Intended for healthcare professionals


Uncorrected refractive error and education

BMJ 2014; 349 doi: (Published 06 October 2014) Cite this as: BMJ 2014;349:g5991
  1. Jugnoo S Rahi, professor of ophthalmic epidemiology123,
  2. Ameenat L Solebo, academic clinical lecturer123,
  3. Phillippa M Cumberland, senior research associate in biostatistics123
  1. 1Lifecourse Epidemiology and Biostatistics Section, Institute of Child Health, UCL, London WC1N 1EH, UK
  2. 2Ulverscroft Vision Research Group, UCL, London, UK
  3. 3NIHR Moorfields Biomedical Research Centre and NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
  1. Correspondence to: J S Rahi j.rahi{at}

A global problem requiring more research measuring outcomes that matter to children and their parents

Understanding and tackling visual disability in childhood is a major concern globally, reflecting both the paucity of available interventions and the high impact of such disability on health and wealth.1 2 Despite the limitations of the approach to identifying visual impairment, it is conventionally defined using thresholds of distance vision in the better seeing eye when measured with spectacles or contact lenses if required, so as to focus on the primary underlying disorder. The World Health Organization classifies people as visually impaired (acuity worse than 6/18 using a Snellen chart), severely visually impaired (worse than 6/60), or blind (worse than 3/60).3 Using these definitions, about two per 1000 children in high income countries and around four per 1000 children in low income countries have some degree of visual impairment.4 Many have disorders of the eye or brain that are present from birth or early childhood and all will experience substantial effects on their development together with educational challenges and curtailed occupational and social prospects.2 4 Although health economic studies are scarce, the economic burden on both individuals and society is thought to …

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