UCL Great Ormond Street Institute of Child Health


Great Ormond Street Institute of Child Health


Visual disability is a sentinel child health event

15 February 2021

Researchers at the UCL Institute of Child Health (UCL GOS ICH), working through a national collaborative study group, have undertaken the first ever national population based epidemiological study of full spectrum of all-cause childhood visual impairment (VI).

Visual disability is a sentinel child health event

The British Childhood Visual Impairment and Blindness Study 2, or BCVIS2, provides detailed epidemiological data, necessary for planning and evaluating population health and clinical strategies and services.

Key findings

In the UK, the overall cumulative incidence of childhood visual disability by age 18 is 10 per 10,000 children. That is almost three children newly affected each day. The most common causes are cerebral visual impairment, retinal disorders and optic nerve disorders, but many children have more than one eye condition. Half of all children affected from birth and almost three-quarters of all affected children have significant additional impairments or disorders. It is clear that there is a constellation of complex needs, underlined by the high proportion of children under 1 year who die within the year after diagnosis (mortality rate of 17·4 per 1000 infants, compared with an overall national infant mortality rate of 3·8 per 1000 infants).

Incidence of childhood visual disability is markedly higher among those from socioeconomically disadvantaged backgrounds; from any ethnic minority group; among those who are born preterm or with low birthweight.

Their findings demonstrate that childhood visual disability epitomises all the challenges in child health articulated in recent influential national and international child health initiatives and policies. However, rather than being an exemplar, it is typically overlooked when developing models for ‘investing in children’s health for lifelong intergenerational and economic benefits’ (WHO/Lancet/UNICEF Global Child Health Commission 2020).

Given the striking findings of socio-demographic inequalities in risk of childhood visual disability and the complex multi-morbidity underlying childhood blindness, inclusion of childhood visual disability in child health policies will become even more important in the aftermath of the COVID-19 pandemic.

The authors propose the urgent inclusion of childhood visual disability as a sentinel health event and ‘target condition’ in national and international child health research as well as strategies and policies.

Professor Jugnoo Rahi, lead author of the study says “the BCVIS2 study shows why childhood visual disability must be part of work tackling child health inequalities, a need which is now even greater with the impact of the COVID-19 pandemic on the most ‘at risk’ families and on NHS children’s eye services”.

This study was undertaken through the Royal College of British Ophthalmic Surveillance Unit (BOSU), the Royal College of Paediatrics and Child Health British Paediatric Surveillance Unit (BPSU) and funded by Fight for Sight and the Ulverscroft Foundation, and supported by the NIHR. The study was made possible by the work of the British Childhood Visual Impairment and Blindness Study Group.


Credit: Dr Ameenat Lola Solebo