Rate Of Blindness Research Articles

Visual Outcomes After Phacoemulsification in Sanjiwani Hospital Gianyar, Bali, Indonesia

The rate of blindness and visual impairment due to cataract is still high, especially in developing countries such as Indonesia. Phacoemulsification is one of the most advanced cataract surgery methods currently available. This study aims to evaluate the result of visual acuity in post-phacoemulsification cataract patients in Sanjiwani Hospital. This retrospective study used data obtained from medical records of patients who underwent phacoemulsification between 2019-2020. There were 45 eyes from a total of 35 patients. Most patients were male with an average age of 71± 9.58 years old. Around 71.1% of samples obtained good outcome (visual acuity of ≥ 6/18) 6 weeks after surgery. Meanwhile, 26.6% obtained a borderline outcome (visual acuity of 6/18-6/60) and one person had a poor outcome (visual acuity of <6/60). No intraoperative complication was recorded. There were 2 postoperative complications in the form of IOL dislocation. This result revealed a low complication rate. However, the percentage of good outcome has not reached WHO’s recommendation, which is 80%. Further studies with larger sample size and more complete data will be good to evaluate visual outcomes of phacoemulsification more optimally.

Clinical characteristics, rates of blindness, and geographic features of PACD in China

ObjectiveTo analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China. MethodsA retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed. ResultsA total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes. ConclusionPACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes.

Clinical profile and outcomes of neovascular glaucoma in the era of anti-vascular endothelial growth factor.

Purpose:To report the clinical profile and visual impairment in various stages of neovascular glaucoma (NVG) at a tertiary eye center in East India.Methods:The electronic medical records of the hospital database of patients with neovascular glaucoma seen between 2013 and 2020 were reviewed. Gonioscopic details were used to stratify patients into nonspecified NVG (Group 1), open-angle NVG (Group 2), and closed-angle NVG (Group 3). The clinical profile, angle features, cause of NVG, systemic associations, visual impairment, and blindness (defined as logarithm of the minimum angle of resolution, LogMar >1.3 at baseline and at final follow-up), and outcomes of medical/surgical interventions were compared between the three groups.Results:Of 846 eyes of 810 patients with NVG (Group 1, n = 564 eyes, Group 2, n = 61 eyes, and Group 3, n = 220 eyes), at baseline, the blindness rates in Groups 3 and 2 were 90 and 75%, respectively. The time from a previous intervention to the onset of NVG ranged from 3 to 5 months, while the median duration of NVG was about 4–4.5 months (0.03–120 months). Multivariate regression identified a longer duration of NVG as the only variable associated with poor final visual acuity.Conclusion:Visual morbidity by NVG remains as high as 75–90% in developing countries, even with the availability of anti-VEGFs and after improved management/investigative at all stages.

Glaucoma Diagnoses and Legal Blindness from Glaucoma among Bedouin Patients of Central Saudi Arabia: A Hospital-Based Study.

PURPOSE:The current study aims to know the glaucoma diagnoses and legal blindness from glaucoma among a tertiary referral center in Riyadh (King Abdulaziz Medical City [KAMC]-Riyadh patients).METHODS:This is a retrospective cohort study on chart review, where all eligible glaucoma patients attending the ophthalmology clinic at KAMC-Riyadh, between 2018 and 2019; were included.RESULTS:A total of 248 patients were included in the study; 142 patients (57.3%) were females and 106 (42.7%) were males. The mean age of the patients was 62.2 ± 18 years and most of them (93.5%) did not have a family history of glaucoma. Nearly one-quarter (26.6%; n = 66) of the included patients were legally blind, out of those, 36.4% had their right eye affected, 34.8% had their left eye affected, and 28.8% had both eyes affected. Legally, blind patients (LBGs) did not show a statistically significant reduction in the intraocular pressure (IOP) in the right eye (P = 0.103), on comparing the IOP in both visits. Nevertheless, there was a statistically significant reduction in the IOP of the left eye among the LBGs in both visits (P = 0.016). Regarding the nonblind group of patients, there were highly statistically significant reductions in both eyes (P < 0.001).CONCLUSION:The present findings show a high prevalence rate of legal blindness among glaucoma patients, with IOP reduction, age, and glaucoma diagnoses being the most important predictors among the study population.

Evaluation of Infectious Uveitis at a Tertiary Referral Center in Turkey: A 31-year Retrospective Study.

Objectives:The aim of this study was to examine the demographic and clinical characteristics of patients with infectious uveitis over time.Methods:The records of a total of 2032 patients treated for uveitis were retrospectively analyzed and 369 eyes of 324 patients diagnosed with infectious uveitis were included in the study. The patients were divided into 2 groups according to the date of presentation. The first group comprised patients seen between January 1988 and August 2009, and patients who presented between September 2009 and April 2019 were classified in the second group.Results:The prevalence of infectious uveitis was 15.1% in the first group and 16.8% in the second group. A statistically significant decrease was observed in the number of toxoplasmosis patients in the second group (p=0.031). There was no significant difference in the number of patients with herpetic anterior uveitis (HAU) (p=0.215). A significant increase was recorded in the number of patients with tuberculosis and acute retinal necrosis (ARN) (p=0.006 and p=0.041, respectively). While there were no patients diagnosed with cytomegalovirus (CMV) anterior uveitis in the first group, 19 patients were diagnosed with the disorder in the second group. There was a decrease in the rate of legal blindness among the patients who were treated in the second period compared with the first period; however, this difference was not statistically significant (p=0.069).Conclusion:Toxoplasmosis and HAU were the 2 most common causes of infectious uveitis. The incidence of CMV anterior uveitis, tuberculosis-related uveitis, and ARN increased over the period studied.

Effects of Amniotic Membrane Transplantation in Ocular Burns: A Meta-Analysis

<i>Background: </i>Ocular burns is a serious eye injury with a high rate of blindness, efforts should be made to eliminate the serious complications, prevent from lifelong disability, and improve emergency interventions and treatment.<i> Objective: </i>To evaluate the effectiveness of amniotic membrane transplantation (AMT) in ocular burns. <i>Methods:</i> The following electronic databases were searched: PubMed, Web of Science, and Cochrane Library. With the keyword “amniotic membrane” and “ocular burn”. No limitation of year, language, gender, age, nationality, etc. Animal trials, patients with other ocular surface diseases, and amniotic membrane transplantation combined with other surgeries were excluded. We evaluated the corneal epithelium healing time (CEHT), tear break-up time (TBUT), Schirmer test (ST), corneal neovascularization, the formation of symblepharon, and lid abnormalities after conventional treatment (CT) and AMT. The differences were tested by referring to the Cochrane Handbook. Pooled estimates were determined with RevMan software, version 5.3. <i>Results:</i> 5 studies with 310 eyes of 282 participants suffering from ocular burns were included. There was no significant difference between CT and AMT among the following outcomes: CEHT, TBUT, ST, formation of symblepharon, and lid abnormalities, except the extent of corneal neovascularization, which was less in patients treated with AMT (RR 0.81; 95% CI 0.68, 0.96; I² = 40%, p = 0.02). <i>Conclusions:</i> Compared to CT, AMT does not show better advantages in promoting epithelial healing, improving tear film status, and preventing complications such as symblepharon formation and eyelid abnormalities except reducing corneal neovascularization.

Identification of risk factors for targeted diabetic retinopathy screening to urgently decrease the rate of blindness in people with diabetes in India.

Purpose:There is an exponential rise in the prevalence of diabetes mellitus (DM) in India. Ideally all people with DM should be periodically screening for diabetic retinopathy (DR) but is not practical with current infrastructure. An alternate strategy is to identify high-risk individuals with vision-threatening diabetic retinopathy (VTDR) for priority screening and treatment.Methods:We reanalyzed four population-based studies, conducted in South India between 2001 and 2010, and reclassified individuals above 40 years into known and newly diagnosed diabetes. Multiple regression analysis was done to identify risk factors in people with known and new DM.Results:The prevalence of DR in 44,599 subjects aged ≥40 years was 14.8% (18.4 and 4.7% in known and new DM, respectively), and the prevalence of VTDR was 5.1%. Higher risk factors of VTDR were older age >50 years, diabetes duration >5 years, and systolic blood pressure >140 mm Hg. Targeted screening of people with diabetes using high-risk criteria obtained from this study was able to detect 93.5% of all individuals with VTDR.Conclusion:In a limited resource country like India, a high-risk group-based targeted screening of individuals with DM could be prioritized while continuing the current opportunistic screening till India adopts universal screening of all people with DM.

Retinopathy of prematurity: Current status, treatment, prevention, and future directions from the perspective of developing countries

Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in pediatric population living in developing countries. Increasing survival rates of premature patients have been globally improving during the last years and this is the main reason of blindness rate escalation secondary to ROP. The advent of intravitreal injections of antiangiogenic agents in therapeutic ophthalmological arsenal has provided an easier and faster way to prevent retinal detachment in this extremely fragile population. In the nearest future, we will witness, how medical science will provide enough scientific evidence to treat properly these patients with the lowest and safest dose of anti-vascular endothelial growth factor intraocular injections with the fewer systemic side effects. Meanwhile, transpupillary retinal laser photocoagulation of the avascular retina will remain the “gold standard” for ROP treatment, and for sure, this option could also provide a feasible alternative in the future for those cases, where intravitreal injections will fail. Neonatologists and ophthalmologists should keep on working together to fight against children's blindness, synchronizing retinal examinations timing criteria by adequate eye screening. Low- and middle-income countries' health governmental care suppliers should organize suitable programs for providing adequate neonatal care for premature patients and preventing, detecting, and treating effectively ROP. Training and teaching ROP screening and treatment programs are also a responsibility to be taken by local health care authorities and university residency courses for young ophthalmologists. This review describes the situation, state-of-the-art treatment, blindness prevention options from developing countries' viewpoints.

Sistem Pakar Diagnosa Awal Penyakit Mata dengan Metode Bayesian Network

Almost every human activity needs an eye to support these activities, therefore it will have a bad effect if the eyes experience interference. Disorders that can be experienced in the eye can occur from minor disorders to disorders that cause loss of vision and even death. Based on the results of the Rapid Assessment Assessment of Avoidable Blindness (RAAB), the blindness rate in districts/cities in NTB was 4%. This is not only due to medical-related problems but also due to social problems related to knowledge from the community, facilities, and resources. To make it easier for the public to make an initial diagnosis of eye disease, one thing that can be done is to use an expert system. Various methods can be implemented for expert systems, one of which is the Bayesian Network method. Based on the results of accuracy testing that has been done, this application provides an accuracy rate of 84.99%. Whereas, if the system diagnosis results are a subset of expert diagnostic results, the accuracy rate is 89.99% and based on the results of the use made by the general public, this application has been running well and has provided clear information related to the diagnosis of eye disease.

A 14-Year Retrospective Analysis of Endogenous Endophthalmitis in a Tertiary Referral Center of Southern Thailand.

Purpose To investigate patient characteristics, clinical features, common causative organisms, and visual acuity outcomes in endogenous endophthalmitis. Methods This was a retrospective chart analysis of patients with endogenous endophthalmitis between January 2006 and December 2019. Collected data included basic patient characteristics, presenting symptoms, causative organisms, treatments, and 3-month and 1-year visual outcomes. Results Twenty-nine eyes of 27 patients were included in the study. The mean age of the patients was 45.4 ± 19.9 years, and 63% were female. Visual acuity at presentation ranged from counting fingers to no light perception. Systemic comorbidities presented in 66.7% of the patients, the majority of which were related to diabetes mellitus (48.1%). The most common primary infection was a urinary tract infection. Positive blood cultures were identified in 48.1% of patients, and positive cultures from vitreous and aqueous samples were identified in 59.3% and 31.6% of eyes, respectively. Among all the specimens, Gram-positive bacteria were identified in 55.5%, Gram-negative bacteria in 22.2%, fungi in 14.8%, and mixed organisms in 7.4%. Among ocular specimens, 61.1% contained Gram-positive organisms, 16.7% contained Gram-negative organisms, and 22.2% contained fungi. Streptococcus spp. was the most common causative organism. From 29 eyes, 18 (62.1%) underwent vitrectomy, and 12 (42.9%) underwent either evisceration or enucleation. Positive vitreous culture was significantly associated with unfavorable final visual outcome. Final visual acuity ranged from 20/125 to no light perception. Although visual improvement at 3 months was significantly better in younger patients, this had no impact on final visual outcome at 1 year. Conclusion Eyes with positive vitreous cultures had significantly poorer visual outcomes. Despite full treatment coverage, visual prognosis was extremely poor and the rates of blindness and evisceration/enucleation were still high.

Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

SummaryBackgroundMany causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error.MethodsWe did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older.FindingsGlobal crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change −0·2% [95% UI −1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by −15·4% [–16·8 to −14·3], while avoidable MSVI showed no change (0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]).InterpretationResults suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached.FundingBrien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

Causes of Blindness in the Adult Population in Somalia.

Objectives:To evaluate the causes and frequency of blindness among the adult Somali population according to the World Health Organization (WHO) criteria.Materials and Methods:The data of 2,605 patients over 18 years old who presented to our tertiary hospital in Mogadishu (the capital of Somalia) were evaluated. Patients with best corrected visual acuity of less than 3/60 in both eyes were categorized as bilaterally blind and those with best corrected visual acuity of less than 3/60 in one eye but 3/60 or better in the other eye were classified as monocularly blind, as per the WHO classification.Results:Of 2,605 patients, 1,251 (48%) were female and 1,354 (52%) were male. Among these, 256 patients were determined to have blindness in one or both eyes and were included in the study. The patients ranged in age from 19 to 85, and the mean age was 52.4±14.6 years. The overall blindness rate in the Somali population was 9.8%. In the monocularly blind group, the most common factor was trauma complication (23.6%), followed by cataract (19%) and diabetic retinopathy (13.2%). In the bilaterally blind group, the most common factors were cataract (26.9%), diabetic retinopathy (21.1%), and glaucoma (15.4%).Conclusion:Trauma is the leading cause of blindness due to the security conditions in the country. Establishing and increasing the number of free public health centers in Somalia can reduce the frequency of blindness.

The invisible breast cancer: Experience does not protect against inattentional blindness to clinically relevant findings in radiology.

Retrospectively obvious events are frequently missed when attention is engaged in another task-a phenomenon known as inattentional blindness. Although the task characteristics that predict inattentional blindness rates are relatively well understood, the observer characteristics that predict inattentional blindness rates are largely unknown. Previously, expert radiologists showed a surprising rate of inattentional blindness to a gorilla photoshopped into a CT scan during lung-cancer screening. However, inattentional blindness rates were higher for a group of naïve observers performing the same task, suggesting that perceptual expertise may provide protection against inattentional blindness. Here, we tested whether expertise in radiology predicts inattentional blindness rates for unexpected abnormalities that were clinically relevant. Fifty radiologists evaluated CT scans for lung cancer. The final case contained a large (9.1 cm) breast mass and lymphadenopathy. When their attention was focused on searching for lung nodules, 66% of radiologists did not detect breast cancer and 30% did not detect lymphadenopathy. In contrast, only 3% and 10% of radiologists (N = 30), respectively, missed these abnormalities in a follow-up study when searching for a broader range of abnormalities. Neither experience, primary task performance, nor search behavior predicted which radiologists missed the unexpected abnormalities. These findings suggest perceptual expertise does not protect against inattentional blindness, even for unexpected stimuli that are within the domain of expertise.

Interaction Contents for Reconsidering Visually Disabled Parents

According to the Ministry of Health and Welfare, “Status of Registered Persons with Disabilities”, the number of people with disabilities is 2,494,460 as of 2015. The lowest rates of children with disabilities were intellectual disabilities (23%) and mental disorders (33.3%). The highest rates of screening were blindness (97%), heart failure (94.4%), and hearing impairment (92.7%). 65.2% of visually impaired people who have already had a disability at the time of marriage, and the remaining 34.8% can be thought to be the cause of high incidence of disability after marriage. ‘SID (Seed in the Dark)’ project was designed to recapture the visually impaired parent’s desire for attachment and the space difficulties of the blind who want to be a normal parent to their children through a visual impairment of a father with 7-year-old daughter. Using Gear VR(Virtual Reality), the general public was able to feel the surroundings as if they had no vision and focused on the hearing. Especially, We expressed the sound wave visually and added the hilarious game element which grasps the terrain of the maze by sound wave like a ‘blind person who perceives the surroundings by sound’ and catches up with daughter. People with disabilities who are far from mental illness often have a form of family with children. The fact that the rate of childbirth is high means that there is relatively little problem in daily life. It is wondered that the rate of blindness among the visually impaired, which accounts for 10% of the total disabled, is the highest at 97%. This is because, in the case of the visually impaired, the obstacle is often caused by aging, accidents, or diseases due to inherited causes rather than the visual disorder. In particular, However, the fact that there is an obstacle in vision that accounts for 83% of the body’s sensory organs causes other difficulties in the nursing process of children who are non-disabled. Parents do not know the face of child when their visual impairment is severe. Parents are extremely anxious about worry that they will be lost or abducted if their children are not by their side. And that the child recognizes the disability of his or her parents other than the other parents easily and takes it as a deficiency. Since visually impaired parents are mentally mature parents with non-disabled people, they may want their children not to feel deprived of their disability. The number of people with visual impairments has been increasing since 2001, and people with impairments often become disabled. In addition, there is much research on the problem of nondisabled parents who have children with disabilities, while there is relatively little interest and research on the problem of nondisabled child rearing of parents with disabilities.

Problems and challenges in the development of keratoprosthesis surgery in China

Keratoprosthesis implantation as an effective therapeutic method has been a treatment strategy in end-stage corneal blindness, contributing to restore vision and reduce the prevalence of blindness, but it has been restricted because of its high surgical technique and devastating complications. There are a large number of patients with corneal blindness in China, and the rate of high-risk or end-stage corneal blindness is high. It is of great significance to improve the understanding of the indications and contraindications of different kinds of keratoprostheses, as well as relevant technologies and knowledge, cope with the problems and challenges in the development period, and conduct safe and efficient clinical applications and related research, so that the technology of keratoprosthesis implantation in our country can go to the world steadily. (Chin J Ophthalmol, 2020, 56: 730-734).

Prevalence and Risk Factors of Glaucoma in Rural China (the Rural Epidemiology for Glaucoma in China [REG-China]): A National Cross-Sectional Study

Background: Glaucoma is the commonest cause of irreversible blindness worldwide. The Rural Epidemiology for Glaucoma in China (REG-China) was conducted to investigate the present status of glaucoma in rural China. Methods: The REG-China Study is a cross-sectional study in a nationally representative sample of population aged 6 years or older from ten provinces, autonomous regions, and municipalities in rural areas of China. All participants underwent a comprehensive eye examination, including visual acuity, intraocular pressure, slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Findings: From June to October 2018, 52 041 individuals were invited to participate, of whom 48 398 were included in the final analysis. The overall prevalence of glaucoma was 1·6% (95% CI 1·52–1·77) among the population aged 6 years or older. The prevalence of all types of glaucoma in persons aged 40 years or older was 2·0% (95% CI 1·96–2·85); 58·2%, and 19·8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, marital status, history of cerebral infarction, location areas and family history of glaucoma were significant risk factors for both PACG and POAG. The overall blindness rate of glaucoma was 31·1% (95% CI 25·91%-34·82%). Those who were older, men, and divorced/separated were more likely to become blindness due to glaucoma. Interpretation: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. Funding Statement: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030). Declaration of Interests: The authors declare there are no competing interests. Ethics Approval Statement: The study protocol was approved by the ethics review committee of Tianjin Medical University and other participating institutes. We obtained written informed consent from all study participants.

A glimpse into smartphone screen reader use among blind teenagers in rural Nepal

Purpose Access to appropriate assistive technology is a challenge worldwide and especially in low GDP-per-capita countries. Nepal is one example of a country with several coinciding challenges: some claim having a high rate of blindness in the general population, a low-GDP-per capita and some studies claim it has a low literacy rate, especially in rural areas. Without appropriate assistive technology, some disabled youth may not get full access to education. Methods To gain insight into assistive technology use in rural Nepal, five blind teenagers in a mixed secondary school with disabled and non-disabled students in rural Nepal were interviewed about their daily smartphone use. Results The results show that all the participants used screen readers on donated smartphones. None of the participants had received formal training in using smartphone screen readers and therefore lacked knowledge about basic and essential operational aspects of the devices as well as misguided expectations about the technology. Conclusions One implication of the findings is that smartphone accessibility features training material needs to be made easily available to schools and all disabled youth worldwide, as smartphones are increasingly becoming available in low-income remote regions with low literacy rates. The built-in accessibility features of smartphones promise disabled youth a non-stigmatizing platform for social participation and access to the information society. Implications for Rehabilitation The built-in accessibility features of smartphones provide disabled youth a non-stigmatizing practical platform for social participation and access to education. Training material on how to use smartphone accessibility features needs to be made easily available to schools and all disabled youth worldwide.

Status of parasitological indicators and morbidity burden of onchocerciasis after years of successive implementation of mass distribution of ivermectin in selected communities of Yeki and Asosa districts, Ethiopia

BackgroundControl and elimination of onchocerciasis requires regular follow-up and evaluation of community directed treatment with ivermectin (CDTi) program implementation. This research was aimed to assess the epidemiological status of onchocerciasis in disease endemic communities of Asosa and Yeki districts of Ethiopia after 5 and 15 years of successive CDTi respectively, and to evaluate the decline in infection and morbidity burden.MethodsA community-based cross-sectional study was conducted from August 2017 to January 2018 (i.e. within 2–7 months since the last treatment) using interview, physical and parasitological examinations. Pre-CDTi epidemiological data were obtained from studies conducted prior to the launch of CDTi.ResultsA total of 3002 individuals (1567 from Asosa and 1435 from Yeki) were included. No infection was detected from Yeki. In Asosa, the prevalence of infection was 1.6%. The geometric mean intensity of infection was 0.02 mf/mg of skin snip. The prevalence rates of dermatitis, depigmentation, nodule, and atrophy in Yeki were 33(2.3%), 57(4%), 37(2.6%) and 11(0.7%), respectively. The prevalence rates of papular dermatitis, depigmentation, palpable nodule, atrophy, and blindness in Asosa were 94(6%), 38(2.4%), 30(1.9%), 28(1.8%) and 2(0.1%), respectively. Five years of CDTi had significantly reduced prevalence and intensity of infection by 91.8% (p < 0.001) and 99.7% (p < 0.001), respectively. Moreover, CDTi reduced prevalence of papular dermatitis by 95.9% (p < 0.001), palpable nodule by 90.5% (p < 0.001), and atrophy by 30% (p = 0.6) in Yeki. Similarly, CDTi reduced prevalence of papular dermatitis by 88.6% (p < 0.001), depigmentation by 90.3% (p < 0.001), atrophy by 89.5% (p < 0.001), and blindness by 90% (p < 0.001) in Asosa.ConclusionsFifteen years of successive CDTi had brought the infection from high to zero in Yeki. However, thorough entomological and serological data need to be generated to ascertain whether complete interruption of parasite transmission has been attained, and for considerations of an evidence-based CDTi cessation. Five years of CDTi in Asosa has significantly reduced the infection and morbidity of onchocerciasis to very low level. We, hereby, recommend biannual CDTi to continue in Asosa and its surroundings until the infection transmission is fully interrupted.

Factors associated with blindness three months following treatment for acute primary angle glaucoma

AimsTo study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.MethodsIn this multicentre...

Six-Year Incidence and Causes of Low Vision and Blindness in a Rural Chinese Adult Population: The Handan Eye Study

ABSTRACT Purpose To determine the six-year incidence, risk factors, and causes of visual impairment in a Chinese population. Methods This was a population-based study of eye disease in Chinese adults in a rural district of Handan in China. 6,830 individuals were invited to participate in 2006 and 5,394 returned for follow-up in 2012. All participants underwent standardized eye examinations. Visual impairment was defined according to WHO criteria. The incidence of visual impairment was age- and gender-standardized to the 2010 China Census. Multivariable logistic regression analysis was used to determine risk factors for visual impairment. Results The leading causes of visual impairment were cataract and refractive error. Based on presenting visual acuity (PVA), the six-year incidence rates of low vision and blindness were 5.2% and 0.5%, respectively. Incidence of low vision was associated with older age (p < .001), less education (p < .001), diabetes (p < .05), and lower BMI (p < .001). The incidence of blindness was associated with diabetes (p < .05). Based on best-corrected visual acuity (BCVA), the six-year incidence rates of low vision and blindness were 0.8% and 0.1%, respectively. Incidence of low vision was associated with older age (p < .001) and lower BMI (p < .05). None of these factors were associated with the incidence of blindness. Conclusion In Handan, the incidence of visual impairment was high and associated with older age, less education, diabetes, and lower BMI. The majority of cases were due to unoperated cataract and uncorrected refractive error, reflecting the need for improved eye care in this region.