海岛地区白内障致盲调查

白内障是致盲的主要眼病之一,为了解海岛地区白内障致盲情况,我们于1985年7月至9月对宁波市象山南田岛、高塘岛、花岙山岛、东门岛、对面山岛和檀头山等六个海岛,五个乡镇60763个居民、农民、渔民进行了盲人调查,现将白内障致盲情况报告知下:方法这次调查先将本村盲人逐一登记,再由经过专业人员检查确诊登记。盲目标准:按照1979年第二届全国眼科会议制定的盲标准与分级法(三级盲0.02～0.05、四级盲光感-0.02、五级盲为无光感)。     

上海北新泾老人白内障流行病学调查

目的:调查上海北新泾街道60岁及以上人群白内障患病率、白内障盲人手术覆盖率和白内障盲人社会负担率。方法:随机整群抽样,对所有60岁及以上人群进行视力和眼部检查。了解接受白内障手术情况。结果:受检者3851例,白内障患病率39.86%。以双眼日常生活视力<0.1为盲的标准,白内障盲人手术覆盖率84.60%,白内障盲人的社会负担率3.87%,女性和文盲分别为4.65%和8.01%。结论:白内障盲人的社会负担率较重,女性和文盲白内障是严重的公共卫生问题。根治白内障盲仍是防盲工作的重要任务。     

北京市顺义区白内障患病和手术状况的调查

目的　调查北京市顺义区50岁及以上人群中白内障患病率、白内障盲人手术覆盖率和白内障盲人社会负担率,以此了解白内障的患病状况及评价10余年来该区实施以白内障手术治疗为主的防盲治盲工作的效果。方法　1996年9月,采用整群随机抽样方法对顺义区抽取28个调查点5084例50岁及以上人群进行视力和眼部检查,包括应用裂隙灯检查受检者晶状体;了解接受白内障手术的情况。结果　5084例受检者中,白内障患病率为23.31%。随着年龄的增加,白内障患病率明显增高。在女性和文盲者中的白内障患病率较高,分别为26.01%及37.33%;1984年后,白内障手术率持续增加,以双眼小孔视力＜0.05作为盲的标准,白内障手术覆盖率为56.36%,白内障盲人的社会负担率为1.63%。以双眼日常生活视力<0.1为标准,白内障手术的覆盖率为47.79%,白内障盲人的社会负担率为2.22%。在70岁以上人群、女性和文盲者中,白内障手术覆盖率较低,分别为36.36%、44.87%及44.09%。白内障盲人的社会负担率较高,分别为6.84%、2.74%及3.90%。结论白内障仍是高龄者的致盲眼病,白内障盲人所造成的社会负担较重。在老龄、女性及文盲中因白内障引起的盲目仍是顺义区目前存在的严重问题。     

与社区医疗机构结合行白内障眼病意识和手术意愿分步调查

目的:探讨通过社区服务管理网络创建白内障无障碍区的有效途径。 方法:选择一社区医疗服务中心及所辖三个居民委员会,参考印度Aravid 眼科医院调查问卷等资料,设计调查问卷。调查方式为两个阶段进行:社区居民白内障眼病认知意识调查;白内障手术意愿调查。 结果:60岁以上老年人约1500例,主动应答者占80.0%。社区居民眼病认知情况回收问卷中有白内障自我意识者,占回收卷中92.0%。分析结果为,患白内障意识存在者占72.0%;白内障主动就诊意识者占54.5%;有健康宣教需求者占96.5%。社区医院将有白内障认知意识问卷结果反馈到居委会,组织患者在社区医院,由眼科医生进行眼科检查,筛查出需手术治疗者占16. 7%。影响白内障手术意愿的因素：经济因素34.0%,个人心理因素40.0%,已经手术者占10.0%（应答率84%）。 结论：在北京城区内,即使是中心城区,对居民（包括高文化层次居民）进行白内障知识健康宣教是十分必要的。居民对白内障知识的了解与经济水平和文化素养无关,拥有白内障手术技术资源的大医院与社区医疗服务中心结合、政府基层组织的参与,是经济发达城区开展白内障无障碍区活动的有效方法。     

西藏林周縣盲患病率及白内障手術狀况調查

目的調查西藏拉薩市林周縣40歲及以上人群中盲患率和白内障盲人手術覆蓋率及盲人社會負擔率.方法2000年4月采用整群隨機抽樣方法對林周縣44個自然村3071例40歲及以上人群進行視力和眼部檢查.結果檢錄40以上共3346.受檢率爲91.8%(3071/3346).以雙眼日常生活視力<0.1爲標準,盲患病率3.3%(101/3071).白内障是致盲的主要原因,有64.4%(65/101)的雙眼盲人致少有1眼是白内障.白内障手術率覆蓋率爲63.0%(85/135).白内障盲人的社會負擔率爲4.4%.結論高原地區盲患病率較高,白内障是致盲的主要原因,白内障所造成的社會負擔較重.     

标准化人工晶状体植入20例观察

我国是一个12亿人口的大国,目前急需手术治疗的白内障盲人约200万,每年新增的白内障盲人超过50万.然而当前我国每年所能完成的白内障手术仅为30万.我们眼科医生面临的挑战是严峻的[1].     

南通市新城桥街道60岁及以上人群白内障流行病学调查

目的调查江苏省南通市城市人口中60岁及以上人群白障患病率、白内障盲人手术覆盖率和白内障人社会负担率,了解白内障患病情况及评价近十年来南通市实施以白内障手术治疗为主的防盲治盲工作效果。方法随机整群抽取新城桥街道14个社区中的8个,并对所有60岁及以上人群进行视力和眼部检查。了解接受白内障手术情况。结果3040例受检者中,白内障患病率为34.87%。2002年南通市城市人口60岁及以上人群白内障手术率为8553。以较好眼小孔视力<0.05为盲标准,白内障盲人手术覆盖率为60%,女性和文盲分别为50%和30%。白内障盲人社会负担率为2.14%,女性和文盲分别为2.63%和4.40%。以双眼日常生活视力<0.1为盲的标准,白内障盲人手术覆盖率为57.33%,女性和文盲分别为50%和31.82%。白内障盲人的社会负担率为2.47%,女性和文盲分别为2.99%和4.84%。结论白内障盲人所造成的社会负担率较重,在女性和文盲中,白内障是严重的公共卫生问题。防盲工作的首要任务仍是根治白内障盲。     

青岛开发区沿海社区50 岁以上人群白内障流行病学调查

目的：通过对青岛开发区沿海社区50 岁以上人群白内障的患病及治疗情况进行调查,了解该地区白内障流行病学状况。方法：调查研究。在2013 年2 月到2015 年1 月期间采用整群随机抽样方法,调查青岛开发区沿海社区9 028 例50 岁以上居民年龄相关性白内障患病情况,通过制订统一的检查方法和诊断标准,固定普查人员深入到社区集中检查。采用χ2 检验对结果进行统计学分析。结果：9 028例接受调查,共发现白内障患者2 008例,患病率为22.24%。70岁以上人群白内障患病率（60.03%）与70岁以下人群（12.70%）相比明显较高,差异有统计学意义（χ2=1 882,P <0.001）;女性患病率（27.11%）明显高于男性（17.05%）（ χ2=132,P <0.01）。糖尿病患者白内障患病率为66.94%,高于非糖尿病者（21.01%）（ χ2=154,P <0.01）。本次调查中发现白内障盲人166例,其中114例已经接受手术,白内障盲人手术覆盖率为68.67%。白内障盲人社会负担率为1.84%,不同年龄段社会负担率不同,随着年龄增长,白内障盲人社会负担率增加（χ2=154,P <0.01）,优势比为5.83。结论：白内障目前仍然是致盲的主要原因,社会上还有大量的白内障盲人得不到及时有效的治疗,给社会和家庭带来较重的负担,白内障复明工作任重而道远。     

沈阳市沈河区盲人普查报告

我们于1982年2～5月间在沈阳市沈河冈进行盲人普查。先由卫生局派一名医生主持,通知该区各卫生院所属地段医生登记盲人,安排各卫生院检查日期,以集中盲人进行检查,对行动不便者走访家庭检查。在全区人口50万中共查盲人总数422名,占全区人口8.4/万人。所谓盲人指的是双眼盲。关于盲的标准是根据1972年世界卫生组织(WHO)所规     

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盲治盲工作

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,目前农村白内障致盲率较高,高质量增加白内障复明手术是防盲治盲的首要任务.     

Present status of eye care in India

India, the second most populous country in the world, is home to 23.5% of the world's blind population. In 1976 India became the first country in the world to start a national program for control of blindness. All surveys in the country have shown that cataract is the most common cause of blindness and all prevention of blindness programs have been "cataract-oriented." However, it has recently been recognized that the visual outcome of the cataract surgeries as well as the training of ophthalmologists has been less than ideal. There is now increasing emphasis on high-quality surgery and up-gradation of skills among ophthalmologists. Other important causes of blindness are refractive errors, childhood blindness, corneal blindness, and glaucoma. The definitions, magnitude, and present status of each of these causes of blindness, as well as efforts at control, are discussed.     

THE TRACHOMA STATUS AND BLINDNESS RATES OF SELECTED AREAS OF PAPUA NEW GUINEA IN 1979-80

A survey of 4 selected areas of Papua New Guinea was made during 1979-80 to establish the prevalence of trachoma and its complications, and blindness rates and causes, in those areas. Trachoma was found to be endemic in all the areas studied, but was of mild intensity and rarely caused visual deficit. It is suggested that the most practical step towards reducing the prevalence of trachoma in P.N.G., in the future, is not by a mass treatment campaign, but by basic education in simple hygiene. An overall blindness rate of 0.50% was found in this survey, indicating that blindness is not a big problem in P.N.G. today. However there is still a need tor improved Primary Eye Health Care, the training of national ophthalmologists, and provision for one institution for the training of the blind in P N G.     

Prevalence and causes of blindness & low vision; before and five years after 'VISION 2020' initiatives in Oman: a review

BACKGROUND: A prevalence survey of blindness and low vision was conducted in Oman in 2005. Here, we present the prevalence and determinants of blindness and low vision among the population >or= 40 years of age. The results are then compared with those of the survey in 1997 and the changes following the 'VISION 2020' initiatives are assessed. METHODS: The survey covered 24 randomly selected clusters (75 houses in each). Teams assessed the distance vision of subjects while wearing glasses. The ophthalmologists examined the anterior segment and fundus to determine the causes of disability. The visual field was tested in those suspected of glaucoma. The prevalence rates of blindness (< 3/60 on presentation), legal blindness (< 6/60) and low vision (< 6/18) were calculated. The data from the 1997 survey was then analyzed to obtain similar rates in the population >or= 40 years of age. RESULTS: The prevalence of blindness was 8.25% (95% CI 7.14-9.36) in the >or= 40 year-old population in 2005. The rate would be 6.95% (95% CI 5.92-7.98) if blindness were defined as vision with best possible correction. The prevalence of legal blindness and low vision were 12% and 45.12%, respectively. In the 1997 survey, the prevalence of blindness in same age group was 7.23% (95% CI 5.91-8.55). Between the two surveys, the prevalence of blindness due to corneal pathology declined from 1.9% to 1.1% but that of blindness due to unoperated cataract increased from 1.8% to 2.3%. CONCLUSIONS: The rate of disability has declined but the number of blind people has increased in Oman. The causes of blindness have changed from communicable/avoidable eye diseases to non-curable/chronic eye diseases, and the number with visual disabilities has increased. An increasing number of operations for cataract and improvements in the care for glaucoma and diabetic retinopathy are recommended.     

The role of Western ophthalmologists in dealing with cataract blindness in developing countries

Of the estimated 35-40 million blindness worldwide, 17 million is caused by cataract and this proportion will double by year 2025. In Africa alone, it is estimated that there are about 3 million cataract blind. As life expectancy in Africa increases so will the incidence of cataract blindness. Existing resources of manpower and services cannot cope adequately with the present backlog of cataracts, let alone the anticipated increased load. The deployment of local ophthalmologists to deal with cataract load would be cost-effective in delivering appropriate eye care but the scarcity of ophthalmologists makes the option ineffective. The role of Western ophthalmologists will be considered in the provision of cataract surgical services and training of ophthalmic assistants, cataract surgeons and ophthalmologists.     

The prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. The Copenhagen City Eye Study

PURPOSE: To study the prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. METHODS: Data originated from a Danish epidemiologic cross-sectional random sample population eye survey conducted during the years 1986-1988. The population consisted of 1,000 inhabitants aged 60 to 80 years in Copenhagen. The participants underwent an extensive ophthalmologic examination. A participation rate of 96.9% was achieved. Any blindness was defined as best-corrected visual acuity (VA) worse than 0.05 (the WHO criteria) and VA of 0.1 or worse (the National criteria (NC) of blindness). RESULTS: The prevalence rates of bilateral and unilateral blindness were, respectively, 0.53% and 3.38% according to WHO, but 1.06% and 4.44% using NC. Bilateral blindness rose significantly with age (p=0.02). According to NC, age-related macular degeneration (AMD) was the leading cause of bilateral blindness, accounting for 60% of all blind persons. Glaucoma, myopic macular degeneration, cataract and retinitis pigmentosa were jointly the second most common cause, each accounting for 10% of all bilaterally blind persons. Diabetic retinopathy was not a cause of bilateral blindness. Amblyopia was the most frequent, AMD the second most frequent, and diabetic retinopathy was among the third most common cause of unilateral blindness accounting for, respectively, 28.60%, 16.66% and 9.52% of all unilateral blindness. CONCLUSIONS: Blindness was associated with increasing age. A calculation indicates that among Danes aged 60 to 80 years 7,736 are bilaterally blind and 35,503 suffer from unilateral blindness. This study highlights AMD as the most important cause.     

Globale Blindheit

Worldwide there are 37 million people who are completely blind and another 112 million whose sight is severely restricted. Of all blind people throughout the world, 85% live in developing countries. In three quarters of cases, blindness could be prevented or treated. The VISION 2020 campaign is dedicated to halving the number of people suffering from the diseases leading to blindness by means of disease control, training of specialist ophthalmic staff and development of appropriate infrastructures. More effort is needed if these goals are to be met. German ophthalmologists engaged in conservative and surgical treatments who join in and support VISION 2020 will be welcomed.     

Assessing the diagnostic validity of a blind register

Background: To validate the accuracy of clinical ophthalmic information held on the West Australian blind register. Design: Community‐based cross‐sectional study. Participants: Legally blind or severely vision‐impaired people were selected randomly from the Association for the Blind of Western Australia register. Methods: Individuals were reviewed by one of two consultant ophthalmologists. Main Outcome Measures: The positive predictive value (ppv), sensitivity and specificity for legal blindness status and diagnostic causes of vision loss were calculated using data extracted from the Association for the Blind of Western Australia blind register. Results: 273 blind or near blind people were reviewed from the register total of 4271 individuals. There were more women (57%) than men, median age 81 years. For legal blindness status the ppv was 0.88 (95% confidence interval [CI] 0.82–0.92), sensitivity 0.75 (95% CI 0.74–0.84) and specificity 0.6 (95% CI 0.46–0.73). The ppv for the diagnostic causes of blindness were: age‐related macular degeneration = 0.95 (95% CI 0.91–0.97), retinitis pigmentosa ppv = 1 (95% CI 0.81–1.0), diabetic retinopathy ppv = 0.9 (95% CI 0.57–0.99), optic neuropathies ppv = 0.77 (95% CI 0.51–0.92) and glaucoma ppv = 0.87 (95% CI 0.7–0.96). Forty individuals (15%) had treatable conditions contributing to their vision loss. Conclusions: The blind register diagnoses and legal blindness status are of high accuracy. This information allows useful linkages to other databases for studies of blindness interactions. A regular updating mechanism would improve the future accuracy of this valuable regional asset. The presence of untreated cataract suggests that regular follow up and appropriate treatment may help optimize vision in blind patients.     

Changes in blindness prevalence over 16 years in Malawi: reduced prevalence but increased numbers of blind

BACKGROUND/AIMS: In the coming two decades significant increases in the burden of blindness are anticipated unless concerted efforts are made to improve eye care in developing countries. Evidence of changing prevalence rates or numbers of blind people are few. The change in blindness prevalence and the number of blind people in an adult population of Malawi was measured over a 16 year period. METHODS: In 1999 a population based survey of blindness in adults (age 50+) was conducted in Chikwawa district of Malawi. Visual acuity and cause of vision loss were recorded for each eye independently. Blindness was defined as presenting better eye vision of <6/60. Findings from a 1983 survey of blindness in the same district (using similar methods) were re-analysed to be comparable with the survey conducted in 1999. RESULTS: Among 1630 enumerated adults 89% were examined. The age adjusted prevalence of blindness in the adult population was 5.4% and more common in women than men. In each age group the prevalence of blindness was lower in 1999 than in 1983; the overall reduction in blindness was 31%. During this period the 50+ population in Malawi increased almost twofold. Extrapolating the Chikwawa district data to the Malawi population reveals that the number of blind people has increased by 24%; the increase is primarily because of the large increase in the size of the most elderly group, aged 70 and above. CONCLUSION: The majority of blind people in Chikwawa (1983 and 1999) are in the age group 70 and over. This group has had the largest proportional increase in population size in this time. Services in this population have improved in the intervening 16 years and yet there was still an increase in the number of blind people. There was little change in excess blindness in women, suggesting that the same barriers that prevented utilisation of services in 1983 probably persist in 1999. Efforts to reach the most elderly and to reach women are needed to lead to a reduction in blind people in settings such as rural Malawi.     

Blindness in leprosy—a forgotten complication

Leprosy remains one of the world's major blinding diseases and yet few ophthalmologists are aware of the spectrum of ocular complications. Cross-sectional studies of the eye changes in leprosy patients, made under standardised conditions, have been carried out in 24 different leprosy centres throughout the world and the preliminary results are presented. They show that up to 20% of leprosy patients develop sight-threatening lesions and between 5% and 7% are blind (depending on the definition of blindness). Visual impairment in leprosy needs special consideration by leprologists and ophthalmologists, not only because much of it is preventable, but also because it is a severe burden to be added to the problems of mobility and social stigma that characterise this ancient disease.     

Blindness in leprosy--a forgotten complication

Leprosy remains one of the world's major blinding diseases and yet few ophthalmologists are aware of the spectrum of ocular complications. Cross-sectional studies of the eye changes in leprosy patients, made under standardised conditions, have been carried out in 24 different leprosy centres throughout the world and the preliminary results are presented. They show that up to 20% of leprosy patients develop sight-threatening lesions and between 5% and 7% are blind (depending on the definition of blindness). Visual impairment in leprosy needs special consideration by leprologists and ophthalmologists, not only because much of it is preventable, but also because it is a severe burden to be added to the problems of mobility and social stigma that characterise this ancient disease.