Abstract
A survey of 776 children who have severe visual handicaps and attend special educational institutions in England and Wales has disclosed the heterogeneity of the causes of visual loss in childhood. In 50% of the children, Fraser and Friedmann found the blindness was genetic in origin. Among the remainder, perinatal difficulties, especially those leading to prematurity, were the most frequent source of blindness. It is interesting that retrolental fibroplasia accounted for visual loss in 177 children, while infectious causes were rarely encountered. A formidable amount of work was involved in preparing this analysis. All the children were examined by an ophthalmologist, extensive personal and family histories were obtained, and, where indicated, neurologic, audiometric, and laboratory investigations were undertaken. Nevertheless, the study has definite limitations which the authors clearly recognize. Excluded are children with monocular visual loss as in unilateral retinoblastoma and those with minor visual handicaps as in some instances

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