Effectiveness of vision stimulation therapy in congenitally blind children.

Dear editor,

We read with interest the Guest editorial ″Retinopathy of prematurity screening in the Indian population, it′s time to set our own guidelines″ by Dr. Vasumathi Vedantham.1

In this regard we would like to bring to the attention of readers how early intervention with vision stimulation therapy can help congenitally blind children with retinopathy of prematurity.

In one of the studies2 which involved vision stimulation in the rehabilitation program, 25% of the sample size showed progression from perception of light to perception of objects.

In a retrospective study done at our center, 104 case records of children aged between three and 24 months, who were referred to the vision rehabilitation center with congenital causes of blindness during the period January 1 2006 to December 31 2006, were analyzed. Vision stimulation for infants and small children can be done by optical and non-optical aids.3 The children with no fixation to light were subjected to vision stimulation therapy using diode lights of primary colors with red, green and blue lights that flicker and move from one light to another. The children were exposed to these lights for 15 min every day. The parents were educated on how to use these lights and were asked to come for a follow- up periodically up to 24 months. The success of the therapy was defined as child developing fixation to light or being able to reach for the objects. The children were followed up in the sixth, 12th, 18th and 24th months. The diagnostic profile of the children who had vision stimulation therapy is as follows.

Thirty-two children had cortical blindness, 13 had delayed visual maturity, and 10 had Leber′s congenital amarosis, seven were diagnosed to have retinopathy of prematurity, seven with disc pallor, six were found to have retinitis pigmentosa, five had persistent hypertrophic primary vitreous and three had albinism. Others which included aphakia, nystagmus, microphthalmos, chorioretinitis and bilateral retinal detachment accounted for 21. Out of the104 children, 40 (38.46%) children had a mean follow-up of 12 months. Of those who came for follow-up, 29(72.5%) children showed improvement with vision stimulation therapy and eleven (27.5%) showed no improvement from the initial presentation.

In this study we did not find any correlation between a particular ocular disorder and the time of presentation to have a favorable or a less favorable outcome.

An ophthalmologist can play an optimistic role in the management of these congenitally blind children, as vision stimulation is proven to help most children with vision impairment.4