Children's Visual Health And Attainment Of Child-Related MDGs

According to the 2007 World Sight Day report, 1.4million children are estimated to be blind in the world and millions more are either blind or visually impaired.

The report further states that a child goes blind every minute and the children most at risk are those below five years and about 60 per cent die within one year of becoming blind. Causes of avoidable blindness in children are many but refractive error remains the biggest cause of visual impairment in schoolage children.

Children’s visual health is not only critical for the child’s educational and psycho-motor skills development but also closely linked to the attainment of child related Millennium Development Goals (MDGs). Visual impairment and blindness in children have a lasting negative impact on every aspect of the child’s life. The burden of vision loss on the family is equally huge.

Greater majority of the incidence of visual impairment and blindness in children occur in resource-constraint countries such as Ghana where it represents an even more critical economic problem due to competing interests.

The Millennium Development Goals (MDGs) are a set of goals and targets aimed at reducing human suffering and improving quality of life. Reducing child mortality is MDG 4 and target five of this MDG is ’’ to reduce by two-thirds the mortality rate among children less than five years of age’’.

It has been observed in developing countries that the main precursors of visual impairment and blindness in children are also major causes of childhood mortality.

Administering of vitamin A supplementation, for instance, has been shown to reduce childhood mortality by over 20 per cent in vitamin A-deficient populations. Detection of vitamin A-deficient children is an intervening opportunity of school vision screening programmes for children.

If 60 per cent of children die within one year of becoming blind, it stands to reason that a mandatory child eye screening programmes is clearly a veritable ‘policy reinforcer’ in the attainment of this target five of the MDG. It would help to find children most at risk of visual impairment or blindness and thereby offer the required intervention timeously.

Thus addressing children’s visual health will most likely translate into an increase in under-five population. MDG 4 is one of the five targets Ghana is said to have either attained or on course to attain. How we stay on course is a question we need to address with as equal importance.

The 2007 WSD report further states that about 90 per cent of children with visual impairment do not get educated. Therefore greater majority of these children will not be able to realise their full potential in life.

For example, a study in Malawi on eye morbidity found the following among children: Of the four million children of schoolage, there were 6,000 children who were blind, 13,000 children with low vision and another 30,000 children with refractive errors. Sadly enough, only about 10 per cent of these visually impaired children are at school.

Achieving Universal Primary Education by 2015 is MDG two. Target three of this MDG is to ensure that all boys and girls complete a full course of primary schooling by 2015.

Ghana is, again, said to be on target to achieving MDG two. This means that a lot more children will be enrolled in school by 2015. However, for a given population, there is a three per cent estimated visual impairment prevalence rate among children mainly due to refractive errors.

Without any policy backed mandatory eye health intervention for school going children, three per cent of our childhood population is potentially going to either not complete a full course or complete it later than the set target. The more successful we are at attaining child health and child education related MDGs, the greater the quantum of children at risk of visual impairment if no proactive step is taken to address children’s visual health needs.

Many parents attending my practice with their children have asked me how frequent and at what age children should be examined for eye problems. The American Optometric Association recommends that all children receive professional eye health examination at every critical stage of their visual developments.

This visual development is greatly influenced by the child’s learning development as visual task becomes more difficult and demanding with every progress in classroom work. So then we can recommend that a child receives first eye examination at six months. Age three is another milestone where professional eye and vision examination is appropriate for the child.

The eyeball stops growing at about age six and half years , which also coincides with the start of basic school. Hence another critical stage where a comprehensive eye/vision assessment is indicated. Thereafter, yearly eye/vision examination is recommended until at least 18 years.

Ghana has already signed up to vision2020-right to sight. Committing resources to the implementation of mandatory child visual health Programmes in schools is the same as directly supporting vision2020. All the restrategising by ministries and departments aimed at achieving child related MDGS will not achieve much if child visual health is not addressed.

Children’s visual health is also a right issue. The welfare principle of The Children’s Act states that the best interest of the child shall be paramount in any matter concerning a child.

Children’s visual health is in the best interest of children. Children’s visual health needs are very critical for the realisation of children’s full potential both inside and outside the classroom. Hence children’s visual health is an essential plank in the attainment of some child related MDGs.

The writer is an Optometrist.
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