高度近视患者盲和低视力情况及相关因素分析

目的:探讨高度近视患者的视力损伤情况及相关因素.方法:对我院就诊的高度近视患者612例1111眼的就诊资料进行回顾性研究,根据WHO制定的盲和低视力标准,分析高度近视盲和低视力情况.采用Logistic回归分析高度近视盲和低视力的相关因素.结果:共收集高度近视患者612例1111眼,其中达到盲标准的共86眼(7.7％),达到低视力标准的共172眼(15.5％);年龄、眼轴长度、后巩膜葡萄肿均是高度近视盲和低视力的独立危险因素(P＜0.05),性别、家族遗传史与患者盲和低视力无显著相关性(P＞0.05);6～20岁组(232眼)、21 ～ 40岁组(407眼)视力损伤眼分别有21眼(9.1％)和51眼(12.5％),其中弱视是两组患者视力损伤的主要原因,分别有17眼(81.0％)和30眼(58.8％);41 ～60岁组(323眼)、＞60岁组(149眼)视力损伤眼分别有105眼(32.5％)和81眼(54.4％);其中眼底病变是两组患者视力损伤的主要原因,分别有86眼(81.9％)和75眼(92.6％).结论:高度近视对视力的损伤严重,年龄、眼轴长度及后巩膜葡萄肿是独立危险因素.弱视是青少年患者视力损伤的主要原因,眼底病变是中年以上患者视力损伤的主要原因.     

杭州市下城区50岁及以上人群眼病流行病学调查

目的：调查杭州市下城区50岁及以上人群眼部疾病的患病情况及盲和中、重度视力损伤的患病率及病因。方法：横断面调查研究。于2015年4-8月期间采用整群随机抽样方法,从杭州市下城区8个街道共抽取50岁及以上人群2 953例,对其进行视力、屈光状态、眼压等检查,分析不同年龄、性别和受教育程度人群盲和中、重度视力损伤的患病率及病因。各数据间的比较采用 χ 2 检验和趋势χ 2 检验。结果：共2 363例接受并完成了检查,受检率为80%,人群中盲和中、重度视力损伤的患病率为1.6%（38例）,并随着年龄增长而上升（ χ 2 =38.094,P < 0.001）;文化程度越低,盲的患病率越高（ χ 2 =39.497,P < 0.001）。导致盲和中、重度视力损伤的主要原因有眼底异常（30眼,39.5%）、白内障（26眼,34.2%）、青光眼（12眼,15.8%）等。人群中眼病患病率由高到低依次为未矫正的屈光不正（2 048例,86.7%）、白内障（1 065例,44.7%）、翼状胬肉（219例,9.3%）、年龄相关性黄斑变性（81例,3.5%）、青光眼（52例,2.2%）、斜视（46例,2.0%）、糖尿病视网膜病变（39例,1.7%）。结论：杭州市下城区50岁及以上人群常见的眼部疾病是未矫正的屈光不正、白内障。盲和中、重度视力损伤的患病率较低,其中眼底异常、白内障是导致盲和中、重度视力损伤的主要原因。     

羊膜移植治疗眼重度碱烧伤的护理

目的 探讨适合早期新鲜羊膜移植治疗重度眼部碱烧伤患者的护理.方法 对早期新鲜羊膜移植治疗35例(38眼)重度眼碱烧伤患者进行观察与护理.结果 眼表损伤迅速稳定,角膜不再继续融解,未发生角膜穿孔,无睑球粘连发生,3个月后随访24眼脱盲,视力≥0.2者有11眼.结论 术前、术后的系统护理、必要的出院指导有助于治疗和康复.     

桂林市郊区50岁以上人群视力损伤及致盲眼病调查

目的:调查桂林市农村地区50岁以上人群中视力损伤及盲的流行病学现状,并对产生视力损伤及盲的原因进行初步探索.方法:采取整群随机抽样方法对桂林市下辖5区12县进行抽样调查,共抽取10252人.登记内容包括:姓名、性别、年龄、民族、文化程度、经济状况、既往患病史、吸烟饮酒史等.登记资料及眼科检查结果输入计算机,采用SPSS 19.0软件进行统计描述.结果:共计调查10252人,其中男4958人(48.4％),女5294人(51.6％);汉族9218人(89.9％),少数民族1034人(10.1％).目前在桂林市农村地区排名前3位导致双眼视力损害和盲的眼病分别是白内障(0.7％)、黄斑病变(0.2％)、糖尿病视网膜病变(0.1％).结论:白内障仍是目前桂林市农村地区50岁以上人群视力损伤的主要原因.高血压、糖尿病等所致视力下降及致盲疾病的发病率有一定程度的增长.加强基础卫生教育,提高基层医疗资源仍是今后防盲、治盲工作的重点.     

海口市郊≥50岁人群的视力损伤及患盲病率调查

目的:调查海南省海口市郊≥50岁人群中视力损伤、严重视力损伤及盲的患病率,并分析其主要原因。方法:选取海口市郊≥50岁人群,随机抽取30个抽样单位的850例进行调查。对受检人员进行矫正视力、外眼、前房、晶状体、玻璃体及眼底检查,调查该人群视力损伤、严重视力损伤及盲的患病率并分析主要原因。结果:调查850例中受检人员为786例,受检率为92.47%,视力损伤、严重视力损伤及盲的患病率分别为2.67%,0.64%和2.54%。致视力损伤、严重视力损伤及盲主要眼病依次为白内障、眼后节疾病、角膜瘢痕及其他疾病。结论:海口市郊≥50岁人群视力损伤、严重视力损伤及盲的首要病因是白内障,眼后节疾病、角膜瘢痕等疾患所致盲也占一定比例。      

上海市宝山区大场镇老年人屈光矫正前后视力损伤情况调查

目的 分析上海市宝山区大场镇60岁及以上人群中屈光矫正前后的视力损伤情况.方法 流行病学调查.2009年11～12月采取整群抽样的方法对上海市宝山区大场镇目标人群进行盲和视力损伤的流行病学调查.主要包括视力及裂隙灯检查、小瞳验光、问卷调查等.视力损伤按照WHO的标准进行分析.同时也分析了与可矫正的视力损伤有关的人群特征.对不同性别、不同年龄组可矫正的视力损伤患病率进行比较时采用卡方检验,各独立变量与可矫正视力损伤患病率之间的相关性采用单因素比值比(OR)方法.结果 本调查共纳入5199人,实际受检4545人,受检率为87.42％.日常生活视力中盲与视力损伤的患病率分别为0.86％和8.82％;屈光矫正后,盲与视力损伤患病率分别为0.66％和3.01％;可矫正视力损伤率为5.81％(264/4545).年龄与性别是可矫正视力损伤的主要危险因素.通过对264例可矫正的视力损伤的病因分析,发现单纯屈光不正为114例(43.18％),合并白内障121例(45.83％),合并黄斑变性21例(7.95％),合并糖尿病视网膜病变4例(1.52％),合并青光眼3例(1.14％),合并角膜病1例(0.38％).眼镜覆盖率为44.12％.随着年龄的增大,眼镜覆盖率下降,男性眼镜覆盖率高于女性.结论 屈光不正是老年人视力损伤的重要因素,屈光矫正是诊断盲和视力损伤的必不可少的步骤.     

白内障患者防盲手术前视力状况和生存质量的调查

目的评价白内障防盲手术前患者视力、主观视功能(visual function,VF)和视觉相关生存质量(quality of life,QOL)状况.方法检查江苏省姜堰市拟接受白内障防盲术的251名患者的术前日常生活视力,由5名调查员进行VF和QOL现场问卷调查.结果单眼盲患者占54.6%,严重盲患者占33.9%,视力损伤占6.4%,中度盲占5.2%;VF和QOL平均得分分别为48.58±31.18、65.97±26.77,与视力等级的相关系数分别为-0.61、-0.56;多因素分析表明VF和QOL得分与视力等级和年龄相关,与其他因素无关.结论接受防盲手术的白内障患者主要为单眼盲和严重盲患者,VF和QOL得分基本随视力状况下降而下降,需重视白内障患者的心理健康问题.(中国眼耳鼻喉科杂志,2005,5:379～381)     

上海市北新泾街道60岁及以上人群盲和视力损伤的现况调查

目的 调查上海市北新泾街道60岁及以上老年人低视力、盲的患病率及致盲原因,并与以前调查结果相比较,评价近年该地区实施防盲治盲项目的 效果.方法 应用横断面研究的流行病学调查方法.由上海交通大学附属第一人民医院和上海市长宁区北新泾社区卫生服务中心于2007年11月至2008年4月采用整群随机抽样方法在上海市长宁区北新泾街道抽取8个社区,对其中所有的60岁及以上老年人进行调查,检查日常生活视力和针孔镜矫正视力,应用裂隙灯显微镜、直接检眼镜和眼底照相机等仪器检查受检者外眼、眼前节及眼底等情况.观察低视力及盲的患病情况,分析致盲的主要原因.正式调查前先进行预试验,通过计算kappa值进行不同检查者诊断结果的重复性检验,保证调查质量.结果 在应检录4153人中,受检人数为3851人,受检率为92.73%.按照世界卫生组织视力损伤标准:双眼盲29人,其中男性11人(占37.93%)、女性18人(占62.07%).双眼低视力104人,其中男性37人(占35.58%)、女性67人(占64.42%).双眼盲和双眼低视力的患病率分别为0.75%和2.70%.致盲的主要原因依次为:黄斑变性、白内障、角膜瘢痕或混浊及视网膜脱离.按照日常生活视力和视力损伤标准:重度双眼盲61人,其中男性20人(占32.79%)、女性41人(占67.21%).轻度双眼盲66人,其中男性27人(占40.91%)、女性39人(占59.09%).单眼盲276人,其中男性120人(占43.48%)、女性156人(占56.52%).重度双眼盲、轻度双眼盲、单眼盲的患病率分别为1.58%、1.71%和7.17%.致盲的主要原因依次为:黄斑变性、白内障、屈光不正及角膜瘢痕或混浊.结论 黄斑变性仍是致盲的首要原因,眼底病患病率逐渐上升,社区防盲项目已初显成效.     

昆明市50岁及以上人群盲的流行病学调查

目的 了解昆明市50岁及以上人群盲和视力损伤的患病率和主要原因.方法 2006年4～8月在昆明市进行流行病学调查,采用多阶段抽样法抽取50岁及以上2760人,进行视力及眼部检查.根据小孔视力和WHO视力损伤标准(标准A)和日常生活视力标准(标准B)计算盲的患病率.结果 2588人接受检查(受检率为93.76%).盲患病率分别为3.17%(标准A)和3.67%(标准B).盲的主要原因分别为白内障(63.15%)、角膜病(14.74%)、青光眼(7.37%).结论 昆明市50岁及以上人群盲患病率相对较高,首位的致盲原因为白内障.     

宁夏银川市322例视力损伤患者特点及康复现状调查分析

目的 了解在宁夏残疾人康复中心进行视力残疾康复的银川市视力损伤人群的人口学和临床特点及助视器使用情况。设计 横断面研究。研究对象 收集在宁夏残疾人康复中心进行视力残疾康复的银川市患者资料共322例。方法 记录患者的性别、年龄、民族、受教育程度、视力、视力损伤的病因,视力损伤程度（分为轻度、中度、重度）和适配的助视器类型。主要指标 年龄、性别、视力损伤程度、视力损伤病因、助视器适配类型的构成比。结果 资料完整者322例,男性占56.2%,平均年龄（50.9±16.2）岁,40~69岁年龄段人数最多（65.2%）。其中中度视力损伤126例（39.1%）,重度视力损伤50例（15.5%）,盲146例（45.3%）。引起视力损伤最主要原因为病理性近视（16.5%）。助视器中非视觉性辅具应用最多（54.2%）。近用助视器使用（45.1%）多于远用助视器（0.7%）。最常用的近用助视器为手持式放大镜（35.9%）和眼镜式放大镜（32.3%）。结论 视力损伤患者多数为中老年人,主要病因为病理性近视。非视觉性辅具对患者日常生活有较大帮助。近用助视器的使用多于远用助视器。（眼科, 2017, 26： 135-138）     

Functional blindness and visual impairment in older adults from three communities.

PURPOSE: The purpose of this study is to examine the association of sociodemographic factors with functional blindness and visual impairment in an aged population. METHODS: Three population-based cohorts (East Boston, MA; New Haven, CT; and Iowa and Washington Counties, IA) of persons aged 71 years and older were screened for bilateral functional near and distant vision during an in-home interview in 1988. RESULTS: Screening was completed by 5335 participants. The prevalence of functional blindness increased with age, from 1% at age 71 to 74 years to 17% in those 90 years of age and older. Functional visual impairment increased from 7% at age 71 to 74 years to 39% in those 90 years of age and older. In multivariate analyses, residence in a nursing home, older age, glaucoma, insulin-requiring diabetes at baseline, East Boston site, history of cataract, and lower 1982 income were independent and significantly associated with both functional blindness and visual impairment. Age and nursing home residence were significantly (P < 0.05) more strongly associated with blindness (odds ratios 4.8 and 6.1, respectively) than they were with visual impairment. CONCLUSION: Functional blindness and visual impairment are quite prevalent among the oldest old and the institutionalized. The number of affected individuals will increase as the population ages and life expectancy increases. Although visual problems are associated with aging, nursing home residence, health problems, and socioeconomic conditions, they may be readily remediable and may lead to immediate improvements in quality of life.     

中国县级及以上医疗机构防盲工作开展情况调查分析

目的：:了解中国县级及以上医疗机构防盲工作的开展情况,为"十四五"时期中国防盲治盲和眼健康水平的全面提升提供参考依据。方法：:横断面调查研究。2015年对全国提供眼科服务的县级及以上医疗机构通过网上填报的方式进行普查,对中国不同地区、级别、类型和经营性质的医疗机构防盲工作情况进行对比统计分析。应用卡方检验对数据进行分析...     

A randomized trial of visual impairment interventions for nursing home residents: Study design,baseline characteristics and visual loss

Introduction Visual impairment among nursing home residents is higher than in community-dwelling elderly. The provision of eye care services may be beneficial to nursing home patients. Our project, a randomized trial of vision restoration and rehabilitation in nursing home residents, compares usual care to targeted interventions. In this paper, we present the baseline characteristics of our sample within the nursing homes. Methods Twenty-eight nursing homes on Maryland’s Eastern Shore were matched in pairs by size and payment type. Each pair was randomized to usual care or targeted intervention. Habitual and bestcorrected acuity was attempted, using standard letter symbol/charts and grating acuity charts. Visual impairment was vision in the better eye &lt;20/40 on letter and/or grating acuity. The MiniMental State Examination (MMSE) was used to determine cognitive impairment. Results Of those participants eligible to be screened, 40% had severe cognitive impairment (MMSE score 0-9). No measure of acuity could be ascertained on 18% of eligibles. Among the 1305 persons with acuity data, 38% had presenting vision worse than 20/40. After refractive correction, 29% had visual impairment. There was no difference by race or gender in those with visual impairment, although they were older, compared to those without visual loss. Conclusions The nursing home residents had high rates of both cognitive impairment and visual impairment, creating a challenging environment for visual intervention. By improving access to eye care within the context of the clinical trial, and changing either the magnitude of visual loss or the resultant impact on function, we hope to demonstrate a change in the quality of life for nursing home residents.     

Availability of eye care services in Missouri nursing homes.

PURPOSE: Residents of nursing homes do not have the same access to health care as do other elderly persons. Some sources have indicated that only 20% of nursing home residents in the United States ever receive eye care services in the nursing home. We sought to determine the availability of eye care services in Missouri nursing homes. METHOD: A survey was mailed to all licensed nursing homes in the State of Missouri (1,199). The survey inquired about the type of nursing facility, their location, and types of medical care and eye care provided at their institution. Information was also requested regarding the number of patients eligible for Medicare, Medicaid, and other third-party coverage. A 6-week period was allowed for responses. RESULTS: A response rate of 26.86% was obtained. Larger facilities were more likely to provide services than smaller facilities, and skilled nursing facilities were more likely to provide services than residential care facilities. Overall, 73% of the responding facilities provided some type of eye care services, as compared with 81% providing medical care. However, only 21% of nursing facilities have any type of regular schedule for provision of these services. Approximately 40% of the nursing homes without eye care services were interested in adding those services within a year, while half of those were not interested in adding them for their patients. CONCLUSIONS: Eye care services are available for many Missouri nursing home patients, but there is a lack of understanding as to how those services can be used. This can have considerable impact in meeting the health care needs of these patients, as well as enhancing the quality of life.     

Characteristics of a paediatric low vision population in a private eye hospital in India.

While private hospitals provide an important access point for low vision services for children in urban India, little is known about this service delivery route. A cross sectional survey was done of consecutive records of 220 children presenting at a newly opened paediatric low vision centre in a private eye hospital in Hyderabad. On presentation, 49% of the children were classified as moderately visually impaired, 31% were severely visually impaired and 20% were blind. The four major causes of visual impairment were the hereditary/genetic conditions of congenital glaucoma, hereditary macular degeneration, retinitis pigmentosa and albinism. Approach magnification was sufficient for required near tasks in all pre-school children and about 50% of school children. Provision of a distance refraction decreased the prevalence of severe visual impairment and blindness by 31%. The most commonly prescribed low vision devices were spectacles indicating a key role for optometry in the management of visual impairment in Indian children. Establishment of low vision clinics in existing Indian eye hospitals using associated optometric staff would be a cost effective method to minimise visual impairment in Indian children.     

Visual abilities of students with severe developmental delay in special needs education – a vision screening project in Northern Jutland,Denmark

Purpose: To investigate the visual abilities of students with severe developmental delay (DD) age 6–8 starting in special needs education. Methods: Between 1 January 2000 and 31 December 2008, we screened all students with severe DD starting in special needs schools in Northern Jutland, Denmark for vision. All students with visual acuities ≤6/12 were refractioned and examined by an ophthalmologist. Results: Of 502 students, 56 (11%) had visual impairment (VI) [visual acuity (VA) ≤ 6/18], of which 21 had been previously undiagnosed. Legal blindness was found in 15 students (3%), of whom three had previously been undiagnosed. Students tested with preferential looking systems (N = 78) had significantly lower visual acuities [VA (decimal) = 0.55] than students tested with ortho types [VA (decimal) = 0.91] and had problems participating in the colour and form tests, possibly due to cerebral VI. The number of students with decreased vision identified by screening decreased significantly during the study period (r = 0.724, p = 0.028). The number of students needed to be screened to find one student with VI was 24 and to identify legal blindness 181 needed to be screened. Conclusion: Visual impairment is a common condition in students with severe DD. Despite increased awareness of VI in the school and health care system, we continued to find a considerable number of students with hitherto undiagnosed decreased vision.     

Causes and frequency of blindness in patients with intraocular inflammatory disease.

AIMS/BACKGROUND: Uveitis, an intraocular inflammatory disease, is a significant cause of visual impairment. It is not known how many patients with uveitis will retain visual acuity and how many develop visual impairment or even blindness. The aim of this study was to assess the frequency of blindness in patients with uveitis and, more specifically, to identify the clinical profile of patients at risk for visual loss. METHODS: A cross sectional and retrospective study of 582 patients with uveitis who visited the ophthalmology departments of two university hospitals in the Netherlands was performed. RESULTS: Within the group of 582 patients, 203 (35%) exhibited blindness or visual impairment; bilateral legal blindness developed in 22 (4%) patients, 26 (4.5%) had one blind eye with visual impairment of the other, and nine (1.5%) had bilateral visual impairment. Unilateral blindness developed in 82 (14%) patients, whereas 64 (11%) exhibited unilateral visual impairment. The most important cause of both blindness and visual impairment was cystoid macular oedema (29% and 41%, respectively). Complications of uveitis were encountered in more than half of the patients and 23% underwent one or more surgical procedures. When the patients were subdivided according to anatomical site, those with panuveitis had the worst visual prognosis. The systemic diseases associated with a poor visual prognosis were juvenile chronic arthritis and sarcoidosis. Ocular toxoplasmosis was the most frequent cause of unilateral visual loss. CONCLUSIONS: Cystoid macular oedema is the most frequent complication of uveitis and its occurrence plays a decisive role in the visual outcome of this disease.     

Evaluation of moderate and severe visual impairments in patients attending an ophthalmology clinic. A prospective study of 1,172 patients

PURPOSE: Data on blindness and visual impairment in patients attending ophthalmology clinics at the Orleans regional hospital center serving a semi-rural area in France were prospectively studied to examine prevalence of visual impairment. MATERIAL AND METHODS: Clinical data on 1,172 consecutive and different patients attending the ophthalmology department during half-days over a 3-month period were collected and analyzed using a computerized system. RESULTS: Prevalence of visual impairment (20/30 or less in the better eye) was 3% in subjects under 60 years of age and rose to 13.7% and 35.9% for patients in the 60-79 age range and over 80 years respectively. For patients under 60, the prevalence of severe visual impairment (20/200 or less in the better eye) was 1.2% and rose dramatically in older patients: 5.8% and 14.6% in the 60-79 year old patients and the over 80 patients respectively. There was no significant difference in the prevalence of visual impairment by sex. Leading causes of severe visual impairment among patients aged 60 years or older were macular degeneration (40%), diabetic retinopathy (16.6%) and cataract (13.3%). The prevalence of irreversible severe visual impairment was 7.4% among patients 60years of age or older. CONCLUSION: A large number of patients attending our ophthalmology clinic have severe visual impairment, particularly those over 60 years of age. Our findings are comparable with extrapolations for population-based studies in English speaking countries and can be used to evaluate the prevalence of visual impairment in French rural areas. As the population ages, need for eye health care becomes more and more evident. It is important to organize systematic visual examination in subjects aged 70 to 80 years and to implement educational programs as part of local national health care policies for helping the visually impaired.