Demographic and urban-rural differences in pediatric low-vision services in China: a hospital-based study

Purpose To identify the profile of a pediatric low-vision population and investigate the differences between low-vision services in urban and rural areas. Methods A retrospective study was conducted of the records of 286 consecutive children presenting at the Low Vision Clinic of the Eye and ENT Hospital of Fudan University from January 2009 to December 2018. The data retrieved included age, sex, education, family history, rural vs. urban residence, cause of visual impairment, and low-vision aids dispensed. Results Of the 286 children (65.0% boys and 35.0% girls), over half (178, 62.2%) were from urban areas. The age range of the patients was 3-15 years (mean 9.54 +/- 4.11). The four major causes of visual impairment were congenital cataract (70, 24.5%), optic atrophy (37, 12.9%), congenital glaucoma (34, 11.9%), and macular dystrophy (31, 10.8%). Low-vision aids were prescribed for 203 children (71.0%), with binocular telescopes (69, 25.0%) and stand magnifiers (66, 23.9%) being the most common. The urban children enjoyed higher rates of low-vision services than the rural children, with more low-vision aids (192, 94.6%) prescribed for the former. Conclusions Congenital and hereditary diseases constituted the major causes of low vision in the study population. In contrast to their urban counterparts, the rural children experienced inadequate low-vision rehabilitation. Our findings suggest that policymakers need to better address gender inequalities and urban-rural disparities in low-vision services and that the coverage of low-vision services, especially in rural areas, should be enhanced in China.