A systematic review and meta-analysis of prevalence and causes of childhood visual impairment in the Eastern Mediterranean Region

Background: Childhood visual impairment has a significant effect on social life, educational performance, and professional choices, and can lead to poverty. Aims: To summarize the available data on the prevalence and causes of visual impairment in children aged 5–17 years in the Eastern Mediterranean Region (EMR). Methods: The study was conducted in 2021 using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method. We searched Google Scholar, PubMed, Web of Science, Scopus, Index Medicus for the Eastern Mediterranean Region, and Medline for studies published between January 2000 and April 2020, to assess the prevalence and causes of paediatric visual impairment in the EMR. The articles included were epidemiological studies of prevalence and causes of childhood visual impairment and were published in peer-reviewed journals. Results: Of 12 705 articles screened, 23 from 9 countries met the inclusion criteria. The pooled prevalence of uncorrected, presenting, and best-corrected childhood visual impairment was 11.57%, 8.34%, and 1.21%, respectively. The most common causes of childhood visual impairment were refractive error (51.89%), amblyopia (11.15%), retinal disorders (3.90%), corneal opacity (3.0%), and cataract (1.88%). There was highly significant heterogeneity between the studies (P < 0.0001). Conclusion: The prevalence of visual impairment among children in the EMR was high, and the leading causes were uncorrected refractive error and amblyopia, which were avoidable. Therefore, access to eye care services may lead to early diagnosis and treatment of preventable causes of childhood visual impairment.