Objectives: To investigate the importance of vitamin A deficiency as a cause of childhood blindness and severe visual impairment (SVI) in India.
Design and setting: Cross sectional survey of children with visual acuity less than 6/60 in the better eye (SVI/blindness), attending 22 schools for the blind in nine states of India.
Main outcome measure: Proportion of children with blindness or SVI from corneal scarring attributable to vitamin A deficiency.
Results: 245 of 1318 (18.6%) of children had SVI/blindness attributable to vitamin A deficiency. The proportion of SVI/blindness due to vitamin A deficiency ranged from 7.5% (7/93) in Kerala to 26.7% (27/101) in Madhya Pradesh. In Tamil Nadu, 7.5% (9/120) of children in the capital city blind school had SVI/blindness due to vitamin A deficiency, compared with 30.4% (51/168) in a blind school in a rural area of the same state.
Conclusion: Overall, vitamin A deficiency is the single most important cause of childhood blindness and SVI in India. There are marked variations by state and also between urban and rural locations.