{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:23:45Z","timestamp":1790198625346,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>This study aimed to determine the prevalence and causes of low vision and blindness among students in special education schools (serving children with disabilities, including intellectual disabilities) and blind schools (for students with blindness or visual impairment) in Shanxi Province, China. A cross-sectional investigation was conducted across nine special education schools and two blind schools in Shanxi Province from March to September 2018. Participants underwent comprehensive ophthalmic examinations, including visual acuity (VA) assessment using Lea Symbols or Cardiff Cards, refraction testing, and anterior\/posterior segment evaluations. Non-cycloplegic refraction was performed initially, with cycloplegic refraction administered when VA was subnormal for age. Visual impairment was classified according to World Health Organization (WHO) criteria. Demographic and general health data were also collected. The study included 441 children from special schools (mean age: 12.3 \u00b1 3.5 years) and 56 children from blind schools or blind classes within special schools (mean age: 13.0 \u00b1 3.2 years). Among special school students, 44 (10.0%) had visual impairment (mild: 9.1%; moderate: 0.9%), primarily attributable to uncorrected refractive errors (90.7%); 10 cases (2.3%) remained undetermined due to poor compliance. In blind schools\/classes, 30 children (53.6%) were classified as blind, 22 (39.3%) as visually impaired (moderate: 28.6%; severe: 8.9%), and 4 (7.1%) as undetermined. Notably, 44.6% of visual impairment cases were avoidable, with nystagmus (25.0%), amblyopia (19.6%), and cataract (8.9%) identified as leading causes. These findings underscore the significant burden of uncorrected refractive errors in special schools and the high prevalence of nystagmus in blind schools. The substantial proportion of avoidable visual impairment highlights the critical need for early screening and targeted interventions to improve visual function for children with disabilities.<\/jats:p>","DOI":"10.1038\/s41598-025-07364-0","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T07:46:25Z","timestamp":1752219985000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The prevalence and causes of visual impairment in special schools and blind schools in Shanxi Province, China: a cross-sectional study"],"prefix":"10.1038","volume":"15","author":[{"given":"Fengchao","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianfeng","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congcong","family":"Linghu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxia","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianlin","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"7364_CR1","doi-asserted-by":"publisher","first-page":"e130","DOI":"10.1016\/S2214-109X(20)30425-3","volume":"9","author":"RRA Bourne","year":"2021","unstructured":"Bourne, R. R. A. et al. Trends in prevalence of blindness and distance and near vision impairment over 30 years: An analysis for the Global Burden of Disease Study. Lancet Glob. Health 9, e130\u2013e143 (2021).","journal-title":"Lancet Glob. Health"},{"key":"7364_CR2","doi-asserted-by":"publisher","first-page":"e682","DOI":"10.1016\/S2468-2667(20)30254-1","volume":"5","author":"T Xu","year":"2020","unstructured":"Xu, T. et al. Prevalence and causes of vision loss in China from 1990 to 2019: Findings from the Global Burden of Disease Study 2019. Lancet Public Health 5, e682\u2013e691 (2020).","journal-title":"Lancet Public Health"},{"key":"7364_CR3","unstructured":"World Health Organization. Blindness and Vision Impairment. https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/blindness-and-visual-impairment."},{"key":"7364_CR4","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.4103\/ijo.IJO_2804_21","volume":"70","author":"S Mannava","year":"2022","unstructured":"Mannava, S., Borah, R. R. & Shamanna, B. R. Current estimates of the economic burden of blindness and visual impairment in India: A cost of illness study. Indian J. Ophthalmol. 70, 2141\u20132145 (2022).","journal-title":"Indian J. Ophthalmol."},{"key":"7364_CR5","volume-title":"Making Eye Health a Population Health Imperative: Vision for Tomorrow","year":"2016","unstructured":"Welp, A. et al. (eds) Making Eye Health a Population Health Imperative: Vision for Tomorrow (The National Academies Press, 2016)."},{"issue":"100","key":"7364_CR6","first-page":"3831","volume":"2020","author":"M Yusufu","year":"2020","unstructured":"Yusufu, M. & Vision, N. W. the progress of blindness prevention and eye health in China. Natl. Med. J. China 2020(100), 3831\u20133834 (2020).","journal-title":"Natl. Med. J. China"},{"key":"7364_CR7","unstructured":"National Bureau of Statistics of China. Final Statistical Monitoring Report on the Implementation of China National Program for Child Development (2011\u20132020) (2021)."},{"key":"7364_CR8","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1136\/adc.2009.159053","volume":"95","author":"M Das","year":"2010","unstructured":"Das, M., Spowart, K., Crossley, S. & Dutton, G. N. Evidence that children with special needs all require visual assessment. Arch. Dis. Child. 95, 888\u2013892 (2010).","journal-title":"Arch. Dis. Child."},{"key":"7364_CR9","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.4103\/ijo.IJO_1851_21","volume":"70","author":"S Bhaskaran","year":"2022","unstructured":"Bhaskaran, S., Flora, J., Perumalsamy, V. & Durairaj, D. C. Visual impairment in children with multiple disabilities in schools for children with special needs in South India. Indian J. Ophthalmol. 70, 1307\u20131311 (2022).","journal-title":"Indian J. Ophthalmol."},{"key":"7364_CR10","first-page":"9","volume":"29","author":"H Kuper","year":"2016","unstructured":"Kuper, H. How to ensure equitable access to eye health for children with disabilities. Community Eye Health 29, 9 (2016).","journal-title":"Community Eye Health"},{"key":"7364_CR11","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.18240\/ijo.2022.07.17","volume":"15","author":"Y Li","year":"2022","unstructured":"Li, Y. et al. Visual acuity of urban and rural adults in a coastal province of southern China: The Fujian Eye Study. Int. J. Ophthalmol. 15, 1157\u20131164 (2022).","journal-title":"Int. J. 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Acuity measurements in adult subjects using a preferential looking test. Ophthalmic Physiol. Opt. 27, 54\u201359 (2007).","journal-title":"Ophthalmic Physiol. 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Ethics approval was obtained from the Ethics Committee of Shanxi Eye hospital (identifier SXYYLL-KSSC0017). Verbal consent was obtained from the parents or legal guardians of all participating children prior to their inclusion. Additionally, permission for conducting the screening was granted by the school principals of the participating institutions.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"25028"}}