Rate Of Blindness Research Articles

Epidemiologic investigation of ocular injury in Dezhou dty.

Objective To investigate the clinical epidemio- logical and development feature of ocular injuries in Dezhou city, and seek the prevention and cure measure. Methods A retrospective study of 2092 cases with ocular injury in hospital from 1998 to 2008 was done. Results A total of 2092 patients with ocular injury in our hospital is analyzed, the ratio was 5.03 ： 1 between male and female, and there was no significant difference between right and left eyes. Ages of the patients with ocular injury range mainly from 21 to 50 years old. The top two list in occupation were workers and farmers, followed by students and preschool chil- dren the main types of ocular injury by turns were blunt injury （41.25%）, penetrating injury （23. 47%）, chemical injury （ 12.28% ） , disruptive injury （ 10. 28% ） , explosive injury （ 8.17% ） and others（4.54% ）. The frequent reasons of ocular injury by turns were road accident, boxing, chemicals, explosion and so on. The rate of blindness after treatment was 8.41%, and the rate of enucleation was 1.78%. Conehmion Many of the eye in- juries are likely preventable. It is very important to strengthen safety education and think highly of work protection to reduce the risk of eye injury, early, prompt and effective drug and microsurgical treatment are the key point of therapeutic efficacy. Key words: ocular injury; epidemic disease

Analysis of ocular trauma in 95 cases.

Objective Discusses the child eye fresh wound and its clinical characteristic, summarizes analyzes in the child eye fresh wound treatment several questions as well as the prevention main point. Methods Carries on the reorganization to 95 example in hospital child eye fresh wound case, statistics and analysis were done. Results The child eye fresh wound occupies in hospital eye wound 30.25%, ratio of the male and female approximately was 9： 1, the age distribution were most by 8 - 14 years old of group （47.37%）. Wounds the reason was in turn the sharp instrument wound, explodes wounds, the obtuse bruise, the animal wound, the bullet wound, the sharp instrument wound were most （ accounts for 47.4% ）. Child eye flesh wound main damage spot inangle scierotic, main complication for prolapse of iris and cataract. The infection occurrence with wounds the nature and the seeing adoctor time related, the seeing a doctor time, the infection for- mation rate is early lower. Conclusion The eye fresh wound is big to the child vision harm, is the child simple eye blinding primary cause, after the wound, prompt correct processing, can reduce the complication effectively, reduces blindness rate. Key words: eye wound ; children ; analysis

The effects of individual differences and task difficulty on inattentional blindness

Most studies of inattentional blindness-the failure to notice an unexpected object when attention is focused elsewhere-have focused on one critical trial. For that trial, noticing the unexpected object might be a result of random variability, so that any given individual would be equally likely to notice the unexpected object. On the other hand, individual differences in the ability to perform the primary task might make noticing more likely for some individuals than for others. Increasing the difficulty of the primary task has been shown to decrease noticing rates for both brief static displays (Cartwright-Finch & Lavie, 2007) and dynamic monitoring tasks (Simons & Chabris, 1999). However, those studies did not explore whether individual differences in noticing arise from differences in the ability to perform the primary task. For our Experiment 1, we used a staircase procedure to equate primary task performance across individuals in a dynamic inattentional blindness task and found that the demands of the primary task affected noticing rates when individual differences in accuracy were minimized. In Experiment 2, we found that individual differences in primary task performance did not predict noticing of an unexpected object. Together, these findings suggest that although the demands of the primary task do affect inattentional blindness rates, individual differences in the ability to meet those demands do not.

Longitudinal Incidence of Adverse Outcomes of Age-Related Macular Degeneration

To describe the visual, functional, and general health complication rates associated with age-related macular degeneration (AMD) in a nationally representative longitudinal sample of elderly persons. This is a longitudinal retrospective cohort study (January 1, 1994-December 31, 2004) that used Medicare claims data. We identified beneficiaries aged 68 years and older who had newly diagnosed AMD in 1994 (n = 32,702) and age-, sex-, and race-matched controls who had routine eye surveillance and no diagnosis of AMD throughout the observational period (n = 32,702). Main outcome measures included cumulative incidence of vision loss, blindness, hip fracture, depression, and nursing home placement and prevalence of 16 general health conditions. Elderly individuals with newly diagnosed AMD had higher rates of blindness, vision loss, depression, hip fracture, and residence in a nursing home than those without AMD during a 10-year follow-up period. Individuals with AMD also had a higher prevalence of 11 of 16 general health conditions compared with controls. Individuals aged 68 years and older with AMD had higher rates of visual and functional impairments and had more illness than controls. Our findings demonstrate the substantial resource commitment of caring for the multifaceted health issues of persons diagnosed with AMD.

The papilla as screening parameter for early diagnosis of glaucoma.

In the industrialized countries 67 million people suffer from glaucoma, which represents the third most common cause of blindness and thus has a high economic impact. Early diagnosis of glaucoma, which does not necessarily involve raised intraocular pressure, is essential because by the time the patient notices functional impairment the damage is irreversible. Early treatment can decrease the rate of blindness 20 years later by about 50%. Selective literature review and clinical investigation of early glaucoma detection and of screening methods. Currently, no evidence-based recommendations for glaucoma screening can be found in the literature. No single method or combination of screening procedures can be recommended unambiguously on economic grounds. From the clinical perspective sensitive, specific, and cost-effective glaucoma screening seems feasible. The high-risk group would need to be defined on the basis of age and family history. A two-stage screening process would then have to be established with initial computer-supported telemedical sorting followed by telemedical ophthalmological diagnosis of cases selected for clarification.

Cost-effectiveness sequential modeling of ranibizumab versus usual care in age-related macular degeneration

To assess effectiveness, cost, and cost-effectiveness of ranibizumab versus the current medical practices of treating age-related macular degeneration in France. A simulation decision framework over 1 year compared ranibizumab versus the usual care using two effectiveness criteria: the "visual acuity improvement rate" (greater than 15 letters on the ETDRS scale) and the "rate of legal blindness avoided". Two decision trees included various sequences of current treatments, with or without ranibizumab. Ranibizumab appeared significantly more effective than the usual care (p < 0.001), providing greater treatment success rate of visual acuity improvement (48.8% versus 33.9%). The cost of the ranibizumab strategy was higher (9,123 euros over 1 year for ranibizumab versus 7,604 euros for the usual care) but the average cost-effectiveness was lower--18,721 euros/success for ranibizumab versus 22,543 euros/success for usual care (p < 0.001). Considering the "legal blindness avoided" success criterion, the ranibizumab strategy appeared significantly more effective (p < 0.001), providing greater treatment success rate for of legal blindness avoided than usual care (99.7% versus 93.1%) although it was more expensive (9,196 euros over 1 year for ranibizumab versus 5,713 euros for the usual care). Ranibizumab significantly improved the rate of visual acuity improvement and reduced the rate of legal blindness. Ranibizumab appeared significantly more cost-effective than the usual treatments in terms of visual acuity improvement.

THE TRACHOMA STATUS AND BLINDNESS RATES OF SELECTED AREAS OF PAPUA NEW GUINEA IN 1979-80

A survey of 4 selected areas of Papua New Guinea was made during 1979-80 to establish the prevalence of trachoma and its complications, and blindness rates and causes, in those areas. Trachoma was found to be endemic in all the areas studied, but was of mild intensity and rarely caused visual deficit. It is suggested that the most practical step towards reducing the prevalence of trachoma in P.N.G., in the future, is not by a mass treatment campaign, but by basic education in simple hygiene. An overall blindness rate of 0.50% was found in this survey, indicating that blindness is not a big problem in P.N.G. today. However there is still a need for improved Primary Eye Health Care, the training of national ophthalmologists, and provision for one institution for the training of the blind in P.N.G.

Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo - Brazil

To determine prevalence and causes of visual impairment, blindness, ocular disorders and cataract surgery outcomes in a low-income elderly population from a metropolitan area in the city of São Paulo, Brazil. Observational study where 801 individuals of 60 years and older underwent presented and best corrected visual acuity measurements as well as ophthalmologic examination. Definition of blindness and visual impairment followed studies conducted in Nepal, China and India. The prevalence of presented and best-corrected visual acuity worse than 20/400 in both eyes was 1.38% (95% CI: 0.69% - 2.45%) and 1.25% (95% CI: 0.60% - 2.29%). Prevalence of visual impairment considering presented and best-corrected visual acuity was, respectively, 24.16% (95% CI: 21.22% - 27.28%) and 12.77% (95% CI: 10.53% - 15.28%). Cataract was the main cause of blindness (30.00%) and visual impairment (54.90%). A total of 54 participants (6.74%) had previous cataract surgery and, with best-corrected visual acuity, 35.12% showed visual acuity better than 20/60 in both eyes. Rates of visual impairment and blindness in this low-income elderly population were high. There was a considerable decrease in prevalence after optical correction emphasizing the importance of uncorrected refractive errors. Cataract was the main cause of blindness; poor visual outcomes in eyes previously operated for cataract reinforce the need to seek good quality cataract services and to provide careful postoperative follow-up.

Caractéristiques cliniques et épidémiologiques du glaucome chronique à angle ouvert

This retrospective study examined the files of patients who consulted at the Women's and Children's Hospital of Yaoundé in Cameroon from March 2003 through December 2006. The main objective was to determine the epidemiological and clinical characteristics of patients diagnosed with chronic open-angle glaucoma (COAG). Of 8,123 files reviewed, 184 patients (54.3% women) were diagnosed with COAG, all but one binocular. Their mean age was 62.2+/-13.01 years. According to the WHO definition of blindness, the rate of bilateral blindness was 34.2%, that of unilateral blindness 21% and low vision 17.4%. Significant statistic correlations were observed between the cup depth of the optic disc and visual acuity on one hand, and between the level of intraocular pressure and cup depth on the other, p=0.0001. Approximately 90.67% of the eyes with glaucoma had high pressure and 9.23% normal pressure. COAG is a major cause of visual disability in Cameroon. Intraocular pressure is an important risk factor, but its positive predictive value for the impairment of optic disc fibres is low (R=0.29); other factors (apoptosis and ischemia of the optic disc) are associated with it. Advanced strategies for early diagnosis of COAG are essential, for this disease is an important cause of blindness. Such programmes would significantly delay the onset of visual disabilities.

Prevalence of Glaucoma in a South Brazilian Population: Projeto Glaucoma

To assess the prevalence of glaucoma in a South Brazilian population. Subjects older than 40 years underwent a screening examination that included a medical interview, slit lamp examination, tonometry, and fundoscopy. Those with suspected glaucoma (based on optic disc appearance and/or intraocular pressure) underwent a comprehensive ophthalmic evaluation during the definitive examination. Glaucoma was diagnosed based on the International Society of Geographical and Epidemiologic Ophthalmology classification. A total of 1636 subjects were examined (76.5% participation rate); 71% of the study population self-reported their race as white and 24% as nonwhite (most black and mixed-black/white). Glaucoma was found in 56 subjects (crude prevalence of all glaucoma: 3.4%; 95% CI, 2.5-4.3), primary open-angle glaucoma (POAG) was found in 40 (2.4%; 95% CI, 1.7-3.2), and primary angle-closure glaucoma (PACG) in 12 (0.7%; 95% CI, 0.3-1.1). Six (12%) subjects with primary glaucoma had a previous diagnosis of the disease. Nonwhite persons had a higher prevalence rate of POAG than did white participants, although this difference was not significant (3.8% vs. 2.1%, respectively, P = 0.11). Unilateral blindness due to primary glaucoma was observed in seven subjects (five POAG/2 PACG), and nonwhites had a higher rate of unilateral blindness than did whites (five versus two cases, respectively, P = 0.014). Compared to incidence in Hispanic and European populations, PACG was more common among South Brazilians, whereas the POAG rates were similar. The rate of undiagnosed glaucoma was almost 90%. The higher POAG prevalence in the population self-reported as nonwhite may affect the estimation of glaucoma in Brazil, as more than 40% of the population self-report their race as nonwhite.

Pay more attention to early diagnosis and intervention for patients with primary glaucoma

Primary glaucoma is an irreversible serious blindness disease. Early diagnosis and intervention is the key measure for prevention of visual function from damage in patients with primary glaucoma. The progress of the basic and clinical research on primary glaucoma in recent years, such as classification of primary angle closure glaucoma (PACG), the risk factors of PACG, the management of PACG, the change of the optic nerve head in primary open angle glaucoma (POAG), and the concept of target pressure in management of primary glaucoma, has greatly promoted the early diagnosis and intervention for the patients with primary glaucoma. By taking the measures including strengthening the continuing medical education of early diagnosis and intervention for primary glaucoma to ophthalmologists and ophthalmic residents, popularizing the knowledge of glaucoma to public, and screening the early primary glaucoma patients and suspects via the way of the public health survey, more patients with primary glaucoma will be early diagnosed and managed. Thus, the rate of blindness in glaucoma patients will decrease.

Prévalence, causes et facteurs de risque de la cécité et de la malvoyance chez les personnes âgées des maisons de retraite libanaises

To determine the prevalence, causes, and risk factors for blindness and visual impairment in the elderly population of Lebanese nursing homes, to encourage the development of an effective campaign against blindness. Transversal study in all nursing homes in two Lebanese regions (298 residents). All respondents (89.6%) underwent a complete ocular examination. Personal and medical data were also gathered for each participant. The prevalence of blindness (visual acuity<or=20/200 in both eyes) was 22.4% (20.3% in residents aged between 80 and 89 years old, 42.9% in patients 90 years or older). The prevalence of visual impairment (visual acuity<or=20/40 and>20/200 in the best eye) was 36%. The rate of blindness in underprivileged residents was found to be double that of the well-off residents (27% and 15%, respectively). Cataract was the leading cause of blindness, followed by age-related macular degeneration and open-angle glaucoma. At least 55% of the causes of blindness and 58% of the causes of visual impairment are potentially curable or avoidable. Blindness and visual impairment were high among Lebanese nursing home residents. This is an unfortunate observation given that the leading ocular diseases are treatable and that good vision is essential to these residents' quality of life.

Comparative study on preventing avoidable blindness in China and in Nepal

"Vision 2020" was initiated in 1999 and many relevant activities are ongoing, but little information is available on what it has achieved and what constraints it faces. It is not yet clear if funding is the most important constraint. Nepal is one of the underdeveloped countries, but an advanced country in preventing avoidable blindness. The aim of this study was to compare the situation in China and in Nepal in prevention of avoidable blindness. Data from literature review and a field visit were combined. All statistical analyses were carried out with SPSS Version 11.5. The chi-square test was used for comparisons involving categorical variables. The blindness rate is higher in Nepal than that in China (P < 0.05). The average number of cataract operations performed by one ophthalmologist is much lower in China than in Nepal. The cataract surgical rate (CSR) is much lower in China than in Nepal (P < 0.001). High cost of the surgery and inadequate qualifications of human resources were found in China. Cataract surgical outcome in China compared well with international standards. Progress towards the "Vision 2020" target in China is much slower than that in Nepal. Further attention to address this issue is urgently needed.

Blindness and low vision in adults in Ozoro, a rural community in Delta State, Nigeria

The objective of this article is to determine the prevalence and causes of blindness and low vision in Ozoro, a rural town of Delta State in Nigeria, in order to provide baseline information for planning a prevention of blindness programme. A cross sectional study using a stratified random sampling method was used to select the compounds. The five communities in the town formed the different sub-groups or strata. Visual acuity were recorded for all adults 40 years and older. Persons who had visual acuity less than 6/18 were further examined to determine the cause of low vision or blindness. The WHO definition of visual impairment according to visual acuity was used as criteria for classification. A total of 815 persons (coverage of 51.7%) were examined using a modified WHO PBL record of blindness form. The prevalence of blindness (VA < 3/60 in the better eye) for people of 40 years and above was 6.3% (95% CI, 4.6% to 8%) and low vision VA 6/24 to 3/60 in the better eye was 25.2%. The estimated prevalence of bilateral blindness for all ages was 1.3% and low vision was 5%. The rate of blindness and low vision increased with age being highest in subjects who were 60 years and above. The main causes of blindness and low vision were cataract, accounting for 60% of all bilateral blindness and 51.7% of all low vision. Other causes of blindness include, posterior segment diseases (11.7%). Glaucoma was presumed to be cause of blindness in 9.8% of cases; others were uncorrected aphakia 5.9%, and globe abnormalities 5.9%. Refractive error was the second major cause of low vision accounting for 22% of bilateral low vision. The magnitude of blindness and low vision in this oil rich Ozoro community in Delta State is high and majority are avoidable causes of blindness.

The Epidemiology of Age-Related Eye Diseases in Mainland China

While many papers have been published regarding age-related eye diseases in Mainland China in the past two decades, the variable quality of those reports limit the conclusions that can be drawn. Many of these studies assessed blindness and low vision rates, and these estimates are likely accurate. However, due to lack of standardization of techniques for assessing cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy, estimates of the burden of these diseases on the population are less reliable. Owing to the rapid economic development of China in the last decade, resources to address eyecare problems are more likely to be available. Therefore, an accurate assessment of the burden of various eye diseases is needed in order to improve blindness prevention planning and program development.

Prevalence and Causes of Blindness & Low Vision; Before and Five Years After ‘VISION 2020’ Initiatives in Oman: A Review

Background: A prevalence survey of blindness and low vision was conducted in Oman in 2005. Here, we present the prevalence and determinants of blindness and low vision among the population ≥ 40 years of age. The results are then compared with those of the survey in 1997 and the changes following the ‘VISION 2020’ initiatives are assessed. Methods: The survey covered 24 randomly selected clusters (75 houses in each). Teams assessed the distance vision of subjects while wearing glasses. The ophthalmologists examined the anterior segment and fundus to determine the causes of disability. The visual field was tested in those suspected of glaucoma. The prevalence rates of blindness (< 3/60 on presentation), legal blindness (< 6/60) and low vision (< 6/18) were calculated. The data from the 1997 survey was then analyzed to obtain similar rates in the population ≥ 40 years of age. Results: The prevalence of blindness was 8.25% (95% CI 7.14–9.36) in the ≥ 40 year-old population in 2005. The rate would be 6.95% (95% CI 5.92–7.98) if blindness were defined as vision with best possible correction. The prevalence of legal blindness and low vision were 12% and 45.12%, respectively. In the 1997 survey, the prevalence of blindness in same age group was 7.23% (95% CI 5.91–8.55). Between the two surveys, the prevalence of blindness due to corneal pathology declined from 1.9% to 1.1% but that of blindness due to unoperated cataract increased from 1.8% to 2.3%. Conclusions: The rate of disability has declined but the number of blind people has increased in Oman. The causes of blindness have changed from communicable/avoidable eye diseases to non-curable/chronic eye diseases, and the number with visual disabilities has increased. An increasing number of operations for cataract and improvements in the care for glaucoma and diabetic retinopathy are recommended.

Visual Loss in Postconflict Southern Sudan

Recent global estimates of the number of blind people put the total at 37–42 million [1,2]. This figure is predicted to rise to over 75 million by the year 2020 as a result of increases in world population and life expectancy, if current age-specific rates of blindness are allowed to persist [3]. The distribution of this global burden is, however, far from even. Blindness disproportionately affects the socioeconomically disadvantaged, both in terms of the numbers affected and in the impact of blindness on quality and length of life [4]. Although this link between blindness and low socioeconomic status is well known, two new studies published in PLoS Medicine are a useful reminder of just how vulnerable the poorest communities are to blindness [5,6].

Improving the diabetes care in Belarus

AbstractDiabetes has become a significant medical and economic problem in Belarus. The direct expenses on diabetes are estimated to be about 10% of the total budget of the Ministry of Health. The incidence of type 2 diabetes has increased 2.5‐fold during the past 10 years, which reflects the growing prevalence of obesity in the adult population, especially in urban areas. The incidence of type 1 diabetes in children and adolescents has been increasing slowly over the past years with a current incidence rate of about 10 in 100 000. The National Diabetes Programme called ‘The Complex Programme Diabetes Mellitus’ was launched in 1999. It created the general goals and targets for improvement in diabetes care in Belarus. As part of the implementation of this programme, all people with diabetes have free access to insulin, syringes and oral glucose‐lowering medications. A decrease in the rate of blindness and end‐stage nephropathy during the last 10 years has been registered. As a result of the Diabetes and Pregnancy Centre activities the data on pregnancy have been improved with a higher number of deliveries in diabetic women and a significant decrease in perinatal child mortality. Unfortunately, the desired reduction in amputations has not been achieved so far, but the percentage of high level amputations has been lowered significantly.The system of diabetes education in Belarus was established in 1987. Since then, diabetes schools have emerged throughout the country. However, recently we have faced the problem of decreased effectiveness of most diabetes schools as they fail to provide an optimal educational process because of lack of testing equipment and teaching materials. There is a great need to change education from the form of lectures to more practical‐directed programmes created for groups of patients with different needs and of different ages. Intensive and repeated education is the major priority for diabetes teams and the Belarusian Diabetes Association in the coming years. Only in cooperation with highly motivated and educated individuals with diabetes will the diabetes teams be able to achieve control over diabetes and decrease its medical and social burden. Copyright © 2006 John Wiley &amp; Sons.

Prevalence of visual impairment in relation to the number of ophthalmologists in a given area: a nationwide approach

Sociological and economic risk factors of visual impairment have never been described in France at a national level as the association between the number of ophthalmologists per inhabitant and visual impairment prevalence. Two national surveys were pooled. First, 2075 institutions were selected at random from the French Health Ministry files. Second, a random, stratified sample of 356,208 citizens living in the community was selected. Blindness and low vision (LV) prevalence rates were estimated by age and gender. Geographical equities were estimated by logistic regression adjusted on age and occupational category. The association between ophthalmologist density and visual impairment prevalence rate was estimated per region. Interviews were completed with 14,603 (94.9%) of 15,403 randomly selected subjects in institutions, and 16,945 (77.8%) of 21,760 randomly selected subjects in the community. Three groups were defined from the interviews: low vision, blind, and control. Prevalence rates were LV 2.08% and blindness 0.12%. Both rates increased exponentially with age. No major difference was found with gender. Injury was the declared reason for both LV (12%) and blindness (12%). Large regional differences in prevalence persisted for LV after adjustment on age and occupation (ORs: 0.35 to 2.10), but not for blindness. Regions with ophthalmologists below the national per capita average were usually those with higher LV prevalence. An inverse correlation was found between ophthalmologist number and LV prevalence rates for subjects of similar age and socio-professional category. This denoted possible inequity in the provision of healthcare.

Diabetic Blindness Significantly Reduced in the Warmia and Mazury Region of Poland: Saint Vincent Declaration Targets Achieved

The authors' aim was to verify if the targets of the Saint Vincent Declaration concerning the reduction of diabetes-related blindness in the Warmia and Mazury Region, Poland, had been achieved. A register of World Health Organization-defined blindness due to diabetes was conducted in the Warmia and Mazury Region between 1989 and 2004. The incidence rate of blindness as the number of new cases/100,000 diabetic population/year and 100,000 total population/year was estimated for three subperiods differing in political-economic system and diabetologic care delivery: 1989-1994, 1995-1999, and 2000-2004. The major cause of blindness among diabetic patients was diabetic eye disease (97%). Out of 70 patients with Type 1 diabetes, 53% lost vision due to proliferative diabetologic vitreoretinopathy, 20% due to neovascularization with glaucoma, while clinically significant macula edema and cataract associated with proliferative diabetologic vitreoretinopathy or clinically significant macula edema predominated in 210 patients with Type 2 diabetes. The incidence rate of blindness due to diabetes in the diabetic population ranged from 102.4/100,000 (confidence interval [CI]: 65.7-139.0) to 13.3/100,000 (3.8-24.9). The incidence rate of blindness due to Type 1 diabetes ranged from 1.3/100,000 (CI: 0.5-2.2) to 0.1/100,000 (CI: -0.1-0.4). The incidence rate of blindness due to Type 2 diabetes was variable in the first subperiod, and it next decreased by 19% each year from 3.9/100,000 (CI: 2.5-5.3) to 0.7/100,000 (CI: 0.1-1.2); p<0.001. The Saint Vincent Declaration target of reducing diabetes-related blindness by one third appears to have been achieved in the Warmia and Mazury Region.