上海市盲校学生病因及视力调查分析

目的通过对上海盲校学生病因及视力调查分析,为防治儿童盲提出依据。方法对盲校224名学生进行矫正视力、裂隙灯、眼底镜、眼压等眼部检查,并对病因和视力进行分析。结果224例盲校学生中97例为盲,低视力97例,矫正视力≥0.3者30例。第1位致盲眼病是早产儿视网膜病变(retinopathyofprematurity,ROP)占32.99%;低视力病因中第1位为先天性白内障术后无晶状体占21.65%;124例患屈光不正学生中配戴矫正眼镜54例。结论上海盲校学生中ROP已成为第1位致盲性眼病,提示建立ROP筛查网络和开展综合防治的重要性。先天性白内障、青光眼的早期诊断和治疗,提高手术成功率及屈光不正儿童的早期验光配镜对于防治儿童盲是十分重要的。     

泉州市盲校学生视力损伤病因

目的：探讨泉州市盲校学生视力损伤的病因及残余视力的情况。方法：横断面研究。在2016 年期间对泉州盲校126 名低视力和盲学生进行病史采集,应用眼科常规检查方法对其行全面的眼科检查,并对学生的主要病因进行诊断和分析。结果：60 名盲学生的病因中：早产儿视网膜病变居第1 位,占23.3%（14 例）,角膜变性和视神经萎缩均列第2 位,各占13.3%（8 例）,第4 位为先天性青光眼占11.7%（7例）。66名低视力学生的病因中,先天性白内障居首位,占27.3%（18例）,眼球震颤为第2位,占13.7%（9 例）,视神经萎缩为第3 位,占10.6%（7 例）,角膜变性为第4 位,占9.1%（6 例）。结论：泉州市盲校的126 名学生中,先天性或遗传性疾病是导致视力损伤的主要原因,早产儿视网膜病变是致盲的首要病因,而先天性白内障是导致低视力的主要原因。     

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。     

上海市盲童学校学生视力状况及致盲原因调查分析

目的 调查上海市盲童学校（以下简称盲校）儿童视力状况及致盲原因,为防治儿童盲提 供依据.方法 横断面研究.根据世界卫生组织防盲计划（WHO/PBL）儿童盲与低视力检查记录表和工作手册自制调查表,于2010年4月对上海市盲校163名学生进行调查,采用标准对数视力表检查裸眼远视力和最佳矫正远视力,部分儿童辅以电脑验光和主觉验光;采用裂隙灯和眼底镜进行眼前段和眼底检查.数据录入后,按WHO/PBL标准定义进行视力损害分级,并分析盲和严重视力损害的原因.对数据进行分类计数,求百分比.结果 163名盲校儿童中,盲89人（54.6％）,严重视力损害者32人（19.6％）,一般视力损害者35人（21.5％）,视力无损害者7人（4.3％）.盲及严重视力损害儿童致盲主要原因为先天性和遗传性因素（37.2％）,致盲首要解剖部位为视网膜（41.3％）,首要病因是早产儿视网膜病变（ROP）（18.2％）.可避免性盲64例（52.9％）,其中可预防盲29例（24.0％）,可治疗性盲35例（28.9％）.导致一般视力损害的主要病因是先天性白内障（15例,42.9％）.结论 上海市盲校儿童盲和严重视力损害儿童致盲原因构成已与其他发达国家和地区相似,ROP是主要致盲原因,建议加快建立健全ROP筛查与诊治网络,并大力推进低视力康复工作.     

陕西省盲校盲童致盲原因调查分析

目的:了解陕西省儿童盲和严重视力损害的原因,以确定潜在的可预防性和可治疗性因素。方法:参照世界卫生组织儿童视力障碍检查法,2004-06对陕西省某盲校33名盲童的盲及低视力情况进行调查,分析其致盲原因。结果:33名盲童中2名为严重视力损害(6.06%),31名为盲(93.94%)。最常见致盲解剖部位依次为视网膜(36.37%)、青光眼(24.24%)、晶状体(15.15%)、视神经(9.09%)、角膜(9.09%)和全眼球(6.06%)。先天和遗传因素为盲校学生致盲致残的主要原因,占90.91%;后天性占9.09%。视网膜色素变性、先天性青光眼和先天性白内障等为主要原因,占先天因素的70%。可避免性盲16例(48.48%),其中可预防者3例(9.09%),可治疗性者13例(39.39%)。结论:营养性和感染性致盲已较少见,先天和遗传性因素是目前陕西省儿童盲的主要原因。     

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。     

长沙市盲校学生视力调查及致盲原因分析

目的探讨儿童致盲原因及早期防治的重要性,为防治儿童盲或低视力提供有效的对策。方法采用常规眼科检查方法对长沙市82名盲校学生进行全面检查,包括视力、眼前节、眼位、眼底检查,以表格问卷形式调查盲童出生史、家族及父母眼病史,既往患病史（外伤、高热及其他全身病史）。结果致盲原因中以先天性遗传性眼病为主,占74．39％,其中包括先天性白内障、先天性青光眼、先天性视神经萎缩、视网膜病变;其次为眼外伤,占16．43％;其他高热脑炎后占9．58％。视力〈0．02-无光感为35例,占42．68％;残余视力≥0．02者47例,占57．32％。结论长沙市盲校学生致盲原因中,先天性遗传性眼病占第一位,眼外伤占第二位。揭示儿童盲的防治必须从胎儿期开始,预防为主,正确及时治疗先天性眼病极为重要,同时应高度重视眼外伤的预防和治疗。     

华东地区七所盲校儿童致盲原因调查

目的 调查盲校≤16岁盲童盲目和严重视力损害的解剖部位及原因。以确定潜在的可预防性和可治疗性因素。方法 采用世界卫生组织防盲计划儿童盲及低视力眼检查记录表,对1998年4月至1999年5月间华东地区7所盲校385例年龄≤16岁盲童盲目及低视力进行调查,并分析其致盲原因。结果 385例盲童盲目和严重视力损害356例（92.5%)。最常见致盲解剖部位集资为晶状体98例（27.5%),视网膜80例（22.5%)。眼球54例（15.2%)及视神经53例（14.9%)。致盲眼病依次为：白内障94例（26.4%)。视网膜营养障碍38例（10.7%)及视神经发育不良30例（8.4%)等,致盲原因依次为：遗传性因素125例（35.1%),脑膜炎19例（5.3%)。外伤10例（2.8%),维生素A缺乏2例（0.6%)及麻疹3例等（0.8%),因母孕期服用药物或酗酒所致者22例（6.2%)。早产儿性视网膜病变10例（2.8%)。因维生素A缺乏或感染所致的角膜瘢痕并非为主要的致盲因素。可避免性盲169例（47.5%),其中可预防性盲82例（23.0%)。可治疗性盲87例（24.4%)。结论 遗传性因素是目前盲童的主要致盲原因。     

社区中老年人群致盲与低视力眼病调查

目的 了解社区中老年人群盲与低视力的情况.方法 根据北京市西长安街社区居委会人口登记,采用逐户上门登记的方法确认被调查者的资格.对待检者2 833人应用问卷调查法询问被调查者的一般状况和生活习惯.对目标受检者进行裸眼视力、小孔视力、非接触眼压测量、裂隙灯检查、检眼镜检查、自动验光仪验光等.采用WHO推荐标准对受检人群盲及低视力结果进行评估,对目标受检人群致盲和低视力的原因进行分析.结果 登记50岁以上人口数2 833人,实际调查人数为2 410人,受检率为85.07%.该社区50岁及以上人群盲的患病率为0.79 %,低视力的患病率为5.64%.导致盲的首要病因是白内障,其次是青光眼和视网膜病变.导致低视力的首要病因是白内障,其次是屈光不正和糖尿病视网膜病变(DR).结论 北京市西城区西长安街社区≥50岁人群防盲及改善低视力工作的重点是白内障、青光眼、DR及屈光不正的早期诊断和治疗.     

太原市盲校学生视残病因及视力分析

目的:探讨太原市盲校学生视残原因并对其视力作出相应分析,为防治儿童盲提出依据,对该盲校盲童及低视力分班教学可行性进行评估。方法:应用眼科常规检查方法对太原市盲校学生进行全面的眼科检查,全部视力检查结果均为矫正视力,对调查结果进行分析评估。结果:视残主要致病因素为先天性/遗传因素,占总例数的69.9%。前3位病因分别为先天性小角膜小眼球、先天性白内障、先天性眼球震颤。盲校中有可利用残余视力者占总例数的50.4%。结论:先天性眼球异常和遗传性疾病是导致儿童视残的主要原因,考虑是由遗传、先天或围产期的原因所致。对目前尚无法治疗的先天性眼球异常应着重预防,对可治性先天性白内障及先天性青光眼,应不断提高两种常见儿童致盲眼病的手术成功率。盲校中可利用残余视力者超过总例数的1/2,说明盲校的低视力分班教学十分必要。     

Causes of severe visual impairment and blindness in children attending schools for the visually handicapped in the Czech Republic

AIMS: To describe the causes of severe visual impairment and blindness in children in schools for the visually handicapped in the Czech Republic in 1998. METHODS: Pupils attending all 10 primary schools for the visually handicapped were examined. A modified WHO/PBL eye examination record for children with blindness and low vision was used. RESULTS: 229 children (146 males and 83 females) aged 6-15 years were included in the study: 47 children had severe visual impairment (20.5%) (visual acuity in their better eye less than 6/60), and 159 were blind (69.5%) (visual acuity in their better eye less than 3/60). Anatomically, the most affected parts of the eye were the retina (124, 54.2%), optic nerve (35, 15.3%), whole globe (25, 10.9%), lens (20, 8.7%), and uvea (12, 5.2%). Aetiologically (timing of insult leading to visual loss), the major cause of visual impairment was retinopathy of prematurity (ROP) (96, 41.9 %), followed by abnormalities of unknown timing of insult (97, 42.4%), and hereditary disease (21, 9.2%). In 90 children (40%), additional disabilities were present: mental disability (36, 16%), physical handicap (16, 7%), and/or a combination of both (19, 8%). It was estimated that 127 children (56%) suffer from visual impairment caused by potentially preventable and/or treatable conditions (for example, ROP, cataract, glaucoma). CONCLUSIONS: Establishing a study group for comprehensive evaluation of causes of visual handicap in children in the Czech Republic, as well as for detailed analysis of present practice of screening for ROP was recommended.     

Causes and temporal trends of childhood blindness in Indonesia: study at schools for the blind in Java

AIMS: To ascertain the causes of blindness and severe visual impairment (BL/SVI) in schools for the blind in Java, to identify preventable and treatable causes and to evaluate temporal trends in the major causes. METHODS: From a total of 504 students, 479 were examined. Data was collected using a modified World Heath Organization Prevention of Blindness (WHO/PBL) eye examination record for children. RESULTS: The majority of the students (95%) were blind and 4.6% were severely visually impaired. The major anatomical site of BL/SVI was whole globe in 35.9%, retina in 18.9%, lens in 16.4% and cornea in 16.1%. The major underlying aetiology of BL/SVI was undetermined/unknown in 32.7% (mainly microphthalmia, anterior segment dysgenesis and cataract), hereditary factors 31.9% (mainly retinal dystrophies), and childhood disorders 28.5%. Avoidable causes of BL/SVI accounted for 59.9% of the total students, whereas measles blindness was the underlying condition for 23.1% of the preventable causes; cataract and glaucoma accounted for 15.5% and 8.2% of the treatable causes, respectively. Exploration on trends of SVI/BL among two different age groups <16 years and > or = 16 years suggested that childhood disorders and corneal factors have declined, while hereditary disorders have increased. Optic nerve disorder, although not counted as a major cause of blindness, seems to be on the increase. CONCLUSIONS: More than half of the BL/SVI causes are potentially avoidable. Cataract and corneal disorders related to measles or vitamin A deficiency were the major treatable and preventable causes. Declining proportions of childhood factors and corneal disorders over a period of 10-20 years could reflect improved vitamin A supplementation and measles vaccination coverage in Indonesia. This finding, and the increased proportion of hereditary disease causes, could suggest improving levels of socioeconomic development and health care services.     

Evaluation of children in six blind schools of Andhra Pradesh

PURPOSE: 1. To determine the anatomical site and underlying causes of severe visual impairment and blindness in children in special education in Andhra Pradesh, India. 2. To compare the causes of blindness in two different regions in the state. 3. To evaluate improvement with correction of refractive error and low-vision devices (LVDs). METHODS: Children in 6 schools for the blind and in 3 integrated education programmes were examined by one ophthalmologist, and were refracted and assessed for LVDs by an optometrist. The major anatomical site and underlying aetiology of severe visual impairment and blindness (SVI/BL; < 6/60 in the better eye) were recorded using the standardised WHO reporting form. RESULTS: Two hundred and ninety one students under 16 years were examined, and after refraction, 267 (91.7%) were classified as being severely visually impaired or blind. The most common anatomical sites of SVI/BL were retina in 31.1% children; cornea in 24.3%; and whole globe in 20.2%. The aetiology was unknown in 38.2%, hereditary in 34.8% and childhood causes in 24%. 114 children (39.2%) had functional low vision (i.e. visual acuity < 6/18 to light perception with navigational vision). In this group, 36 children improved with spectacles and 16 benefited by LVDs. 41 children (15.4%) were able to read N10 point though they were studying Braille. CONCLUSION: Overall 37.4% of children had "avoidable" causes of blindness. The major avoidable causes were vitamin-A deficiency and cataract. Vitamin-A deficiency and congenital anomalies were more common in the dry plateau areas of the state. One in seven children could read normal print with optical support.     

Causes of blindness at the "Wiyata Guna" School for the Blind,Indonesia

AIM: To determine the anatomical site and patterns of cause of blindness in one of the biggest schools for the blind in Indonesia with a view to determining potentially preventable and treatable causes. METHODS: 165 students in one school for the blind in Bandung, Indonesia, were examined clinically and data reported using the WHO/PBL childhood blindness assessment form. RESULTS: Most of the students (96.4%) were blind (BL); 3% were severely visually impaired (SVI). The major causes of SVI/BL in this study were: (1) corneal staphyloma, corneal scar, and phthisis bulbi (mainly attributed to infection) in 29.7%; (2) retinal dystrophies (mainly Leber congenital amaurosis, early onset retinitis pigmentosa) in 20.6%; (3) congenital and familial cataract (13.3%); (4) microphthalmus, anophthalmus (10.9%). The whole globe was the major anatomical site of visual loss (32.7%), followed by the retina (26.0%), cornea (17.6%), lens (13.3%), optic nerve (6.1%), and uvea (4.3%). CONCLUSIONS: This is a small study in a selected population and the results should be interpreted with caution. This blind school study, adopting the WHO/PBL eye form for data analysing, is the first reported for Indonesia. Hereditary disease and infective causes of blindness are the predominant causes of blindness, accounting for 42.4% and 29.7%, respectively. This pattern of causes is a mixed pattern which lies in an intermediate position between the patterns seen in developing countries and those seen in developed countries. The importance both of preventive public health strategies and of specialist paediatric ophthalmic and optical services in the management of childhood blindness in Indonesia are therefore strongly suggested to cover the problems that exist.     

The Pattern of Childhood Blindness in Karnataka,South India

ABSTRACT

Purpose: To determine the causes of severe visual impairment and blindness in children in schools for the blind in southern Karnataka state of India. Method: Children aged less than 16 years with a visual acuity of < 6/60 in the better eye, attending the residential schools for the blind were examined in 2005–2006, in the Karnataka state in the south of India. History taking, visual acuity estimation, external ocular examination, retinoscopy, and fundoscopy were done on all students. Refraction and low vision work-up done where indicated. The anatomical and etiological causes of severe visual impairment (< 6/60–3/60) and blindness (< 3/60 in the better eye) were classified using the World Health Organization's prevention of blindness programs' record system. Results: A total of 1,179 students were examined, 891 of whom fulfilled the eligibility criteria. The major anatomical sites of visual loss were congenital anomalies (microphthalmos, anophthalmos) (321, 35.7%), corneal conditions (mainly scarring due to vitamin A deficiency, measles, trauma) (133, 14.9%), cataract or aphakia in 102 (11.4%), and retinal disorders (mainly dystrophies) in 177 children (19.9%). Nearly one-fourth of children were blind from conditions which could have been prevented or treated (27.8%), 87 of whom were referred for surgery. Low vision devices improved near acuity in 27 children (3%), and 43 (4.8%) benefited from refraction. Conclusions: Congenital anomalies, cataract, and retinal conditions account for most of the blindness in children.