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Indian Journal of Ophthalmology Mar 2022India has been witnessing an epidemic of diabetes for several years now. A large proportion of patients with undiagnosed and poorly controlled diabetes are at great risk... (Review)
Review
India has been witnessing an epidemic of diabetes for several years now. A large proportion of patients with undiagnosed and poorly controlled diabetes are at great risk of developing diabetic retinopathy (DR) and irreversible blindness. The goal of DR screening is to identify people with sight-threatening DR early so that prompt treatment can be initiated, and blindness can be prevented. Systematic DR screening is essential to identify disease early, and a national effort for the same is required. We adopt a health system approach to outline the actions that need to take place for effective DR screening in the public sector in India. We discuss the role of national leadership, needs assessment, finalization of DR screening and referral pathway, trainings, strategies to improve the uptake, allocation of roles and responsibilities, public-private partnerships, quality control, and financing.
Topics: Blindness; Diabetes Mellitus; Diabetic Retinopathy; Humans; India; Mass Screening; Public Sector
PubMed: 35225509
DOI: 10.4103/ijo.IJO_1298_21 -
Indian Journal of Ophthalmology 2012The objective of this review is to discuss the available data on the prevalence and causes of global blindness, and some of the associated trends and limitations seen. A... (Review)
Review
The objective of this review is to discuss the available data on the prevalence and causes of global blindness, and some of the associated trends and limitations seen. A literature search was conducted using the terms "global AND blindness" and "global AND vision AND impairment", resulting in seven appropriate articles for this review. Since 1990 the estimate of global prevalence of blindness has gradually decreased when considering the best corrected visual acuity definition: 0.71% in 1990, 0.59% in 2002, and 0.55% in 2010, corresponding to a 0.73% reduction per year over the 2002-2010 period. Significant limitations were found in the comparability between the global estimates in prevalence or causes of blindness or visual impairment. These limitations arise from various factors such as uncertainties about the true cause of the impairment, the use of different definitions and methods, and the absence of data from a number of geographical areas, leading to various extrapolation methods, which in turn seriously limit comparability. Seminal to this discussion on limitations in the comparability of studies and data, is that blindness has historically been defined using best corrected visual acuity.
Topics: Age Distribution; Blindness; Global Health; Humans; Morbidity; Visually Impaired Persons
PubMed: 22944747
DOI: 10.4103/0301-4738.100532 -
Deutsches Arzteblatt International Feb 2023
Topics: Humans; Blindness; Risk Factors
PubMed: 37005723
DOI: 10.3238/arztebl.m2022.0321 -
Anais Da Academia Brasileira de Ciencias Sep 2009Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from... (Review)
Review
Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from two cross-sectional population-based studies - the São Paulo Eye Study and the Refractive Error in School Children Study is presented. 3678 older adults and 2441 school children were examined between July 2004 and December 2005. Prevalence of blindness in older adults using presenting visual acuity was 1.51% decreasing to 1. 07% with refractive correction. The most common causes of blindness in older adults were retinal disorders, followed by cataract and glaucoma. In school children, the prevalence of uncorrected visual impairment was 4.82% decreasing to 0.41% with refractive correction. The most common cause of visual impairment in school children was uncorrected refractive error. Visual impairment and blindness in Brazil is an important public health problem. It is a significant problem in older Brazilians, reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling. In school-children cost-effective strategies are needed to address a readily treatable cause of vision impairment - prescription and provision of glasses.
Topics: Adult; Blindness; Brazil; Child; Cross-Sectional Studies; Humans; Prevalence; Vision Disorders; Visual Acuity
PubMed: 19722022
DOI: 10.1590/s0001-37652009000300017 -
Clinical & Experimental Optometry Nov 2007
Topics: Blindness; Developing Countries; Humans; Poverty; Prevalence; Refractive Errors; Risk Factors; Socioeconomic Factors
PubMed: 17958560
DOI: 10.1111/j.1444-0938.2007.00217.x -
Indian Journal of Ophthalmology 2012To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries. (Review)
Review
OBJECTIVE
To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries.
MATERIALS AND METHODS
Extrapolation of existing data and experience in eye care delivery and teaching models in an unequally developed country (India) are used to make recommendations.
RESULTS
Parameters like population attributable risk percentage indicate that glaucoma is a public health problem but lack of simple diagnostic techniques and therapeutic interventions are barriers to any effective plan. Case detection rather than population-based screening is the recommended strategy for detection. Population awareness of the disease is low and most patients attending eye clinics do not receive a routine comprehensive eye examination that is required to detect glaucoma (and other potentially blinding eye diseases). Such a routine is not taught or practiced by the majority of training institutions either. Angle closure can be detected clinically and relatively simple interventions (including well performed cataract surgery) can prevent blindness from this condition. The strategy for open angle glaucoma should focus on those with established functional loss. Outcomes of this proposed strategy are not yet available.
CONCLUSIONS
Glaucoma cannot be managed in isolation. The objective should be to detect and manage all potential causes of blindness and prevention of blindness from glaucoma should be integrated into existing programs. The original pyramidal model of eye care delivery incorporates this principle and provides an initial starting point. The routine of comprehensive eye examination in every clinic and its teaching (and use) in residency programs is mandatory for the detection and management of potentially preventable blinding pathology from any cause, including glaucoma. Programs for detection of glaucoma should not be initiated unless adequate facilities for diagnosis and surgical intervention are in place and their monitoring requires reporting of functional outcomes rather than number of operations performed.
Topics: Blindness; Developing Countries; Glaucoma; Humans; Morbidity
PubMed: 22944757
DOI: 10.4103/0301-4738.100546 -
Bulletin of the World Health... 1995Globally, it is estimated that there are 38 million persons who are blind. Moreover, a further 110 million people have low vision and are at great risk of becoming... (Review)
Review
Globally, it is estimated that there are 38 million persons who are blind. Moreover, a further 110 million people have low vision and are at great risk of becoming blind. The main causes of blindness and low vision are cataract, trachoma, glaucoma, onchocerciasis, and xerophthalmia; however, insufficient data on blindness from causes such as diabetic retinopathy and age-related macular degeneration preclude specific estimations of their global prevalence. The age-specific prevalences of the major causes of blindness that are related to age indicate that the trend will be for an increase in such blindness over the decades to come, unless energetic efforts are made to tackle these problems. More data collected through standardized methodologies, using internationally accepted (ICD-10) definitions, are needed. Data on the incidence of blindness due to common causes would be useful for calculating future trends more precisely.
Topics: Blindness; Cataract; Glaucoma; Humans; Trachoma
PubMed: 7704921
DOI: No ID Found -
Scientific Reports Jul 2020To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment...
To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment (MSVI; BCVA < 6/18 but ≥ 3/60) and blindness (BCVA < 3/60) in a local population in Russia, we conducted the population-based Ural Eye and Medical Study. Out of 7,328 eligible individuals aged 40 + years, 5,899 (80.5%) individuals participated. MVI was present in 184 (3.1%; 95% confidence interval (CI) 2.7, 3.6) individuals, MSVI in 182 (3.1%; 95% CI 2.7, 3.5) individuals, and 11 individuals (0.19%; 95% CI 0.008, 0.30) were blind. Causes for MSVI were cataract (n = 109; 59.9%), late stage of age-related macular degeneration (n = 14; 7.7%; geographic atrophy and neovascular AMD in 7 (3.8%) individuals) each), myopic maculopathy (n = 11; 6.0%), glaucoma (n = 9; 4.9%), non-glaucomatous optic nerve damage (n = 5; 2.7%), and diabetic retinopathy (n = 4; 2.2%). Causes for blindness were cataract (n = 3; 27.3%), myopic maculopathy (n = 2; 18.2%), retinal dystrophies (n = 2; 18.2%), glaucoma (n = 1; 9.1%), and corneal scars (n = 1; 9.1%). Higher prevalence of MSVI/blindness was associated with age (P < 0.001; odds ratio (OR)1.10; 95% CI 1.08, 1.12), male gender (P < 0.001; OR 2.32; 95% CI 1.47, 3.66), educational level (P < 0.001; OR 0.83; 95% CI 0.76,0.92), manual grip force (P < 0.001; OR 0.94; 95% CI 0.92, 0.96), diabetes prevalence (P = 0.006; OR 1.67; 95% CI 1.08, 2.56) and axial length (P < 0.001; OR 1.43; 95% CI 1.26,1.62). In this population from Bashkortostan/Russia, prevalence of MVI, MSVI and blindness was 3.1%, 3.1% and 0.19%, respectively. Cataract was the most frequent cause of reversible vision impairment, while AMD, myopic maculopathy and glaucoma were the most common reasons for irreversible vision impairment.
Topics: Adult; Aged; Aged, 80 and over; Blindness; Eye; Female; Humans; Male; Middle Aged; Prevalence; Russia; Visual Acuity
PubMed: 32709931
DOI: 10.1038/s41598-020-69439-4 -
Turkish Journal of Ophthalmology Oct 2021The aim of this study was to investigate the frequency of blindness and the pathologies that cause blindness in the Konya province of Turkey.
OBJECTIVES
The aim of this study was to investigate the frequency of blindness and the pathologies that cause blindness in the Konya province of Turkey.
MATERIALS AND METHODS
The records of individuals over 18 years of age who applied to the health committee of Meram School of Medicine Hospital between January 2015 and December 2018 were evaluated retrospectively.
RESULTS
After reviewing the records of 4,268 applicants, a total of 222 applicants were included in the study (159 patients with monocular blindness, 63 patients with binocular blindness). The most common causes of monocular blindness were optic atrophy (13%), amblyopia (11%), and phthisis bulbi (10%). The most common causes of binocular blindness were retinitis pigmentosa (28%), proliferative diabetic retinopathy (13%), and unoperated cataract (11%). The frequency of monocular blindness was 3.7% (95% confidence interval [CI]: 3.2-4.3%) and binocular blindness was 1.5% (95% CI: 1.1-1.9%) in the sample. The frequency of blindness increased with age, with a positive correlation between mean age and blindness (p=0.002). Monocular blind applicants had a significantly lower mean age than binocular blind applicants (48.8±13.3 vs. 55.0±13.1 years, p=0.002) and binocular blind women had a significantly higher mean age than binocular blind men (62.7±16.0 vs. 53.2±11.7 years, p=0.023). The prevalence of monocular and binocular blindness was significantly higher in men than women (p=0.032).
CONCLUSION
The results of this study show that many of the pathologies that cause blindness are preventable or treatable, and that blindness is associated with age.
Topics: Adolescent; Adult; Blindness; Cataract; Female; Hospitals; Humans; Male; Retrospective Studies; Turkey
PubMed: 34702021
DOI: 10.4274/tjo.galenos.2020.88120 -
Annals of Family Medicine Jul 2018This story is a reflection on the evolving relationship of a family physician with a patient suffering from a severe conversion disorder, expressed inter alia through...
This story is a reflection on the evolving relationship of a family physician with a patient suffering from a severe conversion disorder, expressed inter alia through "blindness." The narrative follows our journey as I attempt to unravel the meaning of the symptoms as a metaphoric expression of her agony. Eventually, I conclude that clinicians at times also may have a "blind spot" that prevents us from entirely grasping patients' complex inner struggles.
Topics: Blindness; Humans; Physician-Patient Relations
PubMed: 29987089
DOI: 10.1370/afm.2268