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The Medical Clinics of North America May 2021Age-related macular degeneration (AMD) is a leading cause of blindness. The main risk factor is advancing age, with the severity of vision loss ranging from mild to... (Review)
Review
Age-related macular degeneration (AMD) is a leading cause of blindness. The main risk factor is advancing age, with the severity of vision loss ranging from mild to severe. There is a 25% risk of early AMD and 8% risk of late AMD in patients over the age of 75, with the number of cases expected to increase because of the aging population. Diagnosis of the disease requires a dilated fundus examination. Physicians should be aware of the symptoms, risk factors, and treatment options for AMD to refer appropriately for ophthalmologic evaluation. Early detection can be helpful to prevent disease progression.
Topics: Blindness; Humans; Macular Degeneration; Risk Factors; Sensory Aids; Vision, Low
PubMed: 33926642
DOI: 10.1016/j.mcna.2021.01.003 -
Archives of Disease in Childhood Sep 2017An estimated 1.4 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during... (Review)
Review
An estimated 1.4 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during childhood and to die in childhood than a child not living with blindness. This update of a previous review on childhood visual impairment focuses on emerging therapies for children with severe visual disability (severe visual impairment and blindness or SVI/BL).For children in higher income countries, cerebral visual impairment and optic nerve anomalies remain the most common causes of SVI/BL, while retinopathy of prematurity (ROP) and cataract are now the most common avoidable causes. The constellation of causes of childhood blindness in lower income settings is shifting from infective and nutritional corneal opacities and congenital anomalies to more resemble the patterns seen in higher income settings. Improvements in maternal and neonatal health and investment in and maintenance of national ophthalmic care infrastructure are the key to reducing the burden of avoidable blindness. New therapeutic targets are emerging for childhood visual disorders, although the safety and efficacy of novel therapies for diseases such as ROP or retinal dystrophies are not yet clear. Population-based epidemiological research, particularly on cerebral visual impairment and optic nerve hypoplasia, is needed in order to improve understanding of risk factors and to inform and support the development of novel therapies for disorders currently considered 'untreatable'.
Topics: Blindness; Cataract; Child; Corneal Opacity; Eye Diseases, Hereditary; Global Health; Humans; Income; Infant, Newborn; Optic Nerve; Prevalence; Retinal Diseases; Retinopathy of Prematurity
PubMed: 28465303
DOI: 10.1136/archdischild-2016-310532 -
The Lancet. Global Health Apr 2021
Review
Topics: Advisory Committees; Blindness; Cost of Illness; Eye Diseases; Global Burden of Disease; Global Health; Health Services Accessibility; Humans; Quality of Health Care; Quality of Life; Sustainable Development
PubMed: 33607016
DOI: 10.1016/S2214-109X(20)30488-5 -
Molecular Aspects of Medicine Aug 2023Glaucoma is a common, complex, multifactorial neurodegenerative disease characterized by progressive dysfunction and then loss of retinal ganglion cells, the output... (Review)
Review
Glaucoma is a common, complex, multifactorial neurodegenerative disease characterized by progressive dysfunction and then loss of retinal ganglion cells, the output neurons of the retina. Glaucoma is the most common cause of irreversible blindness and affects ∼80 million people worldwide with many more undiagnosed. The major risk factors for glaucoma are genetics, age, and elevated intraocular pressure. Current strategies only target intraocular pressure management and do not directly target the neurodegenerative processes occurring at the level of the retinal ganglion cell. Despite strategies to manage intraocular pressure, as many as 40% of glaucoma patients progress to blindness in at least one eye during their lifetime. As such, neuroprotective strategies that target the retinal ganglion cell and these neurodegenerative processes directly are of great therapeutic need. This review will cover the recent advances from basic biology to on-going clinical trials for neuroprotection in glaucoma covering degenerative mechanisms, metabolism, insulin signaling, mTOR, axon transport, apoptosis, autophagy, and neuroinflammation. With an increased understanding of both the basic and clinical mechanisms of the disease, we are closer than ever to a neuroprotective strategy for glaucoma.
Topics: Humans; Intraocular Pressure; Neuroprotection; Neurodegenerative Diseases; Glaucoma; Retinal Ganglion Cells; Blindness
PubMed: 37331129
DOI: 10.1016/j.mam.2023.101193 -
Indian Journal of Ophthalmology Dec 2017Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child,... (Review)
Review
Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child, family, and society. Blindness related to pediatric cataract can be treated with early identification and appropriate management. Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria or strabismus. Etiology of pediatric cataract is varied and diagnosis of specific etiology aids in prognostication and effective management. Pediatric cataract surgery has evolved over years, and with improving knowledge of myopic shift and axial length growth, outcomes of these patients have become more predictable. Favorable outcomes depend not only on effective surgery, but also on meticulous postoperative care and visual rehabilitation. Hence, it is the combined effort of parents, surgeons, anesthesiologists, pediatricians, and optometrists that can make all the difference.
Topics: Blindness; Cataract; Child; Global Health; Humans; Morbidity
PubMed: 29208814
DOI: 10.4103/ijo.IJO_1023_17 -
The Lancet. Public Health Dec 2020Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform...
BACKGROUND
Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform health policy, has not been available. This study aimed to assess the prevalence, causes, and regional distribution of vision impairment and blindness in China in 1990 and 2019.
METHODS
Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to estimate the prevalence of moderate and severe vision impairment and blindness in China and compare with other Group of 20 (G20) countries. We used GBD methodology to systematically analyse all available demographic and epidemiological data at the provincial level in China. We compared the age-standardised prevalences across provinces, and the changes in proportion of vision loss attributable to various eye diseases in 1990 and 2019. We used two different counterfactual scenarios with respect to population structure and age-specific prevalence to assess the contribution of population growth and ageing to trends in vision loss.
FINDINGS
In 2019, the age-standardised prevalence was 2·57% (uncertainty interval [UI] 2·28-2·86) for moderate vision impairment, 0·25% (0·22-0·29) for severe vision impairment, and 0·48% (0·43-0·54) for blindness in China, which were all below the global average, but the prevalence of moderate and severe vision impairment had increased more rapidly than in other G20 countries from 1990 to 2019. The prevalence of vision loss increased with age, and the main causes of vision loss varied across age groups. The leading causes of vision impairment in China were uncorrected refractive error, cataract, and macular degeneration in both 1990 and 2019 in the overall population. From 1990 to 2019, the number of people with moderate vision impairment increased by 133·67% (from 19·65 to 45·92 million), those with severe vision impairment increased by 147·14% (from 1·89 to 4·67 million), and those with blindness increased by 64·35% (from 5·29 to 8·69 million); in each case, 20·16% of the increase could be explained by population growth. The contributions to these changes by population ageing were 87·22% for moderate vision impairment, 116·06% for severe vision impairment, and 99·22% for blindness, and the contributions by age-specific prevalence were 26·29% for moderate vision impairment, 10·91% for severe vision impairment, and -55·04% for blindness. The prevalence and specific causes of vision loss differed across provinces.
INTERPRETATION
Although a comprehensive national policy to prevent blindness is in place, public awareness of visual health needs improving, and reducing the prevalence of moderate and severe vision impairment should be prioritised in future work.
FUNDING
China National Key Research and Development Programme and Beijing Municipal Special Funds for Medical Research on Public Welfare Development and Reform.
Topics: Adolescent; Adult; Age Factors; Aged; Aging; Blindness; Cataract; Child; Child, Preschool; China; Female; Global Burden of Disease; Global Health; Humans; Macular Degeneration; Male; Middle Aged; Prevalence; Refractive Errors; Risk Factors; Severity of Illness Index; Young Adult
PubMed: 33271081
DOI: 10.1016/S2468-2667(20)30254-1 -
British Dental Journal Nov 2022
Topics: Humans; Blindness
PubMed: 36369535
DOI: 10.1038/s41415-022-5203-9 -
Survey of Ophthalmology 2022Given the rising number of patients with blindness from macular, optic nerve, and visual pathway disease, there is considerable interest in the potential of electrical... (Review)
Review
Given the rising number of patients with blindness from macular, optic nerve, and visual pathway disease, there is considerable interest in the potential of electrical stimulation devices to restore vision. Electrical devices for restoration of visual function can be grouped into three categories: (1) visual prostheses whose goal is to bypass damaged areas and directly activate downstream intact portions of the visual pathway; (2) electric field stimulation whose goal is to activate endogenous transcriptional and molecular signaling pathways to promote neuroprotection and neuro-regeneration; and (3) neuromodulation whose stimulation would resuscitate neural circuits vital to coordinating responses to visual input. In this review, we discuss these three approaches, describe advances made in the different fields, and comment on limitations and potential future directions.
Topics: Blindness; Electric Stimulation Therapy; Humans; Visual Prosthesis
PubMed: 34487742
DOI: 10.1016/j.survophthal.2021.08.008 -
Cortex; a Journal Devoted To the Study... Oct 2019
Topics: Aged; Aged, 80 and over; Blindness; Female; Follow-Up Studies; Humans; Male; Middle Aged; Visual Cortex; Visual Perception
PubMed: 30808548
DOI: 10.1016/j.cortex.2019.01.027 -
Eye (London, England) Apr 2024Over 180,000 Cambodian people are blind and a further 10,000 suffer avoidable blindness each year. Ninety percent of this blindness is avoidable, 79% is curable and 11%... (Review)
Review
Over 180,000 Cambodian people are blind and a further 10,000 suffer avoidable blindness each year. Ninety percent of this blindness is avoidable, 79% is curable and 11% is preventable. Three-quarters of this blindness is due to cataracts and the remainder is due to uncorrected vision, glaucoma, corneal scarring and pterygium. The Khmer Sight Foundation (KSF) is a charity reincarnated by Professor Sunil Shah and Sean Ngu. Its mission is to deliver a sustainable eye care model for the country. KSF takes a three pronged approach to this. It is working to develop sustainable eye-care within the country through building physical infrastructure. The second approach is to impact the current cataract backlog of over 300,000 patients with the aid of international support. Thirdly, KSF is paving the way for the next generation through the development of an optometry education programme and training of Cambodian ophthalmologists. Here we present the workings of KSF, clinical cases we have encountered and elaborate upon the future goals of this charity.
Topics: Humans; Ophthalmology; Cambodia; Cataract; Blindness; Southeast Asian People
PubMed: 38135774
DOI: 10.1038/s41433-023-02846-9