Blindness in the Indian state of Andhra Pradesh

PURPOSE: To determine the current prevalence and causes of blindness in the Indian state of Andhra Pradesh to assess if blindness has decreased since the last survey of 1986-1989. METHODS: A population-based epidemiology study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India. Participants of all ages (n = 10,293), 87.3% of the 11,786 eligible, from 94 clusters in one urban and three rural areas representative of the population of Andhra Pradesh, underwent interview and a detailed dilated ocular evaluation by trained professionals. Blindness was defined as presenting distance visual acuity < 6/60 or central visual field < 20(o) in the better eye. RESULTS: Two hundred seventy-five participants were blind, a prevalence of 1.84% (95% confidence interval, 1.49%-2.19%) when adjusted for the age, sex, and urban-rural distribution of the population in 2000. The causes of this blindness were easily treatable in 60.3% (cataract, 44%; refractive error, 16.3%). Preventable corneal disease, glaucoma, complications of cataract surgery, and amblyopia caused another 19% of the blindness. Blindness was more likely with increasing age and decreasing socioeconomic status, and in female subjects and in rural areas. Among the 76 million population of Andhra Pradesh, 714,400 are estimated to have cataract-related blindness (615,600 cataract, 53,200 cataract surgery-related complications, 45,600 aphakia), and 228,000 refractive error-related blindness (159,600 myopia, 22,800 hyperopia, 45,600 refractive error-related amblyopia). If 95% of the cataract and refractive error blindness in Andhra Pradesh had been treated effectively, 3.4 and 7.4 million blind-person-years, respectively, could have been prevented. If 90% of the blindness due to preventable corneal disease and glaucoma had been prevented, another 2.7 million blind-person-years could have been prevented. CONCLUSIONS: The prevalence of blindness in this Indian state has increased from 1.5% in the late 1980s to 1.84% currently, as against the target of the National Program for Control of Blindness to reduce the prevalence to 0.3% by 2000. The number of people with cataract-related blindness has not reduced even with the eye care policy focus on cataract. Reduction of blindness in India will require strategies that are more effective than those that have been pursued so far.     

Relationship between vision impairment and eye disease to vision-specific quality of life and function in rural India: the Aravind Comprehensive Eye Survey

PURPOSE: To determine the impact of vision impairment and eye diseases on vision-specific quality of life and visual function in an older population of rural southern India. METHODS: Presenting and best-corrected visual acuity and burden of eye diseases were determined in a population aged 40 years and older, identified through a random cluster sampling strategy from 50 villages of rural south India. A questionnaire validated previously for use in this population was used to ascertain quality of life and visual function. Visual acuity measurements were obtained with illiterate E Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Cataract was graded and defined based on the Lens Opacities Classification System (LOCS) III. Macular degeneration was defined based on the classification system proposed by the International ARM Epidemiologic Study Group. Glaucoma was defined based on results of clinical examinations including optic disc and visual fields. Analyses were performed to explore the relationship of overall and subscale quality-of-life and visual function scores with presenting acuity in the better-seeing eye, specific eye diseases, and demographic variables. RESULTS: Information on quality of life and visual function were available for 5119 (99.4%) of 5150 study subjects. The mean presenting visual acuity in the better eye was 0.76 +/- 0.53 logMAR (logarithm of the minimum angle of resolution) units. Age, education, occupation, presenting acuity in the better eye, and presence of a cataract, glaucoma, or refractive error were independently associated with overall quality-of-life and vision function scores. After adjustment for demographic variables and ocular disease, persons with vision impairment or bilateral blindness based on presenting visual acuity had lower scores across all domains of quality of life and vision function. Scores for subscales of quality-of-life and vision function domains were significantly lower among those with age-related cataract and glaucoma compared with persons without those eye diseases. CONCLUSIONS: Presenting vision in the better eye was associated with quality of life and vision function in this older population of rural south India. Subjects with glaucoma and age-related cataract had an associated decrease in quality of life and vision function, independent of presenting visual acuity in the better eye.     

The impact of visual impairment and eye disease on vision-related quality of life in a Mexican-American population: proyecto VER

PURPOSE: To describe the relationship of visual acuity impairment and eye disease on vision-related quality of life, as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), in a cross-sectional, population-based study of older Hispanic persons living in Arizona. METHODS: A random sample of block groups with Hispanic residents in Nogales and Tucson, Arizona, were selected for study. Participants were interviewed at home with a questionnaire that included the NEI-VFQ-25, an instrument measuring vision-related quality of life. Acuity was obtained with Early Treatment Diabetic Retinopathy Study (ETDRS) charts and standard protocol. Cataract was determined by clinical examination, diabetic retinopathy was diagnosed on stereo fundus photographs, and glaucoma was diagnosed on the basis of clinical examination and visual field results. Analyses were done to determine the degree of association between subscale scores and acuity in the better-seeing eye, monocular visual impairment, and specific eye diseases, with adjustment for acuity. RESULTS: Of the 4774 participants in the study, 99.7% had completed questionnaires that were not completed by proxy. Participants with visual impairment had associated decrements in scores on all subscales, with a decrease in presenting acuity associated with a worse score (P < 0.05), after adjustment for demographic variables. Monocular impairment was also associated with lower scores in several subscales. In those with cataract, low acuity explained most of the low scores, but those with glaucoma or diabetic retinopathy had low scores independent of acuity. CONCLUSIONS: In this study of Mexican-American persons aged 40 or more, monocular impairment and better-eye acuity was associated with a decrease in most domains representing quality of life. Subjects with uncorrected refractive error, cataract, diabetic retinopathy, and glaucoma had associated decrements in quality of life, many not explained by loss of acuity. Further work on the specific measures of vision associated with reported decreases in quality of life, such as visual field or contrast sensitivity, is warranted.     

Visual function, quality of life and patient satisfaction after ophthalmic surgery: a comparative study

PURPOSE: To compare visual acuity, functional visual performance (VF-14), quality of life (QOL) gain (VF-14 gain) and patient satisfaction in a series of patients undergoing common types of ophthalmic surgery. METHOD: In a prospective trial, the VF-14 QOL questionnaire was administered to 100 patients who underwent surgery by one surgeon between May 2001 and April 2002. The following surgeries were compared: (1) cataract surgery (non-diabetic patients), (2) cataract surgery (diabetic patients), (3) retinal detachment cryo-buckle procedure, (4) pars plana vitrectomy, (5) silicone oil removal. VF-14 questionnaire responses, visual function and clinical data of all patients were recorded pre-operatively and 1 and 3 months postoperatively. RESULTS: In comparison to vitreoretinal surgery, patients who underwent cataract surgery achieved higher VF-14 scores and required less time to recover from the procedure (1 month). The QOL gain (VF-14 gain) was significantly higher in patients who had undergone retinal detachment surgery and vitrectomy (p < 0.0001). The lowest QOL gain was registered in diabetic patients after cataract surgery. Patients with pre-existing eye disease, including patients with improved visual acuity, were least satisfied with the final outcome of surgery. CONCLUSIONS: The highest VF-14 score was achieved by patients with no pre-existing ocular disease, who had undergone cataract surgery. The QOL gain was greater in patients with severer initial ocular conditions. Better patient satisfaction can be achieved in patients with pre-existing eye disease by improving pre-operative patient education.     

Relative afferent pupillary defect in the "better" eye

A relative afferent pupillary defect usually occurs in an eye with unilateral or asymmetric optic nerve or extensive retinal disease. In general, the eye with poorer visual acuity has the afferent pupillary defect. Twenty-five patients are reported, however, in whom an afferent pupillary defect occurred in the eye with better visual acuity. These eyes had optic nerve or retinal dysfunction. The eyes with worse visual acuity but no afferent pupillary defect had an abnormality of the ocular media (corneal opacity, hyphema, anterior segment membrane, cataract, or vitreous opacity), amblyopia, refractive error, age-related macular degeneration, or cystoid macular edema. An afferent pupillary defect does not necessarily occur in the eye with poorer visual acuity.     

Quality of life evaluation of age-related macular degeneration

PURPOSE: To evaluate quality of life (QOL) characteristics and ophthalmic factors influencing QOL in age-related macular degeneration (AMD) patients. SUBJECTS AND METHODS: The subjects were 80 patients with AMD. An eye-disease specific QOL questionnaire, The 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25), was administered. Results were compared with those of glaucoma or cataract patients and those of individuals without eye diseases. The VFQ-25 score was assessed according to visual acuity, absolute scotoma size, and disease type. Multiple regression analysis was used to evaluate ophthalmic factors influencing the QOL score. RESULTS: VFQ-25 scores were significantly lower in AMD patients than in all other groups. Scores of patients with visual acuity less than 0.1, with large absolute central scotoma, and bilateral exudative AMD were lower, for several items, than those of patients with visual acuity of 0.4 or more, those of patients without absolute scotoma, and those of bilateral atrophic AMD patients, respectively. Visual acuity and absolute central scotoma size influenced social functioning and mental health. The exudative form influenced mental health and critical print size influenced dependency. CONCLUSION: The VFQ-25-assessed QOL of AMD patients was lower than that of glaucoma or cataract patients. Visual acuity, absolute central scotoma and the existence of exudative AMD influenced the QOL in AMD patients.     

Unilateral visual impairment in an urban population in southern India

This study assessed the prevalence and causes of unilateral visual impairment in the urban population of Hyderabad city as part of the Andhra Pradesh Eye Disease Study. Stratified, random, cluster, systematic sampling was used to select 2,954 subjects from 24 clusters representative of the population of Hyderabad. Eligible subjects underwent detailed eye examination including logMAR visual acuity, refraction, slitlamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic evaluation of fundus. Automated threshold visual fields and slitlamp and fundus photography were done when indicated by standardised criteria. Unilateral visual impairment was defined as presenting distance visual acuity < 6/18 in the worse eye and > or = 6/12 in the better eye, which was further divided into unilateral blindness (visual acuity < 6/60 in the worse eye) and unilateral moderate visual impairment (visual acuity < 6/18-6/60 in the worse eye). A total of 2,522 subjects (85.4% of eligible), including 1,399 > or = 30 years old, participated in the study. In addition to the 1% blindness and 7.2% moderate visual impairment (based on bilateral visual impairment criteria) reported earlier in this sample, 139 subjects had unilateral visual impairment, an age-gender-adjusted prevalence of 3.8% (95% confidence interval 2.7-4.9%). The major causes of this visual impairment 39.9% were refractive error (42.9%), cataract (14.4%), corneal disease (11.5%), and retinal disease (11.2%). Of this unilateral visual impairment was blindness. The major causes of unilateral blindness were corneal disease (23.2%), cataract (22.5%), retinal disease (18%), and optic atrophy (12.9%). On the other hand, the predominant cause of unilateral moderate visual impairment was refractive error (67%) followed by cataract (9%). Of the total unilateral visual impairment, 34.3% was present in those < 30 years old and 36.2% in those 30-49 years old. Unilateral visual impairment afflicts approximately 1 in 25 persons in this urban population. A large proportion of this unilateral visual impairment is present in younger age groups. The causes of unilateral visual impairment, like those of bilateral visual impairment in this population, are varied, suggesting therefore, that in addition to the current focus of eye care in India predominantly on cataract, other causes of visual impairment need to be addressed as well.     

Childhood blindness in India: a population based perspective

AIM: To estimate the prevalence and causes of blindness in children in the southern Indian state of Andhra Pradesh. METHODS: These data were obtained as part of two population based studies in which 6935 children 相似文献   

Quantitative assessment of quality of vision

The importance of quality of vision (QOV) along with quality of life (QOL) in medicine has been recently widely recognized. We have conducted studies to quantitatively analyze factors related to QOV. Irregular astigmatism can be a significant obstacle for achieving satisfactory QOV. Videokeratography data were broken down using Fourier harmonic series analysis into spherical power, regular astigmatism (second harmonic component, n = 2), asymmetry (n = 1), and higher order irregularity (n > or = 3). The irregular astigmatism component calculated by the Fourier analysis significantly correlated with best spectacle-corrected visual acuity. Software was developed to display color-coded maps for the four Fourier indices. The normal range was defined for each Fourier index, and eyes with pathologic and postsurgical conditions were evaluated using the normal range. Progression of keratoconus over time was quantitatively described by Fourier analysis of the videokeratography data. Using the Fourier method, changes in corneal topography following suture removal after penetrating keratoplasty were evaluated. Fourier analysis of videokeratography data significantly facilitated determination of refraction and measurement of best spectacle-corrected visual acuity in eyes with corneal irregular astigmatism such as post-penetrating keratoplasty eyes. Higher-order wavefront aberrations of the cornea were calculated by expanding videokeratography elevation data into Zernike polynomials, and coma and spherical aberrations were computed. For ocular aberrations, the data obtained with the Hartmann-Shack sensor were decomposed into Zernike polynomials. Coma aberrations of the cornea significantly correlated with age, while corneal spherical aberrations showed no age-related changes. The time-course of changes in corneal higher-order aberrations was reported for photorefractive keratectomy and laser in situ keratomileusis (LASIK). For ocular aberrations, the degree of tilting of the suture-fixed intraocular lens significantly correlated with the amount of coma aberration of the eye. In normal eyes, the ocular coma increased with age mainly because of the increase in the corneal coma, and the ocular spherical aberration increased with age because of the increase in spherical aberration in the internal optics including the crystalline lens. The conventional LASIK significantly increased ocular higher-order aberrations, which compromised postoperative contrast sensitivity and low contrast visual acuity. Both corneal and ocular wavefront aberrations were analyzed in cataract, pseudophakic and aphakic eyes, and the equilibrium of spherical aberrations between the cornea and the eye in those conditions was investigated. In pseudophakic eyes, coma aberrations of the cornea, along with the corneal multifocality, significantly contributed to apparent accommodation. Computer simulation indicated that a focus shift of 0.5 diopters deteriorated the retinal image significantly more in eyes without higher-order aberrations than in eyes having a moderate amount of coma aberrations. Clinical results of aspherical intraocular lens were reported for wavefront analysis and contrast sensitivity measurements, and retinal images were analyzed by simulation. For the assessment of vision-related QOL, National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ 25) was translated into Japanese. After the validation study, the influence of cataract surgery on QOL was investigated. The QOL score was severely impaired in patients with bilateral cataract, which was significantly and dramatically improved by surgery. Forward scattering, backward scattering, and wavefront aberration induced by the crystalline lens were quantified, and the impact of these factors on visual function was analyzed according to the type of cataract. The degree of QOL improvement by surgery was assessed in relation to the type of cataract and intensity of scattering and aberration. By comprehensively analyzing these factors, quantitative parameters could be developed in the near future to describe progression of cataract and determine the indication for cataract surgery.     

The VF-14 index of functional visual impairment in candidates for a corneal graft.

PURPOSE: To validate the Visual Function-14 (VF-14) index of functional visual impairment in candidates for a corneal graft. METHODS: One hundred thirty-four patients who were candidates for a corneal graft participated in this study between August 1996 and February 1997. Demographic, ocular history, best-corrected visual acuity, and detailed ocular examination data were collected. Functional visual impairment information was obtained by telephone interviews using the following: VF-14, SF-36 (Short Form-36, a more generic measure of general health function), and Visual Symptom Score, and four questions measuring the overall amount of trouble with vision, dissatisfaction with vision, ocular pain, and discomfort. RESULTS: The average age of corneal graft candidates was 64 +/- 18 years (range, 18 to 90 years) and 60% were women. The most frequent corneal disease was pseudophakic bullous keratopathy (41%). Ocular comorbidities included glaucoma or ocular hypertension (30%) and cataract (19%). The mean best-corrected visual acuity of the eye scheduled for surgery was 1.33 +/- 0.56 logMAR whereas the best eye best-corrected visual acuity was 0.36 +/- 0.44 logMAR. The mean VF-14 score was 73% +/- 26%, and the internal consistency was high, with a Cronbach alpha value of 0.94. The VF-14 correlated strongly with the best eye best-corrected visual acuity. It also correlated strongly with the Visual Symptom Score, the global measures of trouble and dissatisfaction with vision. Candidates for a corneal graft had low scores for all eight general health concepts evaluated with the SF-36, and the VF-14 correlated with seven of the eight SF-36 subscales. CONCLUSION: The VF-14 is a valid measure of functional visual impairment in candidates for a corneal graft. The Visual Symptom Score and the SF-36 are also useful indices in such patients.     

Long-term visual prognosis in children after corneal transplant surgery for Peters anomaly type I

PURPOSE: To evaluate the long-term visual prognosis in children with corneal transplant surgery for Peters anomaly type I. DESIGN: Retrospective review of interventional case series. METHODS: Twenty-four children treated in a university-based practice were divided into two groups for analysis: a younger preverbal group and an older group of children three years of age or older. Children underwent corneal transplantation surgery (penetrating keratoplasty [PKP]) for Peters anomaly type I as infants (age range, two to 18 months). Visual acuity using Snellen or Allen charts and glaucoma and other complications were tabulated. RESULTS: Twenty-four patients had Peters anomaly; 16 had unilateral disease, eight had bilateral disease. Thirty eyes underwent PKP. Average age at PKP was five months. The mean follow-up from PKP to the most recent visit was 78.9 months. Fifteen eyes (50%) were treated for glaucoma. Five transplants (17%) had graft rejection episodes; two of these failed and were regrafted. Six eyes (20%) required cataract surgery. One eye had a retinal detachment. Currently, 27 eyes (90%) have clear grafts. In the younger group of children, five of six grafts are clear (83%). In the older group of 24 eyes of verbal children, seven eyes (29%) have visual acuity ranging from 20/20 to 20/50, six (25%) have visual acuity ranging from 20/60 to 20/100, nine (38%) have visual acuity ranging from 20/200 to counting fingers, and two eyes (8%) have visual acuity of hand movements. In this group, nine of 12 eyes without glaucoma had visual acuity better than 20/100; only four of 11 eyes with glaucoma were better than 20/100. CONCLUSIONS: Many children with PKP for Peters anomaly type I can experience good or functional vision in their operated eye. Children with glaucoma have a poorer visual prognosis.     

Contributing ocular comorbidity to end-of-life visual acuity in medically treated glaucoma patients,ocular hypertension and glaucoma suspect patients

AimTo assess the visual acuity at the end of life in glaucoma suspect patients, ocular hypertension, and patients treated for glaucoma and to find factors contributing to a reduced visual acuity in this cohort of deceased patients.MethodsIn a cohort of 3883 medically treated glaucoma patients, glaucoma suspect, or patients with ocular hypertension assembled in 2001–2004, 1639 were deceased. Patient data were collected from electronic and paper patient files. The files of 1378 patients were studied and the last measured visual acuity and ocular comorbidities influencing the visual acuity were extracted.ResultsOur results show that only 37.2% of patients had no visual impairment in either eye, 30.5% was visually impaired or blind in both eyes and 4.1% was blind in both eyes, all based on VA. The most common contributing factors for severe visual impairment or blindness (prevalence ≥ 1%) were: glaucoma, retinal vein occlusion, dry and exudative age-related macular degeneration, past retinal detachment, amblyopia, diabetic retinopathy, anterior ischemic optic neuropathy, trauma, decompensated cornea, past keratitis, enucleation, corneal transplantation, and macular hole.ConclusionsDespite the current advanced treatment modalities for glaucoma, 30.5% of patients had a VA < 0.5 in both eyes and 4.1% was blind in both eyes. However, this disability cannot be confidently attributed only to glaucoma. Besides glaucoma, most common contributing factors were among others retinal and macular diseases. Patient management in glaucoma should be based on more than lowering the intraocular pressure to prevent blindness at the end of life.Subject terms: Optic nerve diseases, Pattern vision     

Changing trend in the morphology of cataracts at a tertiary eye care centre in South India due to COVID-19-pandemic related national lockdown

Purpose:To study the changing trends in the morphology of cataracts at a tertiary eye care center in South India due to COVID-19 pandemic-related national lockdown.Methods:A retrospective study conducted at a tertiary eye care center in Andhra Pradesh state of South India, which included 1724 patients (1753 eyes) who underwent cataract surgery at our center during April 2019–July 2019 (1298 eyes of 1271 patients) and April 2020–July 2020 (455 eyes of 453 patients). Factors studied included preoperative lens status, associated phacodonesis or subluxation, pupil size, other eye lens status, associated retinal problems, glaucoma, and complications during surgery. Postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal clarity, intraocular pressure (IOP), and disc status at postoperative day 1, 1 week, and 1-month visits were compared.Results:A significantly lower proportion of nuclear sclerosis (decreased from 83.2% in last year before lockdown to 55.2% during lockdown) and significantly higher proportions of mature, brown, or black cataract and phacomorphic, phacolytic, or Morgagnian cataract (increased from 15.5% in last year before lockdown to 43.8% during lockdown) were observed. The proportion of small-incision cataract surgery decreased significantly (from 63.2% to 57.4%), whereas the proportion of phacoemulsification increased significantly (from 35.9% to 41.5%) during lockdown as compared to last year. A significantly higher proportion of eyes with small pupils and association with retinal pathology were also observed during the lockdown.Conclusion:During the national lockdown, there was a shift from nuclear sclerosis grade toward mature, brown, black grade of cataracts. In addition, the proportion of small-incision cataract surgery decreased significantly whereas the proportion of phacoemulsification increased significantly during the lockdown. More number of cataracts with small pupils and associated retinal pathology were observed during the lockdown.     

Visual function tests, eye disease and symptoms of visual disability: a population-based assessment

Purpose : To examine associations between eye disease and tests of visual function with self‐reported visual disability. Methods : The Blue Mountains Eye Study is a cross‐sectional census‐based survey of eye disease in two postcode areas in the Blue Mountains, west of Sydney, Australia. Of 4433 eligible residents, 3654 (82.4%) participated. Subjects had a detailed eye examination, including tests of visual acuity, contrast sensitivity, disability glare and visual field. Lens and retinal photographs were taken and graded according to standardized protocols for presence of cataract, early and late age‐related maculopathy, glaucoma, diabetic retinopathy, retinal vein occlusion and other eye diseases. An interviewer‐administered questionnaire included questions about perception of visual disability. Results : Scores on all tests of visual function significantly decreased with age (P < 0.0001). This decrease persisted for all tests except disability glare after excluding subjects with identifiable eye disease. The presence of one or more eye diseases was significantly associated with all (self‐reported) measures of visual disability (trouble driving at night, difficulty recognizing a friend across the street, reading a newspaper or recognizing detail on television); mixed cataract (cortical and nuclear, or posterior subcapsular and nuclear) was associated with trouble driving at night and difficulty recognizing a friend across the street. A 10‐letter (two‐line) decrease in best corrected or presenting visual acuity was significantly associated with all self‐reported measures of visual disability, as was a two‐step decrease in contrast sensitivity. A five‐point increase in points missing in the visual field was weakly but significantly associated with all self‐reported measures of visual disability except trouble driving at night. Conclusions : Visual function declines with age. Impaired visual function was strongly, and eye disease relatively weakly associated with reports of visual disability.     

Outcome of vision screening of eye health workers at a tertiary eye hospital in north-western Nigeria

目标:评估尼日利亚三级公共眼科医院中眼部保健工作者的眼部健康状况.方法:基于医院的横断面研究,这项研究中使用自填问卷收集参与研究的工作人员基本的人口统计学信息.每一位受试者都进行了眼部综合检查,包括裸眼或矫正视力、详细的眼前节和眼后节检查,以及使用Goldman眼压计测量眼压.有青光眼视神经病变征象的,或周围前房深度小于角膜厚度25%的受试者接受了房角镜检查.可能患有青光眼的人进行了中央视野分析(24-2,SITA Standard).视力使用WHO视力受损分类标准镜像分类.结果:共有275例保健工作人员进行了筛查,其中176(64%)为非临床工作人员.166人(60.4%)受调查者是男性,13.1%有眼部疾病家族史.大部分受访者(86.2%)视力正常(6/18-6/6).然而1.5%的有严重的视力障碍.女性有严重视力障碍的比例更大(3.7%vs 0%,P=0.018).然而,我们观察到临床工作人员和非临床工作人员的视力情况无统计学差异(P=0.41).右眼和左眼的平均杯盘比分别为0.42、0.45,两者之间的差异没有显著性(t=-0.882,P=0.37).右眼和左眼的眼压平均为14.1、14.0 mmHg.右眼眼压和右眼杯盘比之间、左眼眼压和左眼杯盘比之间存在弱相关.老花和屈光不正是受筛查人群中最常见的眼部疾病.有14位受访者(5.1%)患原发性开角型青光眼.而47人疑患有青光眼.结论:未矫正的屈光不正、白内障和青光眼是眼部保健工作者中最常见的导致视力障碍的眼部疾病.这项研究强调了定期进行工作人员体检以保证及时的诊断和治疗对患病人员的必要性.     

Factors influencing visual outcome after cataract extraction among Arabs in Kuwait.

Of 409 consecutive Arab patients in Kuwait who had extractions for idiopathic (senile and presenile) cataract 385 were followed up for a minimum period of one year. Among these the final visual outcome was 6/12 or better in 208 eyes (54%) but visual acuity was 6/18 or less in 177 eyes (46%). Of these 177 eyes 127 eyes (71.8%) had poor vision due to preoperative ocular disorders and 31 (17.5%) due to surgical complications. The main ocular conditions which limited visual recovery were the presence of corneal opacities, hypermaturity of cataract, advanced glaucoma, senile macular degeneration, diabetic retinopathy, and postoperative retinal detachment in this order of frequency. The prevalence of these disorders in cataract patients among the Arab population was identified and is discussed.     

西北地区眼科单中心1009例单眼盲患者致盲病因和手术疗效分析

目的　分析我国西北地区眼科单中心行白内障手术的单眼盲患者致盲病因和手术效果,为提高防治提供参考。方法　回顾性系列病例研究。纳入2016年7月至2020年11月陕西省眼科医院（西安市第四医院）收治的对侧眼行白内障手术的单眼盲（单眼裸眼视力＜0.05）患者1009例。采用χ²检验及logistic回归分析对患者致盲病因和白内障手术效果进行分析。结果　1009例单眼盲患者中,男465例（46.1%）,女544例（53.9%）,年龄（67.7±11.9）岁。前6种致盲病因分别为青光眼［29.7%（300例）］、视网膜脱离［15.3%（154例）］、眼外伤［14.4%（145例）］、角膜病［6.4%（65例）］、高度近视［6.1%（62例）］、白内障［5.7%（58例）］。对侧眼手术前、后视力完整者989例,术后视力提高者占90.2％（892例）,未提高者占9.8％（97例）;386例单纯白内障患者术后视力均提高,余603例术后视力提高者与未提高者间差异具有统计学意义的相关因素为眼部合并其他疾病及其治疗史(均为P<0.05),进行logistic回归分析后,有意义的独立因素包括青光眼和眼部合并其他疾病治疗史（均为P<0.05）,其中眼部合并其他疾病治疗史回归系数为-2.016,影响最大。结论　青光眼是我国西北地区行白内障手术的单眼盲患者中最常见的致盲病因,且女性多见。单眼盲对侧眼单纯白内障患者在无禁忌证时应尽早行白内障手术。眼部合并疾病尤其青光眼的及时诊治对白内障手术有积极作用。     

Impact of glaucoma, lens opacities, and cataract surgery on visual functioning and related quality of life: the Barbados Eye Studies

PURPOSE: To determine the relationship of open-angle glaucoma (OAG) and lens opacities to visual functioning and related quality of life (QOL), by using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) in a population of African origin. METHODS: The study included 962 black participants of the Barbados Eye Studies with known glaucoma, prior cataract surgery, visual acuity (VA) 相似文献   

Converting visual acuity to utilities

BACKGROUND: Utility theory can be used to quantify dysfunction associated with various diseases and thus can represent a "hard" measure of quality of life. By determining utility values, one can compare the quality of life of patients with ocular disease to that of patients with non-ophthalmic problems. We performed a study to determine whether utility values from patients with ocular disease are associated with clinical variables, including visual acuity in the better-seeing eye, and to develop a mathematical method for converting visual acuity to utility value, if there is an association between the two. METHODS: Cross-sectional study. A total of 239 patients from a tertiary care retinal practice with various ocular conditions, including macular degeneration, cataract, glaucoma and diabetic retinopathy, were interviewed under standardized conditions to determine their utility values by the time trade-off technique. Visual acuity, duration of visual loss and number of concomitant conditions were also determined. Multiple linear regression was performed to determine which variables were associated with utility values. RESULTS: The mean acuity in the better-seeing eye was 0.479 (near 20/40 vision). The mean utility value was 0.72. Accordingly, the average patient in our series was willing to trade 2.8 of every 10 remaining years of life to obtain perfect vision in both eyes. Utility value was significantly associated with visual acuity in the better-seeing eye (F = 69.1, p < 0.001). Other variables were not significantly associated with utility value. The association with duration of visual loss approached statistical significance (p = 0.075). Utility values (U) for patients with ocular disease can be derived from the following formula: U = (0.374)(visual acuity in better-seeing eye) + 0.514. INTERPRETATION: Utility values from patients with ocular disease were strongly associated with visual acuity and could be estimated mathematically.     

Ocular problems of young adults in rural Nigeria

Objectives: To determine the common eye diseases as well as the prevalence and causes of blindness and visual impairment in young adult residents of rural areas of Anambra State, Nigeria. Materials and methods: Three rural villages in Anambra State, Nigeria were selected by simple random sampling. A structured questionnaire on demographic characteristics, symptoms and attitude to eye diseases was administered to residents aged 18–49 years. Ocular examination included visual acuity estimation, colour vision test, tonometry, refraction and ophthalmoscopy. Skin-snip was examined for microfilaria. Results: The common ocular problems in the 510 young adults examined were presbyopia (33.3%), refractive errors (41.1%), allergic conjunctivitis (8.2%), pterygium (8.2%), pingueculum (5.9%) and colour vision defect (2.4%). Bilateral blindness occurredin 1.2%, uniocular blindness in 0.8% and 1.7% had visual impairment in their better eyes. Glaucoma and sequelae of congenital cataract caused bilateral blindness while visual impairment was due to refractive errors, cataract, corneal opacities and uveitis. Trauma predisposed to uniocular blindness and visual impairment. Conclusions: Eyeglasses alone would alleviate visual impairment and ensure good near vision in more than 47% of the subjects. The prevalence of blindness could be reduced through early detection of glaucoma, congenital cataract and ocular trauma. This revised version was published online in July 2006 with corrections to the Cover Date.