Retinopathy of prematurity remains the leading cause of childhood blindness in children attending schools for the blind in Guadalajara: a fifteen-year comparison.

Objective: To identify the main causes of blindness in children attending at 3 schools for blind in the metropolitan area of Guadalajara (MAG), Jalisco, Mexico and to highlight the importance of preventing childhood visual disability. Methods: An observational, cross-sectional, and descriptive study was conducted in students enrolled in three schools for children with visual disabilities during the period September-December 2025 in Guadalajara, Jalisco, Mexico. Information was obtained from the review of clinical and school records, interviews with parents, and ophthalmologic evaluation, with prior institutional approval from the participating schools. A standardized World Health Organization (WHO) form was used to record sociodemographic variables, perinatal history, ophthalmologic diagnosis, etiology, treatments, and comorbidities. A descriptive analysis with an epidemiological approach was carried out using frequencies and measures of central tendency. Finally, the information was anonymized and handled confidentially, in accordance with ethical research principles. Results: This school-based, observational, descriptive cross-sectional study included a total of 106 children, 55 were female (51%) and 51 were male (49%). Retinal disorders constituted the main cause of visual loss with 64 cases (60%), predominantly sequelae of retinopathy of prematurity (ROP) in 50 children (47%). The second cause identified was optic nerve abnormalities with 19 cases (18%). 57 cases (54%) were associated with factors from the neonatal period. 50 children (47%) with diagnosis of ROP, had a mean gestational age of 30.6 weeks and a mean birth weight of 1443 g; 8 children (16%) were outside Mexican screening criteria and 28 (56%) outside United Kingdom criteria. 44 children (88%) with ROP presented blindness and 34 (68%) did not receive treatment and neurodevelopmental comorbidities were identified in 7 children (14%). Conclusions: Childhood blindness in the studied population was predominantly associated with potentially preventable causes, especially sequelae of ROP, positioning itself as the leading cause of childhood blindness in a school-based sample in Guadalajara. It is necessary to strengthen the prevention of retinopathy of prematurity through neonatal care, ensuring timely detection and treatment, as well as adapting neonatal screening programs and criteria to the regional context to reduce the burden of childhood visual impairment. These findings highlight the persistence of preventable ROP-related blindness among children attending specialized schools.