Incidence and causes of blindness among the under 5 age group in Malawi.

The expected incidence of blindness among children under 5 years of age in Malawi is 34 cases per 100 000 children. Direct ocular infections were responsible for the blindness in 32% of the cases (bacterial infections 20% and measles 12%). The instillation of traditional medicine in these cases worsened the ocular condition and induced in all of the cases a "hopeless" situation of total melting of the cornea and protrusion of the uvea. Congenital factors (excluding retinoblastomas) were responsible for 30-8% of the blind cases. Among these, 11 cases of congenital cataracts were successfully treated and will not appear as blind in future. A high incidence (9-3%) of cortical blindness was recorded. Trauma was implicated in 5-3%, while retinoblastoma was found in 8%. It is believed that adequate preventive measures should be able to lower the incidence of blindness among this age group to 5 cases instead of 34 per 100 000 children.