OBJECTIVE: To identify the avoidable causes of childhood blindness and visual impairment in a school of the blind in the Philippines.

METHODS: The medical records of students enrolled at the Resources for the Blind early intervention and preschool program from 1999 to 2012 were reviewed. Demographic characteristics and causes of visual disability were abstracted and tabulated.

RESULTS: A total of 90 records were included in the study. Eighty six (76.7%) had visual acuity classified as blind (<20/400) or severe visual impairment (<20/200 - 20/400, 18.9%). Majority (69.8%) were below 6 years of age and most (44.2%) were below 1 year. Retinopathy of prematurity was the most common cause (47.7%), followed by retinablastoma (11.6%). Perinatal factors accounted for most of the etiologic causes (58.1%) of visual loss.

CONCLUSION: More than half of the causes of severe visual impairment and blindness were potentially avoidable, with retinopathy of prematurity as the leading etiology.

Human ; Male ; Female ; Child Preschool ; Infant ; Early Intervention (education) ; Retinopathy Of Prematurity ; Visually Impaired Persons ; Blindness ; Vision, Low ; Visual Acuity ; Students ; Medical Records

Objective: To assess the level of awareness and practice patterns of pediatricians in various government and private hospitals in the Philippines regarding retinopathy of prematurity (ROP). Methods: This is a prospective, multicenter, cross-sectional study of the practice profile and awareness of pediatricians of the Philippine Pediatric Society (PPS) ROP screening recommendations. Six hundred selfadministered questionnaires were distributed to pediatricians from 40 randomly selected government and private hospitals in the Philippines between July and September 2013. Frequency distribution for each data was noted. Association of referral rates, distribution of barriers, and availability of protocol among the subgroups were analyzed using chi square. Results: A total of 409 eligible surveys were analyzed with a response rate of 68.1%. 92% of the respondents referred their at-risk preterm babies to ophthalmologists for ROP screening. Of those who referred, 57% considered a cut-off value of less than 32 weeks age of gestation, and 45% considered a cut-off value of less than 1500g birth weight. 47% referred at 4-6 weeks post-natal age, and 48% had a protocol for ROP screening. Only 19% were aware of the PPS ROP screening recommendations. The major barrier encountered was the inability of the families to follow up after discharge (41%). Higher referral rates were noted from private institutions (p=0.013) and tertiary hospitals (p=0.019), including those with a protocol on ROP screening (p=0.002). Conclusion Majority of the respondents referred their at-risk preterm babies for ROP screening. A significant proportion was unaware of the PPS ROP screening guidelines. More than half do not have an established protocol. There were variations in practice patterns of the pediatricians in referring babies at-risk for ROP. Based on these, there is still a need to increase awareness among pediatricians. A uniform, national, published guideline on ROP screening, establishment of referral systems, and training of qualified ophthalmologists are recommended.
Retinopathy of Prematurity ; Mass Screening ; Surveys and Questionnaires