Factors affecting childhood blindness and visual impairment in a Tertiary hospital in Northern Luzon, the Philippines

Abstract

Background: Childhood blindness and visual impairment (VI) are among the priorities of VISION 2020 to address the increasing global burden of VI. However, updated data on the prevalence, causes and risk factors of VI as well as dimensions affecting eye care utilization are limited in the Philippines. Methodology: Retrospective cross-sectional study and key-informant interview (KII) were done to determine prevalence, causes and risk factors of VI and dimensions affecting eye care utilization at the Baguio General Hospital and Medical Center (BGHMC) in Northern Luzon, The Philippines. Results: The prevalence of unilateral (14%) and bilateral childhood blindness (3.7%) at the BGHMC in 2018 were high even when compared to Asian and African countries. The top causes of bilateral childhood blindness and VI, which are cataract and refractive errors, respectively, reflect current global data. The top cause of unilateral childhood blindness is ocular trauma (32%). Among the risk factors, only age of onset of eye disease was significantly associated with VI severity (p<0.001). Among dimensions affecting eye care utilization, affordability (mild p=0.019, moderate p=0.004 and blind p=0.047) and accessibility (mild p=0.03) were significantly associated with VI. Availability of eye doctors, subspecialists, allied medical staff, medicines and equipment were significant dimension in the utilization of eye care in BGHMC together with adequacy, acceptability and unawareness. Conclusion and Recommendation: Prevalence of childhood blindness and VI were high in BGHMC in 2018 and their common causes reflect national and global data. Age of onset was associated with severity of VI while all dimensions and unawareness affected eye care utilization in BGHMC. Early diagnosis of VI and intervention are vital. Programs to increase awareness on early eye consult and prevention shall be implemented. Financial assistance programs for non-medical expenses shall be proposed. Priority shall be given to physician from Mountain Province (MP) applying for ophthalmology residency and a telemedicine system in MP shall be set-up. Doing so can improve over-all affordability, availability and accessibility for patients from Northern Luzon and in turn, adequacy and acceptability of BGHMC services.