Eusebio Cristina, Kuper Hannah, Polack Sarah, Enconado John, Tongson Noel, Dionio Donald, Dumdum Anne, Limburg Hans, Foster Allen
London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Br J Ophthalmol. 2007 Dec;91(12):1588-92. doi: 10.1136/bjo.2007.119123. Epub 2007 Jun 13.
To conduct rapid assessments of avoidable blindness to estimate the magnitude and causes of blindness in people aged >/=50 years in Negros Island and Antique district, Philippines.
Clusters of 50 people aged >/=50 years were sampled with probability proportionate to size. Households within clusters were selected through compact segment sampling. Visual acuity (VA) was measured with a tumbling "E" chart. Ophthalmologists examined people with VA<6/18 in either eye.
In Negros, 2774 of 3649 enumerated subjects were examined (76.0%) and 3177 of 3842 enumerated subjects in Antique (82.7%). The prevalence of blindness (presenting VA<3/60 in better eye) was 2.6% (95% CI = 2.0 to 3.2%) in Negros and 3.0% (2.4 to 3.6%) in Antique. The leading cause of blindness was untreated cataract, and was refractive error for visual impairment (VA<6/18 to >/=6/60). Most of the cases of blindness (67% in Negros, 82% in Antique) and visual impairment (94% in Negros, 95% in Antique) were avoidable (ie, operated and unoperated cataract, refractive error and corneal scar). In Negros, 23% of eyes had a poor outcome after cataract surgery, and 13% in Antique.
The prevalence of blindness in two areas in the Philippines was relatively low. Since most cases were avoidable, further reductions are possible.
对菲律宾内格罗斯岛和安蒂克地区50岁及以上人群的可避免失明情况进行快速评估,以估计失明的程度和原因。
按规模大小成比例概率抽样选取50名50岁及以上人群组成的群组。通过紧凑分段抽样在群组内选取家庭。使用翻转“E”视力表测量视力。眼科医生对任何一只眼睛视力<6/18的人进行检查。
在内格罗斯岛,3649名登记对象中有2774人接受了检查(76.0%),在安蒂克地区,3842名登记对象中有3177人接受了检查(82.7%)。失明患病率(较好眼最佳矫正视力<3/60)在内格罗斯岛为2.6%(95%可信区间=2.0%至3.2%),在安蒂克地区为3.0%(2.4%至3.6%)。失明的主要原因是未治疗的白内障,而视力损害(视力<6/18至≥6/60)的主要原因是屈光不正。大多数失明病例(内格罗斯岛为67%,安蒂克地区为82%)和视力损害病例(内格罗斯岛为94%,安蒂克地区为95%)是可避免的(即已手术和未手术的白内障、屈光不正和角膜瘢痕)。在内格罗斯岛,23%的眼睛白内障手术后效果不佳,在安蒂克地区为13%。
菲律宾这两个地区的失明患病率相对较低。由于大多数病例是可避免的,因此有可能进一步降低患病率。