Bansal R K, Khandekar R, Nagendra P, Kurup P
Ophthalmology Department, Rustaq Hospital, Ministry of Health, Rustaq, Oman.
Eur J Ophthalmol. 2007 May-Jun;17(3):418-23. doi: 10.1177/112067210701700325.
To report the magnitude and causes of unilateral absolute blindness (no light perception) and barriers faced by persons with unilateral blindness in the South Batinah region of Oman.
Between January and June 2002, 12,000 patients were evaluated for visual acuity, ocular pressure, anterior ocular biomicroscopic examination, and posterior segment indirect ophthalmoscopy examination by ophthalmologists at Al Rustaq hospital in Oman. Patients having no perception of light in at least one eye were included in the cohort. A closed-ended questionnaire was used to collect data on the personal profile, history of blindness, barriers perceived as the cause of blindness, and participants' attitude towards eye care and quality of life following visual disability.
In the 12,000 patients studied, absolute unilateral blindness (no perception of light) was present in 122 persons, a rate of 1.0% in our series. The onset of blindness was gradual in 78 (63.9%) persons and 64 (54.9%) persons had unilateral blindness for more than 10 years. The main causes of blindness e phthisis/absent/disorganized blind eye, which was present in 64 (52.5%) persons; glaucoma, seen in 49 (40.2%) participants; and corneal opacity, seen in 8 (6.5%) persons. Eighty 4.8%) persons had <3/60 vision in the fellow eye. Thirty (24.6%) persons had cataract and 19 (15.6%) persons glaucoma in the fellow eye. Forty-eight (39.3%) persons had undergone cataract surgeries while 2 (1.6%) persons were operated for glaucoma in the fellow eye. Lack of access to ophthalmic services and use of traditional medicines during the onset of blindness were reported by nearly half of the cohort. The attitude towards blindness was negative in two thirds of subjects.
Cataract and glaucoma were important determinants of visual impairment in the fellow eyes of this cohort. These patients are at higher risk of developing bilateral impairment and need special care to prevent/treat visual disabilities in the fellow eyes. Using appropriate services, one can attempt attitudinal changes, rehabilitate them, and create a positive attitude towards life.
报告阿曼南巴提奈地区单侧完全失明（无光感）的发生率、病因以及单侧失明患者所面临的障碍。
2002年1月至6月期间，阿曼鲁斯塔克医院的眼科医生对12000名患者进行了视力、眼压、眼前节生物显微镜检查和眼后段间接检眼镜检查。至少一只眼睛无光感的患者被纳入该队列。使用封闭式问卷收集有关个人资料、失明病史、被视为失明原因的障碍以及参与者对视力残疾后眼保健和生活质量的态度的数据。
在研究的12000名患者中，122人存在单侧完全失明（无光感），在我们的系列研究中发生率为1.0%。78人（63.9%）失明起病缓慢，64人（54.9%）单侧失明超过10年。失明的主要原因是眼球痨/眼球缺失/眼球结构紊乱，有64人（52.5%）；青光眼，49名参与者（40.2%）；角膜混浊，8人（6.5%）。80人（65.6%）的对侧眼视力<3/60。30人（24.6%）的对侧眼有白内障，19人（15.6%）的对侧眼有青光眼。48人（39.3%）接受了白内障手术，2人（1.6%）的对侧眼接受了青光眼手术。近一半的队列报告在失明发作期间无法获得眼科服务并使用了传统药物。三分之二的受试者对失明的态度是消极的。
白内障和青光眼是该队列对侧眼视力损害的重要决定因素。这些患者发生双侧视力损害的风险更高，需要特别护理以预防/治疗对侧眼的视力残疾。通过使用适当的服务，可以尝试改变态度，使他们康复，并培养对生活的积极态度。
