Vision and Vulnerability: A Critical Review of Ocular Challenges and Their Implication on Adolescent Reproductive Health
Abstract
Adolescents with visual impairments face significant yet underexplored barriers to accessing sexual and reproductive health (SRH) services and information. This review examines how ocular challenges influence SRH outcomes, particularly in low- and middle-income countries. Causes of visual impairment, such as refractive errors, cataract, infections, glaucoma, trauma, and congenital conditions, can reduce independence, affect relationship, heighten vulnerability to abuse, and complicate menstrual hygiene management. Limited accessibility of SRH content, stigma, and poor digital inclusivity further deepen these disparities. Innovative responses include inclusive SRH education in Braille and audio formats, peer-led models, assistive technologies, and cross-sectoral collaborations across health, education, and social services. However, major gaps remain in disability-disaggregated data and SRH research for adolescents with ocular disabilities. A rights-based, intersectional approach, guided by the Convention on the Rights of Persons with Disabilities (CRPD), is vital to ensure visually impaired adolescents are not left behind in SRH progress.
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References
WHO. Adolescent Health [Internet]. 2025 [cited 2025 May 20];Available from: https://www.who.int/health-topics/adolescent-health/#tab=tab_1
UNFPA. Millions of lives transformed [Internet]. 2016 [cited 2025 May 20];Available from: https://sdgs.un.org/sites/default/files/2021-10/UNFPA_Annual-Report-2016.pdf
Lanza M, Incagli F, Ceccato C, Reffo ME, Mercuriali E, Parmeggiani F, et al. Quality of life, functioning and participation of children and adolescents with visual impairment: A scoping review. Research in Developmental Disabilities 2024;151:104772.
Kapinga OS, Aloni M. Measuring levels of self-esteem of students with visual impairments in regular schools in Tanzania. British Journal of Visual Impairment 2023;41(2):388–99.
Fadamiro CO. Causes of blindness and career choice among pupils in a blind school; South Western Nigeria. Annals of African Medicine 2014;13(1):16–20.
Abdolalizadeh P, Chaibakhsh S, Falavarjani KG. Global burden of paediatric vision impairment: A trend analysis from 1990 to 2017. Eye 2021;35(8):2136–45.
Ezegwui IR, Oguego NC, Okoye OI, Maduka-Okafor FC, Udeh N, Aghaji AE, et al. Prevalence of refractive errors and visual impairment in school children in Enugu South-East Nigeria. Nigerian journal of clinical practice 2021;24(3):380–6.
Kwarteng MA, Mashige KP, Kyei S, Dogbe DSQ, Govender-Poonsamy P. Prevalence and causes of visual impairment amongst hearing impaired school-going children in sub-Saharan Africa: a scoping review. African Health Sciences 2022;22(4):199–204.
Maduka-Okafor FC, Okoye O, Ezegwui I, Oguego NC, Okoye OI, Udeh N, et al. Refractive Error and Visual Impairment Among School Children: Result of a South-Eastern Nigerian Regional Survey. OPTH 2021;Volume 15:2345–53.
Adebusoye SO, Onovae O, Adebusoye T, Sotunsa JO. Prevalence of refractive error in Nigerian children. Clinical and Experimental Optometry 2024;107(4):374–84.
Collins ME, Antonio-Aguirre B. Bridging the Gap in Adolescent Vision Care Through Schools. JAMA ophthalmology 2023;141(11):1073–4.
Peng L, Gao L, Zheng Y, Dai Y, Xie Q. Refractive errors and visual impairment among children and adolescents in southernmost China. BMC Ophthalmol 2021;21(1):227.
George AS, George AH, Shahul A. The Myopia Epidemic: A Growing Public Health Crisis Impacting Children Worldwide. Partners Universal International Research Journal 2023;2(3):120–38.
Schaftenaar E, Van Gorp ECM, Meenken C, Osterhaus ADME, Remeijer L, Struthers HE, et al. Ocular infections in sub‐Saharan Africa in the context of high HIV prevalence. Tropical Med Int Health 2014;19(9):1003–14.
Ogbonna EC, Ikani OR. Systematic review on onchocerciasis infection in Nigeria in the past five decades. 2020 [cited 2025 May 21];Available from: https://www.researchgate.net/profile/Odama-Ikani/publication/343334652_Systematic_Review_on_Onchocerciasis_Infection_in_Nigeria_in_the_Past_Five_Decades/links/5f23ab44458515b729f5e4c5/Systematic-Review-on-Onchocerciasis-Infection-in-Nigeria-in-the-Past-Five-Decades.pdf
Thylefors B. Epidemiological patterns of ocular trauma. Australian and New Zealand Journal of Ophthalmology 1992;20(2):95–8.
Gillette JS, Zaidat K, Waldman OV, Greenberg PB. Epidemiology of Motor Vehicle Accident-Associated Eye Injuries Presenting to United States Emergency Departments, 2000–2020. Ophthalmic Epidemiology 2025;1–8.
Singh S, Satani D, Patel A, Vhankade R. Colored cosmetic contact lenses: an unsafe trend in the younger generation. Cornea 2012;31(7):777–9.
Shukla R. Victimization of women by acid attack: a critical legal study. 2022;
Bwalya WM. Ocular manifestations of sickle cell disease at the University Teaching Hospital, Lusaka, Zambia [Internet]. 2014 [cited 2025 May 21];Available from: https://erepository.uonbi.ac.ke/handle/11295/74358
Maniyali F, Sanchez O, Papaconstantinou E, Barakat C. Determinants of Health Care Needs in Relation to Vision Correction among Adolescents in the United Arab Emirates: A Cross-Sectional Study. International Journal of Environmental Research and Public Health 2023;20(16):6547.
Aghaee-Chaghooshi S, Khodabakhshi-Koolaee A, Falsafinejad MR. Puberty challenges of female adolescents with visual impairment. British Journal of Visual Impairment 2023;41(1):96–107.
Mueller C. Adolescent understandings of disability labels and social stigma in school. International Journal of Qualitative Studies in Education 2019;32(3):263–81.
Anderson EM, Spain B, Clarke L. Disability in adolescence [Internet]. Routledge; 2022 [cited 2025 May 21]. Available from: https://www.taylorfrancis.com/books/mono/10.4324/9781003347903/disability-adolescence-elizabeth-anderson-lynda-clarke-bernie-spain
Jones N, Presler-Marshall E, Stavropoulou M. Adolescents with disabilities. London: ODI [Internet] 2018 [cited 2025 May 21];Available from: https://www.researchgate.net/profile/Kassahun-Tilahun/publication/332037124_Adolescents_with_disabilities_enhancing_resilience_and_delivering_inclusive_development/links/5c9c817445851506d730144e/Adolescents-with-disabilities-enhancing-resilience-and-delivering-inclusive-development.pdf
Salminen AL, Karhula ME. Young persons with visual impairment: Challenges of participation. Scandinavian Journal of Occupational Therapy 2014;21(4):267–76.
He M. THE STREAMING CONTENT USAGE OF YOUNG VISUALLY IMPAIRED PEOPLE IN PUBLIC SERVICE MEDIA. 2024 [cited 2025 May 21];Available from: https://trepo.tuni.fi/bitstream/handle/10024/157356/HeMengying.pdf?sequence=5
Gür K, Albayrak S. Exposure to Violence of Secondary School Children with Visual Impairment. J Interpers Violence 2017;32(15):2257–74.
Wea LD, Hepilita Y, Fachry ME. The experiences of visually impaired teenage girls on menstrual hygiene management: a qualitative study. Enfermeria clinica 2020;30:222–5.
Mesiäislehto V. Sexual and reproductive health and rights through the lens of belonging: Intersectional perspectives on disability, gender, and adolescence in Tanzania. JYU dissertations [Internet] 2023 [cited 2025 May 21];Available from: https://jyx.jyu.fi/bitstreams/d88093a9-86f1-4a5f-828e-ab5c56cf2a14/download
Dube N. Educating Adolescents with Visual Impairments on Sexual Reproductive Health and Rights in Resource-Poor Environments an Uphill Struggle: A Case Study of Practices from the Field in Zimbabwe [Internet]. In: Rugoho T, Maphosa F, editors. Sexual and Reproductive Health of Adolescents with Disabilities. Singapore: Springer Singapore; 2021 [cited 2025 May 21]. page 191–209.Available from: http://link.springer.com/10.1007/978-981-15-7914-1_10
ERIC A. Sexual Health And Academic Experience Among Female Adolescents With Visual Impairment In Ghana [Internet]. 2023 [cited 2025 May 21];Available from: https://ir.ucc.edu.gh/xmlui/handle/123456789/11618
Wild A. Sustainability of Adolescent Sexual and Reproductive Programs Utilizing Peer Educators in Sub-Saharan Africa: A Scoping Review. 2024 [cited 2025 May 21];Available from: https://search.proquest.com/openview/ab4b6e07bd9c15a29e3ffc73e5751ec7/1?pq-origsite=gscholar&cbl=18750&diss=y
Allen LN. Improving equitable access to community-based health services: Developing and testing a new model in Kenya’s national eye screening programme [Internet]. 2024 [cited 2025 May 21];Available from: https://researchonline.lshtm.ac.uk/id/eprint/4674965
Setiawan A. Intelligent Systems For Disabilities Technology For A More Inclusive Life. Available at SSRN 5062273 [Internet] 2024 [cited 2025 May 21];Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5062273
Wilkins NJ, Rasberry C, Liddon N, Szucs LE, Johns M, Leonard S, et al. Addressing HIV/sexually transmitted diseases and pregnancy prevention through schools: an approach for strengthening education, health services, and school environments that promote adolescent sexual health and well-being. Journal of adolescent health 2022;70(4):540–9.
Eriksen SH, Grøndahl R, Sæbønes AM. On CRDPs and CRPD: Why the rights of people with disabilities are crucial for understanding climate-resilient development pathways. The Lancet Planetary Health 2021;5(12):e929–39.
ERIC A. Sexual Health And Academic Experience Among Female Adolescents With Visual Impairment In Ghana [Internet]. 2023 [cited 2025 May 21];Available from: https://ir.ucc.edu.gh/xmlui/handle/123456789/11618
Krugu JK, van der Kwaak A. RESEARCH IN BRIEF Adolescent Sexual and Reproductive Health in low-and middle income countries: A synthesis of research findings for improved program development and implementation [Internet]. 2024 [cited 2025 May 21];Available from: https://www.kit.nl/wp-content/uploads/2019/05/Adolescent-Research-in-Brief_Sida.docx
Six actions to improve adolescent health [Internet]. [cited 2025 May 21];Available from: https://www.who.int/news-room/spotlight/six-actions-to-improve-adolescent-health
Renzaho AMN, Kamara JK, Doh D, Bukuluki P, Mahumud RA, Galukande M. Do Community-based Livelihood Interventions Affect Sexual and Reproductive Health and Rights of Young People in Slum Areas of Uganda: a Difference-in-difference with Kernel Propensity Score Matching Analysis. J Urban Health 2022;99(1):164–89.
Sebbas LM. Policy approaches to dis/ability inclusive development. 2021 [cited 2025 May 21];Available from: https://lup.lub.lu.se/student-papers/search/publication/9046299
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