创建防盲先进县推动浙江省防盲治盲工作

目的 探讨创建防盲先进县的经验。方法 收集1996—1998年浙江省20个县(市)防盲治盲资料,以“全国防盲先进县标准”为依据对其进行汇总分析。结果 创建防盲先进县的有效方法是：将防盲治盲工作列入政府工作的议事日程,争取有关部门的高度重视与积极配合;建立防盲指导组;健全三级防盲治盲网络;培训防盲技术人员,配备必要眼科设备。20个县(市)中,经逐级检查验收,7个县(市)成为卫生部审批的全国防盲先进县,其中绍兴市成为全国防盲先进市。13个县(市)虽未达标,但仍做了大量的防盲治盲工作,推动了全省防盲工作的开展。全省1996-1998年白内障复明手术每年达2万例,眼科医师的数量由602人增加至1850人,裂隙灯与手术显微镜等眼科设备成倍增加。结论创建全国防盲先进县是推动防盲治盲工作的有效措施。     

我国防盲与眼科流行病学研究的现状及发展

2005年以来的时期是我国防盲与眼科流行病学研究进展最显著的一个时期.全国眼病和视力残疾人抽样调查发现白内障(56.7%)、视网膜葡萄膜病(14.1%)和角膜病(10.3%)是目前我国盲和视力损伤的主要原因."视觉第一中国行动"二期、"百万贫困白内障患者复明工程"等重大防盲项目已取得巨大成就.2005年至2009年我国共施行了387.1万白内障复明手术,2009年百万人口白内障手术率达到796.2.全国已建成白内障无障碍县673个、无障碍市70个、无障碍省(自治区)2个.近5年已为175 501例低视力患者验配了助视器,为47 009例盲人提供了定向行走训练.初级眼保健和沙眼、糖尿病视网膜病变的防治也取得了一定成果.5年来,虽然基本完成了国家防盲任务,但远未达到"视觉2020"行动的目标要求,特别是还存在白内障手术率仍然偏低、主要致盲性眼病并未根治;流行病学研究缺少创新性、深度和广度不够等问题.今后,应切实把握好眼科流行病学的良好发展趋势,开展原创造性和分子流行病学研究;还应整合包括初级眼保健在内的各级眼保健力量,"高质量、低价格"地开展白内障、视网膜病、角膜病、沙眼、屈光不正、低视力、青光眼等防盲工作,争取早日达到"视觉2020"根治我国可避免盲的宏伟目标.     

在新形势下继续推进我国的防盲治盲工作

目前我国的防盲治盲工作正处于有利的时期,取得了一些重要进展。近5年来,我国实施了一系列的防盲治盲项目,白内障手术率显著提高;我国正在进行的医药卫生体制的改革有利于深入持久地开展防盲治盲工作;我国已有较好的条件和足够的技术力量来开展白内障复明手术为主的防盲治盲工作。但是,防盲治盲依然是我国眼科界面临的巨大挑战。我国盲和视力损伤的状况还没有从根本上得到改善,根治白内障盲的进展缓慢。因此,应当进一步推进我国防盲治盲工作,包括进一步提高对防盲治盲工作的认识,加强眼病防治和防盲治盲的网络建设,做好眼病的预防和控制工作,以及加强防盲治盲的科研工作。     

江苏省初级眼保健与防盲的调查研究

目的了解江苏省农村基层的眼保健与防盲工作状况。设计横断面调查研究。研究对象江苏省13个全国防盲先进县的34个乡76个村。方法对上述乡、村的防盲治盲人员、职责、业务、设备进行检查、评估,并作统计分析。主要指标按卫生部标准所规定的乡村初级眼保健与防盲的各项指标。结果所有乡、村达到或超过了卫生部颁布标准中有关组织网络、职责、设备指标。约50％的乡、村达到或超过了卫生部颁布标准规定的常见眼病的诊疗技术要求。部分乡、村存在统计报表不准确、白内障手术方法落后等不足。结论江苏省防盲先进地区的农村基层眼保健与防盲工作基本达到了卫生部颁布标准,但业务水平有待提高。(眼科,2006,15：355-358)     

我国防盲治盲工作的进展

进入新世纪以来,我国继续将白内障盲的手术治疗作为防盲治盲的重点。全球最大的防盲项目“视觉第一中国行动”取得了重大成效。1997年至2001年的5年内施行了206万例白内障复明手术,实现了我国每年白内障手术数超过了白内障盲新发人数40万例的历史性转变。地方各级政府积极组织开展防盲治盲工作。白内障手术率明显提高。眼病流行病学研究取得了新的进展。目前防盲治盲中存在的最主要问题是根治白内障盲的进展缓慢,这是我国防盲治盲工作发展过程中的问题,是可以解决的。     

防盲治盲依然是我国眼科界面临的巨大挑战

近5年来,我国防盲治盲取得了重大进展.但是,我国盲和视力损伤的状况还没有从根本上得到改善.2006年第2次全国残疾人抽样调查结果表明,我国视力残疾的患病率为1.53%.以此推算,我国视力残疾的人数达2003.5万人.导致视力残疾的主要原因是白内障.我国根治白内障盲的进展缓慢,白内障手术率仍然相当低.如果不努力抓好防盲治盲工作,我国有可能不能实现"视觉2020"行动的目标.防盲治盲依然是我国眼科界面临的巨大挑战.目前,我国已经为进一步开展防盲治盲工作创造了一些有利的条件.我国已有大量开展防盲治盲的人力、财力资源;医疗卫生体制的改革有利于防盲治盲工作的开展;我国眼科事业的发展已经能够为防盲治盲提供足够的技术力量.在防盲治盲的实际中,我国眼科界还面临着探索建立持续、高效的防盲治盲机制的任务.最近我国实施的"百万贫困白内障患者复明工程"项目是我国防盲治盲工作中里程碑式的重大事件,必将加速推进我国的防盲治盲工作.     

北京市顺义区防盲治盲十八年

目的 探讨城市三级医院和医疗研究机构如何与基层卫生单位合作,创建防盲治盲模式单位,降低盲目患病率的经验。方法 北京协和医院眼科与北京市顺义区卫生局合作,开展防盲治盲项目,干预对象为北京市顺义区居民。防盲治盲措施：(1)于1984年进行眼病流行病学调查;(2)实施防盲治盲项目,重点开展白内障盲人的手术治疗;(3)评价1996年防盲治盲项目;(4)针对防盲治盲工作中存在的主要问题,改进工作,提高工作效率和手术质量。结果 参与单位发挥各自优势,密切合作,使北京市顺义区防盲治盲工作逐步深入、普及。1984年眼病流行病学调查基本上摸清了北京市顺义区眼病的现状。在1987年开始实施的防盲治盲项目中,建立县、乡、村三级初级眼保健网,建立发现和治疗白内障盲人的转诊系统。1996年防盲治盲项目评价表明,在人口增加及老龄化趋势加重的情况下,持续开展防盲治盲工作可降低盲目的患病率。结论 城市三级医院和医疗研究机构与基层卫生单位及科研工作与防盲治盲工作密切结合,可促进防盲治盲工作的深入和普及,逆转盲人增加的趋势。     

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.     

防盲治盲依然是我国眼科界面临的巨大挑战

近5年来,我国防盲治盲取得了重大进展.但是,我国盲和视力损伤的状况还没有从根本上得到改善.2006年第2次全国残疾人抽样调查结果表明,我国视力残疾的患病率为1.53%.以此推算,我国视力残疾的人数达2003.5万人.导致视力残疾的主要原因是白内障.我国根治白内障盲的进展缓慢,白内障手术率仍然相当低.如果不努力抓好防盲治盲工作,我国有可能不能实现"视觉2020"行动的目标.防盲治盲依然是我国眼科界面临的巨大挑战.目前,我国已经为进一步开展防盲治盲工作创造了一些有利的条件.我国已有大量开展防盲治盲的人力、财力资源;医疗卫生体制的改革有利于防盲治盲工作的开展;我国眼科事业的发展已经能够为防盲治盲提供足够的技术力量.在防盲治盲的实际中,我国眼科界还面临着探索建立持续、高效的防盲治盲机制的任务.最近我国实施的"百万贫困白内障患者复明工程"项目是我国防盲治盲工作中里程碑式的重大事件,必将加速推进我国的防盲治盲工作.     

中国防盲进展概况

为响应ＷＨＯ提出的“到２０００年人人都享有看见的权利”这一战略性口号，在我国广泛地开展了防盲治盲及将初级卫生眼保健纳入初级卫生保健网的工作并取得了可喜的成绩，本文就我国防盲进展情况作一介绍。     

Points of action in the campaign against blindness in developing countries

This article provides a survey of the problems of prevention of blindness in developing countries. The World Health Organization estimates that 31 million people are blind and 15 million people partially-sighted. The main cause of blindness is cataract. Other causes are trachoma, glaucoma, xerophthalmia, river blindness, corneal scars and leprosy. Prevention or treatment of these causes is possible in more than 80% of cases. The number of blind persons, however, is still increasing due to the increase in population and the immense shortage of all kinds of ophthalmological equipment and personnel. An effective strategy for the prevention of blindness in developing countries should focus on: more cheap cataract operations, increasing teaching facilities for ophthalmic personnel, integration of ophthalmic care into the general health system and the promotion of blindness prevention in political organizations.     

甘肃省平凉市崆峒区人群盲和低视力现况调查

目的:探讨与了解甘肃省平凉市崆峒区人群盲与低视力的患病率及致病原因。方法:应用横断面研究的流行病学调查方法,以村(社区)为基础,采用随机整群抽样原则抽取6个乡镇2个街道办事处作为调查地点。采用世界卫生组织制定的盲与低视力标准,对全区按0.719%抽样比例抽取样本进行盲与低视力的流行病学调查。结果:检录3235例中,受检人数为2801例,受检率为86.58%,双眼盲21例,盲率为0.75%(男0.59%,女0.91%);双眼低视力125例,低视力患病率为4.46%(男3.73%,女5.16%),≥60岁以上盲与低视力患者的患病率明显增高。致盲病因前三位的眼病依次为白内障(47.62%)、角膜病(14.29%)、青光眼(14.29%)。结论:崆峒区人群中盲和低视力的眼病以白内障居首位,因此手术治疗白内障仍是今后防盲治盲工作的首要任务。     

Outcome and number of cataract surgeries in India: policy issues for blindness control

Purpose: To assess what impact attention to quality of cataract surgery and postoperative follow up can have on cataract blindness in India, and to estimate the number of surgeries needed to eliminate cataract blindness in India. Methods: In a population‐based sample of 5268 persons in two rural areas in the state of Andhra Pradesh, India, data on the visual outcome of cataract surgery were obtained on 129 eyes of 106 persons operated previously. These were compared with the visual outcome of cataract surgery performed during 1999 in 2394 eyes of 2213 persons at two new rural eye centres set up in these areas that pay particular attention to the quality of eye care. Blindness in an eye was defined as presenting distance visual acuity less than 6/60, and in a person as this acuity level in the better eye. These data were extrapolated to India. Results: In the population‐based sample, of the 129 operated eyes, 51 (39.5%) were blind after surgery, which included 41 (31.8%) from cataract surgery‐related causes. Of the 106 persons in the population sample who had had cataract surgery in one or both eyes, 26 (24.5%) were still blind. In contrast, for the cataract surgery at the two rural eye centres paying attention to quality, 3.1% of the eyes and 1.8% of the persons were blind soon after surgery, but these figures could increase 2.6 times over the lifetime of these persons. The 3.5 million cataract surgeries in India in 2000 are estimated to result in 0.32 million persons having blindness averted over their lifetime. To eliminate cataract blindness in India, an estimated 9 million good‐quality cataract surgeries are needed every year during 2001?2005, increasing to over 14 million surgeries needed every year during 2016?2020 on persons most likely to go blind from cataract. Conclusions: The number of persons in whom blindness is being averted due to cataract surgery in India is currently a very small fraction of the number blind from cataract. If adequate attention is given to the quality of eye care, for the current number of cataract surgeries in India it should be possible to increase by threefold the number in whom blindness can be averted with cataract surgery. In addition to improving quality, the annual number of cataract surgeries has to be at least threefold the current number during 2006?2010 if cataract blindness in India is to be eliminated.     

Blindness and low vision in Cape Verde Islands: results of a national eye survey

AIMS: Prior to establishing a national prevention of blindness program a population based survey was conducted in Cape Verde Islands in1998. The objectives of the survey were to estimate the overall and age-specific prevalence of blindness and low vision, to identify the main disorders causing blindness and low vision, and to estimate the population need for basic eye care services. METHODS: A two-level cluster random sampling procedure was used, selecting 30 clusters from the nine inhabited islands and 3,803 persons of all ages were included in the sample. RESULTS: 3,374 persons were examined (coverage 88.7%). The prevalence of bilateral blindness (visual acuity in the better eye less than 3/60) was 0.8% (95% confidence interval [CI] 0.5-1.1), of bilateral low vision (6/18 to 3/60 in the better eye) 1.7% (95% CI: 1.3-2.2) and of monocular blindness 1.5% (95% CI: 1.2-2.0). The major causes of blindness were age related cataract and glaucoma (57.7% and 15.4%, respectively, of blind people recruited). The major causes of bilateral low vision were cataract, refractive errors, and macular disorders (46.2%, 26.8%, and 8.9%, respectively, of persons with low vision). Nontrachomatous corneal opacities accounted for 7.7% of bilateral and for 11.5% of monocular blindness. Vascular retinopathy was responsible for 7.7% of bilateral and for 9.6% of monocular blindness. Trachoma is not a public health problem as only 2.3% of children less than 10 years of age were suffering from active trachoma. Palpebral or limbal vernal conjunctivitis were encountered in 4.5% of persons under 25. CONCLUSION: More than half of the visual impairments are treatable by provision of cataract surgery and cataract has been indicated as a priority target in the recently designed National Blindness Program of the Cape Verde Republic. Pathologic conditions such as diabetes are emerging as serious burden for ageing populations and account for most of the retinal vascular disease.     

Blindness and Low Vision in Cape Verde Islands: Results of a National Eye Survey

Aims: Prior to establishing a national prevention of blindness program a population based survey was conducted in Cape Verde Islands in1998. The objectives of the survey were to estimate the overall and age-specific prevalence of blindness and low vision, to identify the main disorders causing blindness and low vision, and to estimate the population need for basic eye care services. Methods: A two-level cluster random sampling procedure was used, selecting 30 clusters from the nine inhabited islands and 3,803 persons of all ages were included in the sample. Results: 3,374 persons were examined (coverage 88.7%). The prevalence of bilateral blindness (visual acuity in the better eye less than 3/60) was 0.8% (95% confidence interval [CI] 0.5–1.1), of bilateral low vision (6/18 to 3/60 in the better eye) 1.7% (95% CI: 1.3–2.2) and of monocular blindness 1.5% (95% CI: 1.2–2.0). The major causes of blindness were age related cataract and glaucoma (57.7% and 15.4%, respectively, of blind people recruited). The major causes of bilateral low vision were cataract, refractive errors, and macular disorders (46.2%, 26.8%, and 8.9%, respectively, of persons with low vision). Nontrachomatous corneal opacities accounted for 7.7% of bilateral and for 11.5% of monocular blindness. Vascular retinopathy was responsible for 7.7% of bilateral and for 9.6% of monocular blindness. Trachoma is not a public health problem as only 2.3% of children less than 10 years of age were suffering from active trachoma. Palpebral or limbal vernal conjunctivitis were encountered in 4.5% of persons under 25. Conclusion: More than half of the visual impairments are treatable by provision of cataract surgery and cataract has been indicated as a priority target in the recently designed National Blindness Program of the Cape Verde Republic. Pathologic conditions such as diabetes are emerging as serious burden for ageing populations and account for most of the retinal vascular disease.     

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     

云南省个旧市盲人调查和治疗

目的