埃塞俄比亚德布拉巴汁地区盲目分析

埃塞俄比亚德布拉巴汁市医院眼科门诊病人１４３６人中查出盲目患者１６８人，占门诊病人的１１．７％。其中双眼盲６７人，占门诊病人的４．６７％，占盲人的３９．８８％；单眼盲１０１人，占门诊病人的７．０３％，占盲人的６０．１２％。通过分析，初步找出了在埃过时的三大致盲病因，即白内障，青光眼和眼外伤。其中白内障具有重要的开盲意义。     

我国白内障的流行病学调查资料分析

目的 探讨我国白内障的患病率与各地检查条件、诊断标准及地理环境的关系。方法 采用世界卫生组织盲与低视力标准,对全国抽样调查资料进行统计学分析。结果 双眼视力〈０．３的白内障患者约５００万人,患病率为０．４６％;盲与低视力的患病率分别为０．４３％和０．５８％。盲人中白内障致盲占４１．０６％;低视力患者中４９．３８％为白内障所致;白内障致老年盲（年龄≥６０岁）及低视力占７３．１３％。以晶体混及视力〈０     

小切口非超声乳化白内障囊外摘除术的临床观察

白内障是最常见的致盲性眼病，虽不能预防但可治疗，经济而有效的手术治疗可以减少白内障盲。据初步统计，我国现有500万白内障患者中，每年有近40万人致盲。根据西藏自治区最新眼病抽样调查结果显示，白内障是我区最常见的致盲性眼病，患病率为14．6％。按最新人口普查数据推算，约有3万名盲人，其中白内障致盲占46．8％，即全区约有14040名白内障致盲患者。随着人口老龄化，新生的白内障患者也逐年增加，我区的防盲治盲工作任务将十分艰巨。     

北京市顺义县初级眼保健网和无白内障区的建立

在北京市顺义县进行眼病流行病学调查的基础上，１９８７年建立了县初级眼保健网和３个眼病防治中心，以手术治疗白内障为重点，开展防盲工作，具体采取以下措施：（１）成立防盲治盲领导小组；（２）建立３级初级眼保健网、转诊制度和监测信息系统；（３）培训眼科医师７名、初级保健员４４９名，验光医师６名；（４）大力宣传眼病防治知识；（５）盲和低视力调查，全县筛出致盲白内障８１５例；（６）开展义诊咨询活动。截止１９９１年１２月，共做白内障手术６６７例，占总数的８１．８４％，达到无白内障区的标准。９０．６４％的盲人恢复了视力（脱盲），５９．１６％的盲人能参加劳动（脱残）。无一例感染，无并发症者占９７．４２％。     

斗门县45岁以上人群的盲与低视力流行病学调查

我们于１９９１年在广东省斗门县对４５岁以上的人群进行了盲和低视力的流行病学调查。样本量是９３２人，视力＜０．３者占１０．９０％。双眼低视力率３．２２％，双眼盲人患病率１．６１％，而低视力和盲的患病率随年龄的增加而增加。白内障致盲居首位４５．２０％，其次是角膜病。     

山东省章丘市盲人流行病学调查和治疗

目的 调查山东省章丘市进行了盲患病率及治疗效果。方法 采用分层随机抽样原则,按ＷＨＯ盲目分级标准。对全市按１．２７％抽样比例抽取１１８８４例作为调查对象。结果 双眼盲３７例,盲率为０．３１％,致盲的主要眼病依次为白内障（４５．９５％）、青光眼（２４．３２％）及玻璃体视网膜病（１３．５１％）。对全市１０１６例白内障盲人行白内障复明手术,占按盲率推算白摧障盲人的７３．８９％,人工晶体植入率为８４．１５     

河南省信阳市创建“白内障无障碍市”活动中白内障患病率调查——开展以白内障手术治疗为主的防肓治肓工作

目的调查信阳市（含八县两区）白内障患病率，白内障致盲率，白内障手术负荷量；评价我市创建“白内障无障碍市”，实施以白内障手术治疗为主的防盲治盲工作效果。方法2006年12月-2007年7月，对全市眼病人群进行白内障的筛查。白内障定义为：至少1眼晶状体浑浊矫正视力〈0．6者，其中最好眼矫正视力〈0．05者为白内障盲人，矫正视力〈0．1眼为白内障手术对象。结果眼病人群共3472例，接受检查3469例，总受检率99．91％，白内障患病率为65．84％，白内障致盲率为3．06％，白内障手术负荷量为30．18％。结论白内障盲人所造成的社会负担较重，目前农村门内障致盲率较高，高质量增加白内障复明手术是防盲治盲的首要任务。     

四川省眼病及盲人调查

1981～1984年,在我省川南纳溪县,川北达县地区,凉山彝族自治州昭觉和宁南县,川东涪陵和垫江县,选点进行了眼病和盲人调查。每点选2～3个生产大队,检查其人口的绝大多数。各地区所选点的人口总数为51,858人,受检人数为49,644人,受检率为95.73％。盲人:采用国际卫生组织1975年盲眼标准。共检查49,644人,查出双眼盲人0.05以下者267人,盲率为0.54％。盲目的主要原因为:沙眼91人,占盲人的34.1％;老年性白内障77人,占28.8％;角膜病38人,占14.2％;葡萄膜病19人,占7.1％;眼底病10人,占3.7％;眼外伤8人,占3.0％;先天性眼病4人,占1.5％;原发性青光眼1人,占0.4％。部分沙眼、老年性白内障或角膜病是可治者,占65.5％。常见眼病:各地查出眼病在60种以上。沙眼患病率最高,平均为50.58％,以宁南彝族及达县山区为最高,分别达69.61％及58.87％;平原和丘陵地区为18.57～35.08％。其它常见眼病依次为角膜病,2.05％;翼状胬肉,1.88％;老年性白内障,1.58％;睑内翻,1.06％;慢性泪囊炎,0.76％;先天性眼病,0.39％;眼外伤,0.19％;葡萄膜病,0.18％;原发性青光眼0.08％。     

山东省荣成市眼病及盲目流行病学调查

目的 对荣成市进行眼病及盲目的流行病学调查。方法 采用分层随机抽样原则，以2．16％的抽样率抽取14789人做为调查对象。结果 各种眼疾患病率为2．64％，盲目患病率为0．142％，其中白内障占首位（38．1％），第二位为青光眼（14．3％），第三位为视神经萎缩、角膜白斑及糖尿病性视网膜病变（各占9．5％），其它占（19．1％）。结论 眼病及盲目的流行病学调查结果提示了主要致盲病因为白内障，手术治疗白内障仍是今后防盲治盲的首要任务。     

眼球穿孔伤术前术后致盲率比较及原因分析

本文报告眼球穿孔伤２４２例，其中角膜穿孔伤１３７例占５６．６％，巩膜穿孔伤３８例占１５．７％，角巩膜穿孔伤６７例占２７．７％，术前致盲率为７２．８％，术后致盲率为４２．１％，脱盲率为３０．７％。对致盲原因、受伤部位、伤口大小、伤口处理、并发症的处理与致盲率的关系作了讨论。     

哈尔滨市盲校学生致盲原因及视力调查

目的探讨儿童盲早期防治和康复的重要性。方法应用眼科常规方法对73名盲校学生进行全面检查。并对致盲原因及视力进行分析。结果病因以先天性和遗传性眼病为主要因素。其中第一位为先天性白内障、术后无晶体眼(24.66%);第二位为重度屈光不正(伴有或不伴有斜视),占13.70%。视力,该盲校中有可利用残余视力(视力≥0.02)者为79.46%。视力为光感与无光感者15例,占总数的20.55%。盲目者占47.94%;低视力及以上者占52.06%。结论哈尔滨市盲校学生致盲原因中,第一位为先天性白内障、术后无晶体眼,提示眼病的早期诊断和治疗的重要性。第二位为重度屈光不正,提示屈光不正患儿的早期验光配镜对于防盲是极为重要的。学生中存在大量有残余视力者,根据视力情况进行分班教学、区别教育极为重要。     

Incidence and causes of blindness among the under 5 age group in Malawi.

The expected incidence of blindness among children under 5 years of age in Malawi is 34 cases per 100 000 children. Direct ocular infections were responsible for the blindness in 32% of the cases (bacterial infections 20% and measles 12%). The instillation of traditional medicine in these cases worsened the ocular condition and induced in all of the cases a "hopeless" situation of total melting of the cornea and protrusion of the uvea. Congenital factors (excluding retinoblastomas) were responsible for 30-8% of the blind cases. Among these, 11 cases of congenital cataracts were successfully treated and will not appear as blind in future. A high incidence (9-3%) of cortical blindness was recorded. Trauma was implicated in 5-3%, while retinoblastoma was found in 8%. It is believed that adequate preventive measures should be able to lower the incidence of blindness among this age group to 5 cases instead of 34 per 100 000 children.     

Effect of vision loss on plasticity of the head and neck proprioception

AIM: To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy (DON). METHODS: PubMed, EMBASE, the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies. The primary outcomes were the improvement in visual acuity and responder rate. Secondary outcomes were the proptosis reduction, change in diplopia, and clinical activity score (CAS). RESULTS: One randomized controlled trial, three retrospective case series and one prospective case series met the inclusion criteria. They were divided into intravenous high-dose glucocorticoids (ivGC) group and orbital decompression (OD) group. Both groups demonstrated improvement in visual acuity. In addition, the proportion of patients with improved vision in OD group was higher than that in ivGC group (P<0.001). Post-treatment proptosis reduction was also reported in both groups. Overall, weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively. This study also presented results regarding pre-existing and new-onset diplopia. Apart from diplopia, a wide variety of minor and major complications were noted in 5 included studies. The most common complication in ivGC group and OD group was Cushing’s syndrome and epistaxis respectively. CONCLUSION: The present systematic review shows that both glucocorticoids treatment and orbital decompression are effective in treating DON and orbital decompression may work better in improving visual acuity and reducing proptosis. However, high-quality, large-sample, controlled studies need to be performed in the future.     

宁波市盲校学生视残情况调查

目的通过调查宁波盲校在校学生视力情况并分析其原因,说明早期预防和康复对儿童视残的重要性。方法采用眼科常规检查方法对41名盲校学生进行眼科检查,并对致病原因、残存视力以及儿童视残特点进行分析。结果先天性和遗传性眼病是致盲的主要因素,其中第一位为先天性眼球震颤、小眼球小角膜等,占总例数的34.15%,第二位为先天性白内障、青光眼等眼病,占总例数的26.83%。有视力残存者即低视力及以上者(视力>0.02)28人占62.29%,视力为光感至指数之间者9人占21.95%,无光感者4人占9.75%,盲目者共计31.7%。结论宁波市盲校学生眼病致盲原因中,主要是先天性遗传性眼病,提示儿童眼病及早发现并治疗的迫切性。     

Causes of blindness in Northern Tanzania: a hospital and rural health centre based study

Objective:To identify the main causes of blindness in Northern Tanzania.Methods:Ophthalmic patients at the Kilimanjaro Christian Medical Centre and on outreach clinics in the Kilimanjaro region of Northern Tanzania were examined. The cause of blindness was documented for any eye seeing less than 3/60 Snellen. If more than one factor contributed to the visual loss, the single factor deemed to be the most visually disabling was documented.Results:1045 blind eyes of 781 patients were examined. 264 patients were bilaterally blind. The main cause of bilateral blindness was cataract [39%]. The other chief causes of blindness were glaucoma, trauma and corneal scarring. The most important cause of corneal scarring, approximately half the cases, was microbial keratitis. Refractive error alone was responsible for 4.2% of bilateral blindness, of which 2.7% was uncorrectedpost-cataract surgery aphakia. Conclusions:Treatable causes of blindness, including cataract and refractive error account for over a third of all blindness in Northern Tanzania. Trauma, glaucoma and microbial keratitis are other important causes of blindness in the region.     

Changing pattern of childhood blindness in Saudi Arabia.

We studied 187 patients attending special educational institutions in Saudi Arabia who were blind before the age of 14. All patients underwent complete ophthalmological evaluation. The visual acuity in 31% of the patients was no light perception and in 58% light perception to counting fingers at 3 feet (1 m). 70% were blind before age 2. Prior to 1962 acquired diseases led to blindness in 75% of the patients. From 1962 onwards genetically determined diseases accounted for 84% of childhood blindness. 56% of this group were the product of consanguineous marriages. On the other hand in the group who acquired blindness only 14% were from consanguineous marriages (p less than 0.0001). We here describe guidelines for the prevention of childhood blindness in Saudi Arabia.     

Causes of severe visual impairment and blindness in children in schools for the blind in Ethiopia

AIMS: To determine the causes of severe visual impairment and blindness in children in schools for the blind in Ethiopia, to aid in planning for the prevention and management of avoidable causes. METHODS: Children attending three schools for the blind in Ethiopia were examined during April and May 2001 using the standard WHO/PBL eye examination record for children with blindness and low vision protocol. Data were analysed for those children aged less than 16 years using the EPI-INFO-6 programme. RESULTS: Among 360 pupils examined, 312 (96.7%) were aged <16 years. Of these children, 295 (94.5%) were blind or severely visually impaired. The major anatomical site of visual loss was cornea/phthisis (62.4%), followed by optic nerve lesions (9.8%), cataract/aphakia (9.2%), and lesions of the uvea (8.8%). The major aetiology was childhood factors (49.8%). The aetiology was unknown in 45.1% of cases. 68% of cases were considered to be potentially avoidable. CONCLUSIONS: Vitamin A deficiency and measles were the major causes of severe visual impairment/blindness in children in schools for the blind in Ethiopia. The majority of causes acquired during childhood could be avoided through provision of basic primary healthcare services.     

Blindness in painters]

The purpose of this study was the inventory of historical painters who were blind, and the analysis of their attitude in the face of the blindness. METHODS: The population study was extracted from the dictionary of painters by Benezit. The method of the study was ophthalmological, to assess precisely the type and the etiology of the blindness; and psychological and artistic to study the reactions of the painters. RESULTS: Blindness was found among 85 painters. They were 5 cases of transitory blindness; 20 cases of unilateral blindness; and 60 cases of bilateral definitive blindness. The psychological attitudes of the painters were either negative, with depression, and even suicide (5 cases); or positive, with perseverance to paint till to blindness, teaching of the painting after blindness. CONCLUSIONS: The small number of painters with a blindness caused by a precise etiology was disappointing, but the variety of the reactions gave a good account of the attitude of the painters who became blind.     

Prevalence of glaucoma types and legal blindness from glaucoma in the western region of Saudi Arabia: a hospital-based study

To determine prevalence of glaucoma subtypes and legal blindness in patients on their first visit to an ophthalmic center in the western region of Saudi Arabia a chart review analysis was carried out of new patients in 2006 with glaucoma diagnosis in our Glaucoma Unit. Diagnosis was confirmed clinically and by glaucoma workup. The main outcome was prevalence of glaucoma types and legal blindness from glaucoma. Of 2,354 new patients in 2006, 417 were glaucomatous. Mean age was 56.4 years and mean intraocular pressure (IOP) was 26.5 mmHg; 54.4% had prior glaucoma diagnosis. Prevalence of primary open-angle glaucoma was 30.5%, primary angle-closure 24.7%, neovascular 7.6%, surgically induced 6.5%, and exfoliative 5.2%. One-third of patients were unilaterally legally blind, whereas 11.3% were bilateral. Primary glaucoma represents two-thirds of glaucoma cases in Saudi Arabia. Approximately one-half of patients were legally blind in at least one eye at time of presentation.     

Prevalence and causes of blindness in the northern Transvaal.

During November 1985 a survey was carried out to determine the prevalence and causes of blindness in the Elim Hospital district of Gazankulu in the Northern Transvaal, South Africa, and to assess the Eye Department's effectiveness in preventing blindness. Using a random cluster sample technique, we screened 18,962 of the estimated 71,200 inhabitants of the district (26.6%). We found 109 blind people. The prevalence of blindness was 0.57% (95% confidence interval 0.46%-0.68%). The main causes of blindness were senile cataract (55%), corneal scarring due to trachoma (10%), uncorrected aphakia (9%), and open-angle glaucoma (6%). There were 14 aphakic blind persons who did not have aphakia glasses (43% of all persons operated on for cataract). Women had a significantly higher prevalence of blindness than men. After the age of 60 years the prevalence of blindness increased sharply. Women were 1.6 times less likely to have undergone cataract surgery than men. The two most effective steps to reduce the prevalence of blindness in the Elim district further are to provide aphakia glasses to all aphakic patients and to improve the accessibility of the Eye Department's surgical services.