Blindness Secondary to Retinopathy of Prematurity in Sub-Saharan Africa

Ophthalmic Epidemiol. 2022 Apr;29(2):156-163. doi: 10.1080/09286586.2021.1910315. Epub 2021 Apr 4.


Purpose: Retinopathy of Prematurity (ROP) has been suggested to be increasing in Africa. However, it was only previously documented as a cause of blindness in 8 of 48 (16.7%) sub-Saharan African countries. The purpose of this study was to better understand the magnitude and breadth of blindness from ROP in sub-Saharan Africa.

Methods: A questionnaire was sent to 455 ophthalmologists practicing in sub-Saharan Africa; the questionnaire was available in English, French and Portuguese.

Results: Responses were received from 132 of 455 (29%) ophthalmologists to whom the survey was sent. Eighty-three respondents were identified as ROP-involved ophthalmologists and were from 26 of 48 (54%) sub-Saharan African countries. Ophthalmologists in 23 countries reported that they examined at least one child who was blind from ROP during the last 5 years. Sixteen of these countries had not previously reported cases of blindness from ROP in the literature. The perceived occurrence of Type 1 or more severe ROP was reported to be increasing by 31 of 77 (40%) ROP-involved ophthalmologists. ROP-involved pediatric ophthalmologists and retinal surgeons reported the number of infants they examined annually with Type 1 or more severe ROP increased from a median of 1 (range: 0-15) to a median of 4 (range: 0-40) from 2015 to 2019. ROP was estimated to be the cause of blindness for 10% of all blind children examined by ROP-involved pediatric ophthalmologists and retinal surgeons during 2019.

Conclusions: ROP is becoming a more important and widespread cause of childhood blindness in sub-Saharan Africa.

Keywords: Blindness; Childhood Blindness; Children; Retinopathy of Prematurity; sub-Saharan Africa.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Blindness / complications
  • Blindness / etiology
  • Child
  • Humans
  • Infant
  • Infant, Newborn
  • Ophthalmologists*
  • Retinopathy of Prematurity* / complications
  • Retinopathy of Prematurity* / epidemiology
  • Surveys and Questionnaires