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Albinism and Blindness or Low Vision in Children

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What Is Albinism?

Albinism includes a group of inherited disorders characterized by a variable lack of pigment in the skin, hair, and/or eyes.

The amount of pigment varies greatly depending on the type of albinism. The two primary types of albinism are oculocutaneous and ocular. Oculocutaneous albinism affects the pigment in skin, hair, and eyes; ocular albinism, far rarer and more frequently found in males, predominantly affects the pigment in the eyes.

Children with albinism have low vision caused from low pigment in the iris, atypical development of the center of the retina called foveal hypoplasia, and abnormal nerve connections between the eye and the brain called optic nerve misrouting. Furthermore, strabismus, nystagmus, and refractive errors (nearsightedness, farsightedness, and astigmatism) are common in individuals with albinism.

How Is It Diagnosed?

Albinism is typically detected by the appearance of light hair, skin, and eyes.

An ophthalmologist should examine the child’s retinas and pattern of nerve connections between the eyes and the brain. If found, the child will be given a diagnosis of albinism.

Additionally, genetic testing can diagnose albinism.

Are There Treatments for Poor Eyesight Attributed to Albinism?

Eyeglasses may be prescribed to improve any refractive error. Surgery is an option for correcting strabismus and for minimizing nystagmus.

How Would You Describe the Eyesight of One with Albinism and How Will My Child Function with It?

There is much variation in quality of vision for individuals with albinism. According to the American Association for Pediatric Ophthalmology and Strabismus, those with the least pigment will typically have the poorest “functional vision”. This is likely the case because they have more significant foveal hypoplasia and optic nerve misrouting, and additionally, because the less pigment in the iris, the more (unnecessary) light floods into the eyes.

Foveal hypoplasia is atypical development of the fovea (center of the retina), the role the fovea plays in providing sharp, detailed vision is impaired. Your child may have difficulty recognizing faces and facial expressions. Accessing information from a distance, identifying small images or letters on paper, and recognizing details.

Due to the extra light that enters the eyes of children with albinism, they are sensitive to bright light and glare. Your child will likely have difficulty traveling outdoors in the bright sunlight. The environment may appear all white or lack contrast and using the eyes in such an environment will cause strain and discomfort. Tinted eyeglasses and use of a brimmed hat will provide some relief to the eyes. Additionally, the child may need an orientation and mobility specialist to provide instruction on using a cane and public transportation.

Nystagmus is defined as involuntary and repetitively darting of the eyes, is present, your child may or may not have additional vision issues. If a functional vision issue is present, it will likely be reduced visual acuity.

Assessments

Your child may benefit from increased contrast of the environment. Your child may also benefit from assistive technology and to utilize techniques and accommodations to perform activities with limited vision. He or she may even be a good candidate for braille.

Your child’s TVI should perform a functional vision assessment to determine how your child sees in functional environments and a learning media assessment to determine which senses your child primarily uses to get information from the environment. These assessments, along with an orientation and mobility assessment conducted by a mobility specialist, will give the educational team information needed to make specific recommendations for his or her environment.

Resources for Families of Children with Albinism