Risk Factors for Childhood Blindness in Punjab, Pakistan

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European Journal of Scientific Research


In this matched pair case-control study, we examined the risk factors associated with visual impairment among children aged 10 years or younger. Data were collected in 2010 from two hospitals in Lahore Pakistan, Punjab Institute of Preventive Ophthalmology (PIPO) - Mayo Hospital, and The Children's Hospital. The study consisted of 260 participants, 130 each in case and control groups. Using a structured questionnaire, data were collected from the parents and the guardians who accompanied the children to the hospital. Monocular and binocular visual acuity (VA) was measured using a typical Snellen chart. Expected risk variables were categorized into six groups: Socio economic background, family history, clinical observations, prenatal conditions, postnatal conditions, and environmental conditions. The results indicate that children with rural residence, from cousin marriages, and of a father with a habit of smoking cigarettes had elevated risk of being visually impaired. The risk of visual impairment was also higher for children with certain congenital anomalies, and those with certain conditions including retinal dystrophies, cataract, glaucoma, and cerebral palsy (CP). Further, premature birth and lack of vitamin A in the mother’s diet were significant risk factors of visual impairment. Some other factors were not statistically significant predictors of blindness among children in our study. These factors included father’s occupation, grandparents’ history of blindness, and retinopathy of prematurity (RoP). Our study findings imply that policy makers and public health practitioners should consider raising awareness about proper nutrition, promoting prenatal care, preventing premature births, and eliminating indoor smoking to eventually reduce the risk of childhood blindness in Pakistan. Public health agencies should consider providing counseling about cousin marriages, and concomitant risk factors such as congenital anomalies, and risk of blindness.