Abstract
BackgroundMost estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations. We aimed to evaluate frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park.MethodsCross-sectional study performed at Xingu Indigenous Park, Brazil, from 2016 to 2017. Residents from 16 selected villages were invited to participate and underwent a detailed ocular examination, including uncorrected (UVA) and best-corrected visual acuity (BCVA). The main cause of UVA < 20/32 per eye was determined.ResultsA total of 2,099 individuals were evaluated. Overall, the frequency of visual impairment and blindness was 10.00% (95% CI: 8.72–11.29%) when considering UVA, decreasing to 7.15% (95% CI: 6.04–8.25%) when considering BCVA. For each increasing year on age, the risk of being in the visually impaired or blind category increased by 9% (p < 0.001). Cataracts (39.1%) and uncorrected refractive errors (29.1%) were the most frequent causes of visual impairment and blindness in this population. The main causes among those aged 45 years and more were cataracts (54.5%) while refractive errors were the main cause in adults aged 18 to 45 years (50.0%) and children up to 18 years old (37.1%).ConclusionsA higher frequency of visual impairment and blindness was observed in the indigenous population when compared to worldwide estimates with most of the causes being preventable and/or treatable. Blindness prevention programs should focus on accessibility to eye exam, cataract surgeries and eyeglass distribution.
Highlights
Most estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations
The purpose of the current study is to evaluate the frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park
Ophthalmic technologists, clinical doctors and logistics professionals travelled to the Xingu Indigenous Park carrying ophthalmological equipment and supplies in order to set up itinerant ophthalmic clinics in each village included in the project
Summary
Most estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations. We aimed to evaluate frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park. The burden of visual impairment and blindness may be underestimated and the public health policies derived from it may insufficiently attend the demand of those minority groups. Those groups are often under-represented in research because population-based studies aim to select samples that represent the overall population and/or due to the low response. A recent systematic review on visual loss among indigenous populations has shown a lack of data on the burden of visual loss in most countries and has pointed the importance of improvements in quality and number of researches about eye health and eye care in indigenous communities [9]
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