山东省盲校盲童致盲原因调查

目的：确定山东省盲校16岁以下盲生致盲的解剖及发病原因,为防治儿童盲提供依据。方法：WHO儿童视力障碍检查法对山东省11所盲校盲生进行检查,诊断,结果：275名16岁以下盲生中,258人为严重视障或盲,占93．8％;主要病变部位为全眼球、视网膜、晶状体、视神经;主要致盲原因为先天异常及遗传性眼病;26．8％为潜在性可防治盲,以先天性白内障,青光眼为主,结论：本调查一定程度上反映了山东省儿童盲的现状,营养性及感染性盲病少见,无天异常及遗传性眼病是主要原因。     

浙江省盲校学生屈光矫正及低视力康复效果

目的 调查浙江省盲校学生视力状况,评价屈光矫正和低视力康复效果.方法 横断面调查研究.对219例来自浙江省3所盲校的学生采用裂隙灯检查眼前节、用眼底镜检查眼底,并进行UCVA、屈光度和BCVA检查,采用4×、6×或8×的单筒望远镜进行低视力康复.采用配对t检验对康复检查结果进行分析.结果 屈光矫正前后患者视力比较差异有显著的统计学意义(3.53±0.34 vs.3.85±0.27,t=-14.997,P＜0.01),153例BCVA＜3.7,66例BCVA≥3.7.盲患者配戴远用助视器前后视力比较差异有统计学意义(2.03±0.94 vs.2.12±1.06,t=-5.537,P＜0.01),低视力患者比较差异也有统计学意义(3.90±0.23vs.4.55±0.24,t=-28.537,P＜O.01).配戴远用助视器后脱盲率为24％,低视力患者的脱残率为80％.结论 屈光矫正和助视器验配可以有效地改善盲和低视力患者远视力,对患者进一步接受教育极其重要.     

A survey of visual impairment and blindness in children attending eight schools for the blind in Myanmar: An update

Purpose:To determine the causes of visual impairment (VI) and blindness among children in schools for the blind in Myanmar; to identify the avoidable causes of VI and blindness; to provide spectacles, low-vision aids, and ophthalmic treatment where indicated; to provide an update of the 2007 survey performed and identify any major epidemiological changes.Methods:Two hundred and ninety children under 16 years of age from all eight schools for the blind in Myanmar were examined and the data entered into the World Health Organization Prevention of Blindness Examination Record for Childhood Blindness.Results:In total, 271 children (93.4%) were blind (visual acuity [VA] <3/60 in the better eye) and 15 (5.17%) had severe visual impairment (SVI = VA <6/60 to 3/60 in the better eye). Most children had whole globe as the major anatomical site of SVI or blindness (105, 36.6%). The cause was unknown in the majority of these (155, 54.0%). One hundred and twelve children had avoidable causes of blindness and SVI (39.0%). Forty children (13.9%) required an optical device and 10.1% required surgical or medical attention, with a potential for visual improvement through intervention in 3.48%.Conclusion:In all, 39.0% of children had potentially avoidable causes of SVI and blindness with cataracts and measles being the commonest causes. This follow-up survey performed after the first one completed in Myanmar in 2007 demonstrates a change in the major site of abnormality from the cornea to whole globe and a reduction in avoidable blindness but highlights the ongoing burden of measles.     

Visual impairment and refractive errors in school children in Andhra Pradesh,India

Purpose:Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization’s (WHO) combating blindness strategies. The primary aim of this study was to estimate the prevalence of VI, causes, and its risk factors in school children in Krishna district, Andhra Pradesh, India.Methods:Children aged 4–15 years were screened in schools using the 6/12 Snellen optotype by trained community eye health workers, and those who failed the test and those reported or found to have obvious eye conditions were referred to primary (VC), secondary (SC), or tertiary (TC) care centre appropriately, where they underwent a complete eye examination including cycloplegic refraction and fundus examination.Results:A total of 56,988 children were screened, of whom 51.18% were boys. The mean age was 9.69 ± 3.26 years (4–15 years). Overall, 2,802/56,988 (4.92%) children were referred to a VC, of which 632/56,988 (1.11%) required referral to SC/TC. PVA of <6/12 was found in 1.72% (95% confidence interval [CI]: 1.61–1.83). The prevalence of refractive error (corrected and uncorrected) was 2.38% (95% CI: 2.26–2.51) and myopia was 2.17% (95% CI: 2.05–2.29). In multivariable analysis, older children, those in urban schools, private schools, and children with a disability had an increased risk of VI and myopia. Additionally, the risk of myopia was higher among girls than boys. Of those referred and reached SC/TC, 73.64% were due to avoidable causes.Conclusion:Childhood VI prevalence was 1.72% in this region. Uncorrected refractive error (URE) was the major cause of VI in children. Older age, schools in urban locations, private schools, and the presence of disability were associated with the risk of VI among children.     

Causes of visual impairment in children

The populations formed by the pupils of the eleven Dutch institutions for visually handicapped children on the first of January 1980 were investigated, repeating the investigation of the International Association for Prevention of Blindness in 1970. The total number of pupils was nearly the same in both instances (1300 in 1970 and 1334 in 1980). No significant differences were found in the distribution of diagnoses and etiologies between the two groups. The congenital cataracts, the tapeto-retinal dystrophies and the optic nerve affections are still the three diagnostic groups with the highest prevalence (together 48.6%). To gain more reliable insight into morbidity patterns one needs longitudinal investigations with central registration of patient data, especially in studying the influence of pre-and perinatal problems.     

中老年人视觉损害的流行病学调查

视觉损害严重影响患者的生活质量,加重家庭和社会负担,因此全面认识视觉损害具有重要意义。近年来全世界开展了许多以中老年人群为基础的眼病流行病学调查,报道了视觉损害在中老年人群中的患病率及主要病因。我们应密切关注中老年人群的视力健康,制定相应的干预措施,预防不可矫治的视觉损害。     

Causes of visual impairment among patients referred to a visual rehabilitation clinic in Iran

Purpose

Epidemiologic evaluation and investigating the causes of visual impairment in any society is a matter of concern and has a direct effect on the country''s health care planning. In this study we describe causes of low vision and blindness in Iranian patients referred to rehabilitation clinics for taking vision aids.

Methods

In this cross-sectional study, visual acuity was classified based on best-corrected visual acuity in the better eye according to the World Health Organization definition (blindness, visual acuity [VA] < 20 / 400; severe visual impairment, VA < 20 / 200-20 / 400; mild to moderate visual impairment, VA < 20 / 60-20 / 200). The causes of blindness and low vision were determined using the 10th version of International Classification of Diseases based on the main cause in both eyes. To describe data, we used mean ± SD and frequency.

Results

The study included 432 patients, 65% male, with a mean age of 43.6 ± 25.5 years (range, 3 to 92 years). Mild to moderate visual impairment, severe visual impairment and blindness were present in 122 (28.8%), 196 (46.4%) and 105 (24.8%) of the patients, respectively. The main causes of visual impairment were retinal and choroidal diseases (74.5%), optic nerve and optic tract diseases (9.8%), vitreous and globe disorders (5.3%), congenital cataract (3.1%), and glaucoma (2.6%). The distribution pattern of the causes was similar in all age subgroups.

Conclusions

Diseases of the retina and choroid are the main cause of visual impairment among patients referred to an academic visual rehabilitation clinic in Iran.     

Prevalence and causes of visual impairment and blindness in Sichuan province of China

AIM: To describe the prevalence and causes of low vision and blindness in a population within Sichuan province in southwestern China. · METHODS: A stratified, multi-phased and cluster probability sampling design was employed to enumerate 125641 participants from 40351 households within 38 counties/cities. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle resolution charts. Prevalence was age- and gender-standardized to the 2000 China Census. · RESULTS: Population-weighted prevalence of blindness was 0.77% (95%CI: 0.72-0.82, n=966) and low vision was 1.22% (95%CI: 1.14-1.27, n=1513). Overall, the prevalence of visual disability was 1.40% in the urban population, and 2.22% in the rural population (P<0.01). Cataract was the leading cause of visual disability (55.7%, n =1381), and was of similar frequency in both urban and rural populations. Retinal disease was the second leading cause(9.7%, n =236), but was more common in urban than in rural participants (34.3% vs 2.7%, P <0.01). Corneal disease accounted for 6.5% (n=161) of cases of visual disability, and was more common in the rural population (7.2% vs 3.9%, P =0.006). · CONCLUSION: We estimate that 1.72 million people suffer from visual disability within Sichuan province, of which 525000 are blind, the focus of blindness prevention should be in rural area.     

中国四川省视力损伤及盲的原因和发病率

目的:了解四川省低视力及盲的原因和发病率。方法:分层多阶段及随机抽样调查38个县市40351户125641人,进行全面眼部检查,包括标准对数视力表检测视力,发病率以年龄和性别为标准根据2000年中国人口普查结果进行分析。结果:盲率0.77%(95%可信区间:0.72～0.82,n=966),低视力率1.22%(95%可信区间1.14～1.27,n=1513)。视力残疾率城市1.40%,农村2.22%(P<0.01),白内障无论城市还是农村均是首位致残原因(55.7%,n=1381),视网膜疾病居第二(9.7%,n=236),但是城市明显高于农村(34.3%vs2.7%,P<0.01)。角膜病居第三(6.5%,n=161),农村明显多于城市(7.2%vs3.9%,P=0.006)。结论:四川省估计有约172万视力残疾患者,其中52.5万盲人,防盲重心在农村。     

Causes of childhood blindness in the northeastern states of India

Background:

The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region.

Aim:

To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India.

Design and Setting:

Survey of children attending special education schools for the blind in the NER.

Materials and Methods:

Blind and severely visually impaired children (best corrected visual acuity <20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization′s reporting form was used to code anatomical and etiological causes of visual loss.

Statistical Analysis:

Microsoft Excel Windows software with SPSS.

Results:

A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%).

Conclusion:

Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies.     

Causes of childhood blindness in Malaysia: results from a national study of blind school students

A national study was conducted in children attending six schools for the blind in Malaysia to identify the anatomical site and underlying causes of blindness (BL) and severe visual impairment (SVI), with a view to determine the potentially preventable and treatable causes so that appropriate control measures can be implemented in the future. The standardized clinical examination of eyes was performed and the findings were recorded on the WHO Prevention of Blindness Programme eye examination record form for children with blindness and low vision.A total of 358 children aged between 7 and 17 years were examined, of whom 332 (92.7%) were blind or severely visually impaired. The results relate to these 332 children. Lens was the major anatomical site (22.3%) of visual loss followed by retina (20.8%), whole globe (17.2%), cornea (15.1%), optic nerve (8.7%) and uvea (5.1%). Glaucoma was responsible for BL/SVI in 7.2% and others in 3.6% of cases. Hereditary diseases were responsible for visual loss in 29.5%, intrauterine factors in 4.5%, perinatal factors in 9% and childhood factors in 7.8% of cases. However, the aetiology was unknown in 49.1% of cases which included congenital anomalies of the globe.Childhood cataract and corneal scarring are major treatable causes of BL/SVIthat can benefit from future intervention strategies. Perinatal screening forintrauterine factors and hereditary eye diseases, and appropriate interventionaltherapy will help in reducing the prevalence of childhood blindness.     

陕西省视力残疾抽样调查结果及致残原因分析

目的:调查陕西省视力残疾人的数量、患病率及其性别、年龄分布以及致残原因。方法:2006-04-01/05-31,按照分层、多级、概率比例、整群的抽样方法(PPS抽样),陕西省共抽出22个县(区),176个调查小区,实际调查样本量73425人。由经过专门视力残疾鉴定培训的眼科医生对其进行视功能检查,经鉴定属于视力残疾者再进一步行裂隙灯及眼底镜检查,判断出其最主要的一个致残原因,并按照全国抽样调查办公室统一印发的表格进行登记。结果:陕西省视力残疾总患病率为1.12%,其中盲的患病率为0.42%,低视力的患病率为0.69%,与1987年第一次全国残疾人抽样调查的患病率比较无统计学差异(P>0.05);盲与低视力的患病率分别为男0.14%,0.28%,女0.29%,0.41%,女性均显著高于男性(P<0.01),农村显著高于城市(P<0.05)。盲与低视力的患病率随年龄增长而呈明显的递增趋势(P<0.01)。视力残疾的主要致残原因依次是白内障(48.72%),屈光不正、弱视(17.70%),视网膜、色素膜病变(11.60%),角膜病(10.87%)和青光眼(9.52%)。结论:白内障和屈光不正、弱视是我省致盲眼病的主要原因,防盲治盲工作任务还很艰巨,还需要做大量的工作。     

Impact of low vision care on reading performance in children with multiple disabilities and visual impairment

Background:

Lack of evidence in literature to show low vision care enhances the reading performance in children with Multiple Disabilities and Visual Impairment (MDVI).

Aim:

To evaluate the effectiveness of Low Vision Care intervention on the reading performance of children with MDVI.

Materials and Methods:

Three subjects who were diagnosed to have cerebral palsy and visual impairment, studying in a special school were recruited for the study. All of them underwent detailed eye examination and low vision care evaluation at a tertiary eye care hospital. A single subject multiple baseline (study) design was adopted and the study period was 16 weeks. The reading performance (reading speed, reading accuracy, reading fluency) was evaluated during the baseline phase and the intervention phase. The median of all the reading parameters for each week was noted. The trend of the reading performance was graphically represented in both the phases.

Results:

Reading speed increased by 37 Word per minute, 37 Letters per minute and 5 letters per minute for the subject 1, 2 and 3 respectively after the intervention. Reading accuracy was 84%, 91% and 86.4% at the end of the baseline period and 98.7%, 98.4% and 99% at the end of 16 weeks for subject 1, 2 and 3 respectively. Average reading fluency score was 8.3, 7.1 and 5.5 in the baseline period and 10.2, 10.2 and 8.7 in the intervention period.

Conclusion:

This study shows evidence of noticeable improvement in reading performance of children with MDVI using a novel study design.     

Prevalence and causes of blindness and visual impairment among school children in south-western Nigeria

The aim of the study was to assess the prevalence and identify the causes of blindness and visual impairment in school children of Ilesa-East Local Government Area of Osun State, Nigeria. A total of 1144 school children in primary and secondary schools were selected using a 2-stage random sampling method and examined to determine the prevalence and causes of blindness and visual impairment. A total of 17 (1.48%) children were blind or visually impaired. These comprised of 11 (0.96%) children who were visually impaired and 4 (0.3%) who were severely visually impaired. Only 2 (0.15%) school children were blind. The causes of visual impairment were refractive error 10 (0.87%) and immature cataract 1 (0.08%), causes of severe visual impairment included corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and 1 cataract 1 (0.08%). The causes of blindness in school children were corneal scars presumed to be due to vitamin A deficiency 1 (0.08%) and keratoconus 1 (0.08%). Causes of blindness and visual impairment in children attending regular schools in Nigeria were treatable. Prevention, early recognition and prompt treatment of these diseases by regular screening of school children would definitely reduce unnecessary visual handicap in Nigerian school children so that they can attain their full potential in the course of their education. Also, information from this study is relevant for the purpose of planning eye care programmes for the prevention of blindness in Nigerian school children. This will go a long way in the prevention of unnecessary blindness and visual impairment in school children.     

Correctable visual impairment in older people: a major unmet need

This review seeks to determine the prevalence of correctable visual impairment (VI) in older people in the UK, to discover what proportion of these cases are undetected, to suggest reasons for the poor detection and to make recommendations for improving the detection. To establish the context of these issues, the review will also touch on the general prevalence and causes of VI in older people in developed countries and on the impact of VI in older people. Typically, studies suggest that VI affects about 10% of people aged 65-75, and 20% of those aged 75 or older. There is a strong relationship between impaired vision in older people and both reduced quality of life and increased risk of accidents, particularly falls. The literature suggests that those with low vision are about two times more likely to have falls than fully sighted people, and the annual UK cost of treating falls directly attributable to VI is pound 128 million. The literature on the prevalence of undetected reduced vision in older people reveals that between 20 and 50% of older people have undetected reduced vision. The majority of these people have correctable visual problems (refractive errors or cataract). It is particularly startling that, in 'developed countries', between 7 and 34% of older people have VI that could simply be cured by appropriate spectacles. The reasons why so many cases of treatable VI remain untreated are discussed, and suggestions are made for improving the detection of these cases. We conclude that there should be better publicity encouraging older people to attend for regular optometric eye examinations. A complementary approach is annual visual screening of the elderly, possibly as part of GPs annual health check on people aged 75 years and older. Recommendations are made for evaluating new approaches to screening and for improving the management of cases detected by screening.     

不同程度视力残疾儿童应用助视器康复的研究

目的对有残余视力的视力残疾儿童在给予光学和电子助视器康复后进行远、近视力的分析和效果评估,探讨不同程度视力残疾患儿有效的康复手段及其对低视力康复对象范围界定的影响。方法对盲校及低视力门诊共206名4～14周岁（含14岁）视力残疾儿童按视力残疾的程度进行分组,比较应用国产4倍、6倍望远镜前后远视力和应用国产眼镜式助视器、国产简易电子助视器后两种助视器间阅读成功率的差异。远视力康复结果采用秩和检验,近视力康复结果采用卡方检验进行统计学分析。结果视力0．05以下至眼前指数的盲童组和0．3以下至0．05的低视力组应用远用助视器前后远视力差异均有统计学意义（P〈0．05）;视力0．05以下至光感的肓童和低视力儿童分别使用眼镜式近用助视器与简易电子助视器后,两种助视器间阅读成功率的差异均有统计学意义,使用简易电子助视器的阅读成功率均明显高于使用眼镜式近用助视器。结论助视器康复的对象可以从低视力范围扩展到0．01甚至以下的盲童。低视力助视器是视力残疾儿童视觉康复有效和必要的手段,早期视觉康复特别是使用简易电子助视器进行近视力阅读的康复,对视力残疾儿童提高学习认知能力、促进身心健康成长和回归社会具有重要意义。     

Pattern of eye diseases and visual impairment among students in southwestern Nigeria

Purpose The aim of the study was to determine the prevalence and causes of eye diseases and visual impairment in students in the Ilesa East local government area of Osun state, Nigeria. Methods A cross-sectional survey that utilised a multistage random sampling method to select 1,144 primary and secondary school students. Results A total of 1,144 students (504 males and 640 females) were involved in the study. Their ages ranged from 4 to 24 years. The majority (97.8%) of them were below 18 years of age. A total of 177 (15.5%) of the school children were found to have eye diseases. The major ocular disorders were in the following order: conjunctiva 91 (51.4%), refractive error 66 (37.3%), lid 7 (4.0%), corneal, including staphyloma and keratoconus 5 (2.8%) and then others. These included conjunctival diseases 91 (8%) constituted mainly by allergic/vernal conjunctivitis 85 (7.4%), refractive error 66 (5.8%), lid disorders 6 (0.6%), squint 3 (0.3%), corneal scarring 3 (0.3%) and cataract 2 (0.2%). A total of 15 students were visually impaired, with a prevalence of 1.26%. Only two students were blind, with a prevalence of 0.17%. Causes of visual impairment were refractive error 10 (0.87%), bilateral immature cataract 1 (0.08%), corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and cataract 1 (0.08%). The causes of blindness in students were bilateral corneal scars presumed to be due to vitamin A deficiency in one (0.08%) student and complicated bilateral keratoconus with complicated vernal ulcers in another (0.08%). Conclusions Eye diseases are common amongst Nigerian students. Eye examination for all new intakes and regular screening in both public and private primary and secondary schools is advocated. Wearing of corrective glasses should be emphasised for children with refractive error. Causes of blindness and visual impairment in children attending regular schools in Nigeria were avoidable.     

Visual impairment and blindness among children from schools for the blind in Maharashtra state,India: Changing trends over the last decade

Purpose:To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India.Methods:Children aged <16 years, enrolled in the schools for the blind in Maharashtra state, India were examined between October 2018 and December 2019. The anatomical sites and etiology for blindness were recorded using the World Health Organization’s standard reporting form. Causes of blindness were compared among different regions of the state and also by different age groups.Results:Of the 1,969 students examined from 39 schools for the blind, 188 children (9.5%) had severe visual impairment and 1,666 children (84.6%) were blind. Whole globe anomalies (794, 42.8%) were the most common anatomical site of vision loss in children, followed by corneal (289, 15.6%) and retinal abnormalities (280, 15.2%). Corneal causes were second most common in the poorer districts of Vidarbha (15.3%) and Marathwada (14.6%), whereas retinal causes were second most common in the wealthier regions of western Maharashtra (18.3%) and Khandesh (24.1%). Nearly one-third (593, 32%) of children were blind from potentially avoidable causes. Preventable blindness consisting of corneal causes and retinopathy of prematurity was seen in 281 (15.2%) cases, whereas treatable causes comprising of lens-related causes, glaucomas, refractive errors, amblyopia, and uveitis accounted for another 311 (16.8%). Among the younger children (≤10 years), the proportion of corneal blindness was lower (83/623, 13.3% vs. 206/1232, 16.7%) and that of retinal blindness was higher (119/623, 19% vs. 163/1232, 13.2%) than the older children.Conclusion:Whole globe anomalies constitute a major cause of SVI and blindness in Maharashtra. There seems to be an increase in the proportion of retinal blindness, especially retinopathy of prematurity, suggesting a need for increased screening coverage.