Hesperian Health Guides

Causes of Loss of Vision

In this chapter:

Different people have different beliefs about what causes loss of vision. In some parts of the world, people think a child is born without sight as punishment for something the parents have done. In parts of Latin America, villagers believe that a bat’s urine fell in the baby’s eyes, or that a “black witch moth” flew by the baby’s face. These things do not really cause vision loss, and as people get new information, many are leaving these older beliefs behind.

We now know that vision loss in children is most often caused by poor nutrition or infection, and most often can be prevented.

COMMON CAUSES OF LOSS OF VISION IN CHILDREN ARE:

  1. “Dry eyes” (xerophthalmia, or nutritional blindness) is the most common cause of child vision loss. It is especially common in parts of Africa and Asia. It results when a child does not get enough vitamin A, found in many fruits and vegetables and in milk, meats, and eggs. “Dry eyes” develops in children who do not eat enough of these foods. It often starts or gets worse when these children get diarrhea or have measles, whooping cough, or tuberculosis. It is much more common in children who are not breast-fed.

    Dry eyes can be prevented by feeding children foods with vitamin A. Encourage families to grow and eat things like papaya, squash, carrots, and leafy green vegetables in a family garden. Be sure the child eats these foods regularly, beginning at 6 months old.

    Vitamin A capsules or liquid can also prevent dry eyes, but should not take the place of a well-balanced diet. For prevention, give a single dose of vitamin A (retinol) every 4 to 6 months: 50,000 IU (15 mg) for children younger than 6 months, 100,000 IU (30 mg) for children 6 months to 1 year, and 200,000 IU (60 mg) for children older than 1 year. Do not give this large dose more often than 4 to 6 months, because too much vitamin A can poison the child. For treatment of children over 1 year old, use the same dosages as above, but give once on the first day, once the following day, and then once two weeks later. To treat children less than 1 year, use half the dose above. See a health worker.
SIGNS OF XEROPHTHALMIA
First sign may be night blindness. Child has difficulty seeing at night or in the dark. Child may get fussy, fearful, or very hesitant at dusk, may ask for more lights to be turned on, or may revert to crawling after dark. a child tripping and falling on a dark night.
Next the eyes look “dry”. The white part loses its shine, begins to wrinkle, and forms patches of little gray bubbles (Bitot’s spots). illustration of the above: a dry eye.
Later, the dark part (cornea) also gets dry and dull, with little pits. DVC Ch30 Page 244-3.png
Finally, the cornea may get soft, bulge, or burst, causing loss of vision. an eye with a bulging cornea.
FOODS THAT HELP PREVENT IT
  • breast milk
  • dark green, leafy vegetables
  • yellow, red, or orange vegetables
  • whole milk
  • egg yolks
  • liver and kidneys
  • fish
DVC Ch30 Page 244-5.png
3. Gonorrhea or chlamydia in the eyes of newborn babies causes loss of vision if not treated immediately. Visual impairment can be prevented by putting erythromycin 0.5% to 1% ointment, tetracycline 1% ointment, or 1 drop of 2.5% povidone-iodine or silver nitrate in the eyes of all babies at birth. These infections can spread from the mother to the baby at birth, even if she has no signs of infection.
a baby with swollen eyes.
If the baby’s eyes get red, swell, and have a lot of pus in them within the first month, he may have one or both of these infections. If you cannot test to find out which disease is causing the infection, give the baby medicines for both.
DVC Ch30 Page 245-6.png
Put the ointment inside the lower lid.
To treat chlamydia or gonorrhea or both:

If the baby is less than 7 days old

  • inject 125 mg ceftriaxone in the thigh muscle, 1 time only


If the baby is 7 to 28 days old

  • inject 125 mg ceftriaxone in the thigh muscle, 1 time only, and
  • give 50 mg azithromycin by mouth, 1 time a day, for 3 days, OR
  • inject 125 mg ceftriaxone in the thigh muscle, 1 time only, and
  • give 30 mg erythromycin by mouth, 4 times a day, for 14 days
Both parents must be treated for these infections too. See Where There Is No Doctor (236, 237 and 359) or Where There Is No Doctor.


4. River blindness is a very common cause of visual impairment in parts of Africa and Latin America (see Where There Is No Doctor, p. 227). It is spread by a kind of black fly that breeds in rivers and streams. There is no cure, but the medicine Ivermectin can treat and prevent it (see Where There is No Doctor, p. 379).
a very small black fly.
actual size
BLACK FLY
5. Measles, which can injure the surface of the eyes, is a common cause of vision loss, especially in children who are poorly nourished.


6. Brain injury causes loss of vision in many children, usually in combination with cerebral palsy or other disabilities. Brain injury can happen before, during, or after birth. Causes include German measles during pregnancy, delayed breathing or feeding at birth, and meningitis.
7. Eye injuries often cause blindness in children. Pointed tools, fireworks, acid, lye, and homemade bombs to dynamite fish are common causes.
a child carrying scissors while running.
WARNING!
Running with a pointed object is dangerous to the eyes.
8. Vision loss in children is sometimes caused by other conditions such as hydrocephalus, arthritis, leprosy, brain tumors, or certain medicines. Cataracts (clouding of the lens inside the eye) develop more often in children with Down syndrome, and may result from a mother's infections during pregnancy.



This page was updated:04 Apr 2024