Vision is an important sensory channel for the early development of attention and is likely to provide a unifying mechanism through which the information perceived through different sensory modalities can be organized and related(1). As a result, detecting visually impaired child and allowing getting correct and on time treatment has importance on child’s growth and development.
It was estimated in 2010 that there are 19 million children (age 0–14) globally with visual impairment (VI) of whom 1.4 million were irreversibly blind(2). The causes of blindness in children vary widely from region to region, reflecting socioeconomic development, cultural practices, coverage of preventive measures (e.g. measles immunization), and access to appropriate eye care and optical services(3, 4). Corneal scarring due to vitamin A deficiency, measles infection, ophthalmia neonatorum, and the effects of harmful traditional eye remedies are the most common causes of VI in developing countries whereas cortical visual impairment (CVI), retinal disorders (including ROP), and disorders of the optic nerve are the main causes in developed countries. Retinopathy of prematurity (ROP) is an important cause of VI in children in middle-income countries and in urban centers of developing countries(4–8).
A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalized during childhood and to die in childhood than a child not living with blindness. Of those who are blind, two-third lives in developing countries and up to 60% of such children die within 1 year of becoming blind(9, 10).
Eye problems in Ethiopia are among the major public health challenges of the country and pose huge economic and social impact for affected individuals and to the society and the nation at large. Childhood blindness in Ethiopia is a considerable public health challenges which accounts for over 6% of the total blindness burden. A sight or life threatening ocular disorders, such as congenital cataract, corneal blindness, mainly as the result of measles and vitamin A deficiency, congenital eye anomalies, retinoblastoma and glaucoma, are common ocular morbidity in Ethiopia(11, 12). Many of the causes are either preventable or treatable with early diagnosis and treatment. Pediatricians play an important role in preventing blindness in children through routine vision screening, routinely performed at well child visits. Nevertheless, early detection and appropriate referral to an ophthalmologist largely depends on the pediatrician’s knowledge, attitude and practice.
Study done to assess practices, attitudes, and perceived barriers toward pediatric vision screening among national pediatrician, the majority of respondents (67%) indicated that they did not begin formal visual acuity testing until age 3 or over. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%)(13). A survey carried out in the state of Illinois USA by John and Sharon on compliance with requirement of vision 0screening by pediatricians showed that 60% of pediatricians tested visual acuity in children aged 5 years and above, while half of this group tested children 2 to 4 years old. The most common reasons for not testing visual acuity were inadequate time (42%), children too young (18%), or that screening would be done at school (18%)(14). Another survey on preschool vision screening in pediatric practice was conducted by Alex R. Kemper et al where a national sample of pediatricians was surveyed to evaluate preschool vision screening practices. The rate of acuity screening for 3-year-old children was low (35%), but increased for 4- (73%) and 5-year-old children (66%). Common barriers to vision screening were that screening is too time-consuming (49%) and children are uncooperative (23%). In the same survey few pediatricians (3%) reported that screening is unnecessary because vision problems would be identified elsewhere (e.g., by the family)(15). A study done by Situma Peter Wanyama on Knowledge, attitude and practice (KAPs) of eye diseases in children among pediatricians in Kenya showed that 69.6% of participants had poor knowledge about eye diseases in children. Of the 69.6% of participants reported doing eye examination in children, only 43.5% do it as a routine part of every child’s examination. The reasons reported by those who don’t do eye examination (30.4%) were lack of enough time to do examination (39.5%) and not knowing how to do eye examination (31.6%)(16). Currently there is inadequate distribution of ophthalmologists and eye care worker in the regions of the country compared to pediatricians. In spite of the prominent role of pediatricians in prevention of childhood blindness, KAPs of these populations about childhood eye disease is not known in Ethiopia. Therefore, this study was conducted to assess the KAPs of Ethiopian pediatrician on childhood ocular illness.