OBJECTIVE. To identify the causes of blindness in children attending a school for the blind in Hong Kong.

DESIGN. Cross-sectional observational study.

SETTING. School for blind children in Hong Kong.

PARTICIPANTS. Eighty-two blind students at the Ebenezer School and Home for the Visually Impaired were examined between December 1998 and August 1999.

MAIN OUTCOME MEASURES. Demographic data were obtained from students and a questionnaire assessment made of their medical and ocular history. Visual acuity was assessed and visual loss classified according to the World Health Organization classification of visual impairment. Complete ophthalmic assessments were performed in all students including slit-lamp examination and dilated binocular indirect ophthalmoscopy.

RESULTS. The mean age of the students was 12.2 years. Ten (12.2%) had a family history of eye disease. Major past medical illnesses were reported in 50% with prematurity and diseases of the central nervous system found in 26.8% and 11.0% of students, respectively. The most common anatomical site for visual impairment was the retina (47.6%), followed by diseases of the optic nerve (14.6%), and diseases of the anterior segment and the lens (14.6%).

CONCLUSIONS. The pattern of childhood blindness in Hong Kong is similar to that seen in other developed countries. Preventable causes of childhood blindness, such as prematurity and birth asphyxia, were responsible for a large proportion of cases. Early diagnosis and treatment of such conditions may reduce the incidence of childhood blindness in Hong Kong.

Key words: Blindness; Cataract; Child; Optic nerve diseases; Retinopathy of prematurity

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