Shaping eye care services for children

Childhood blindness is still a significant problem for a developing country like Bangladesh. The eye care services for children are still inadequate, disproportionately distributed. There is a dire need to integrate childhood blindness into health system workframe.
Many children in Bangladesh are afflicted with blindness due to bilateral cataract, complications of cataract surgery, retinopathy of prematurity (ROP), refractive error, vitamin A deficiency and measles.
Increased capacity for finding blind children, safe surgery and care are extremely inadequate in many areas. Sometimes, the facilities and ophthalmological team are in place but underutilised due to many reasons.
Many causes of childhood blindness are either preventable or treatable. Cataract is completely treatable with cost effective and safe surgery if we can intervene timely. But it is sometimes logistically complex to identify the children who will benefit the most from surgery and reliably transport them to a treatment center.
Neonatal screening for cataract can be done by paediatricians and obstetricians to detect at the earliest phase. Incorporating childhood blindness in maternal and child health is now essential to combat childhood blindness from avoidable causes like cataract, vitamin A deficiency, ROP.
Certain studies suggest that refractive errors are more prevalent in children in Asian countries than in other regions, and myopia (short sightedness) is the commonest refractive error in older children. High proportion of children with refractive error are found in school screening programmes. Again, when these children are provided spectacles, many of them do not wear them. Treating refractive errors need little logistic support and one of the cheapest tools — just a spectacle. It should be include in school health programme and training for school teacher to detect refractive error is a important way to reduce the burden.
The elimination of avoidable childhood blindness is a priority than those for adults. Shaping eye care services for children will shape their future as well as the nation.

The writer is Honorary Executive Director, Child Sight Foundation (CSF).
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