added. "The overall budget in health sector and tertiary care facilities should be increased and it needs political commitment of the government. Meanwhile, paediatric ophthalmology should be established as a discipline in the hospitals," said Dr Shafiq.
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