Improving functional vision in school for the blind students with low vision aids in Pune, India

Context: Many students admitted in schools for blind have some vision. Aim: To study cause of blindness (<6/60) and functional vision improvement in visually impaired students by providing optical low vision aids (LVAs). Setting and design: Prospective series among schools for blind students. Materials and Methods: Ocular evaluation of students enrolled in special schools in Pune district was done using World Health Organization's eye examination protocol. Medical records of the students were examined and ocular examination done by using torchlight, slit lamp examination, ophthalmoscopy and retinoscopy and visual acuity estimation with low vision assessment. The logMAR chart at a distance of 4 m and reduced Snellen's acuity charts and LVAs were used. Results: Four hundred and sixty students were examined; their mean age was 12.6 years (std dev 3.3 years, range 5-20 years) and 246 (53.5%) were males. Four hundred and fifteen (90%) were blind since birth. The students were blind due to microphthalmos and anophthalmos 142 (30.9%), cornea 60 (13%), lens 78 (16.9%), uvea 5%, retina 43 (9.3%) including retinopathy of prematurity (ROP) and optic nerve lesions 6%. LVA for distance was prescribed to 59 students (12.8%) who improved >1 line and for near was prescribed to 72 students (15.7%) of whom 68 attained N6-N12 acuity. Seventy-seven (16.7%) of the total students were benefited with LVA. Conclusion: LVA prescription improved visual acuity of 'blind' students and allowed them to learn and read print. ROP was a new addition in past decade as the cause of blindness.