Kansakar I, Thapa H B, Salma K C, Ganguly S, Kandel R P, Rajasekaran S
Lumbini Eye Hospital, Lumbini, Nepal.
Kathmandu Univ Med J (KUMJ). 2009 Jan-Mar;7(25):44-9. doi: 10.3126/kumj.v7i1.1764.
The present study is first of its kind to evaluate causes of visual impairment of blind students in Nepal and assess their need for low vision rehabilitation services.
To evaluate causes of vision impairment of students enrolled in blind schools in Nepal and assess the need for low vision rehabilitation services in these students.
A survey was conducted in 12 blind schools in Nepal, which were registered with Nepal Association for Welfare of Blindness (NAWB).It was conducted by a team of an ophthalmologist and an optometrist, by using standard eye examination protocols of the World Health Organization Prevention of Blindness Program (WHO/PBL).
Of the 345 students enrolled in 12 schools, 285 students were examined (response rate of 82.61%). The students were in the 5 - 29 years age group. Nearly three-fourth of the children had become blind within one year of age and 52.3% visually impaired at birth and 20.7% developed vision impairment within one year of age. After refraction, 26 students (9.12%) had mild visual impairment, 21 students (7.37%) had severe visual impairment and 238 students (83.51%) were blind. The main cause of vision impairment was found to be corneal 35.79% and retina diseases, mainly dystrophy, 20.35% followed by problems with the whole globe, lens and optic nerve, accounting for 13.33%, 12.63% and 12.98% respectively. The major etiological factors were those of childhood such as Vitamin A deficiency, measles and similar causes (42.11%) followed by hereditary causes (25.26%). Of the total students examined, 48.07% were visually impaired due to preventable causes and 16.14% treatable aggregating to 64.21% of avoidable blindness. Fifty seven (28.22%) students could read smaller than 2 M print size after low vision assessment for near and 33(15.78%) students benefited with telescopic trial for distance low vision.
In Nepal, renewed focus on providing best possible quality of life for visually impaired children by proper low vision assessment and eye health education focusing on, general public and community health workers, with governmental and institutional support is required to achieve Vision 2020 objectives to decrease childhood blindness.
本研究首次对尼泊尔盲校学生视力损害的原因进行评估，并评估他们对低视力康复服务的需求。
评估尼泊尔盲校学生视力损害的原因，并评估这些学生对低视力康复服务的需求。
在尼泊尔12所盲校进行了一项调查，这些学校均在尼泊尔盲人福利协会（NAWB）注册。该调查由一名眼科医生和一名验光师组成的团队进行，采用世界卫生组织防盲计划（WHO/PBL）的标准眼科检查方案。
在12所学校注册的345名学生中，有285名学生接受了检查（应答率为82.61%）。这些学生年龄在5至29岁之间。近四分之三的儿童在1岁前失明，52.3%在出生时视力受损，20.7%在1岁内出现视力损害。验光后，26名学生（9.12%）有轻度视力损害，21名学生（7.37%）有重度视力损害，238名学生（83.51%）失明。视力损害的主要原因是角膜病变（35.79%）和视网膜疾病，主要是营养不良（20.35%），其次是眼球、晶状体和视神经问题，分别占13.33%、12.63%和12.98%。主要病因是儿童期因素，如维生素A缺乏、麻疹及类似病因（42.11%），其次是遗传因素（25.26%）。在接受检查的学生中，48.07%因可预防的原因视力受损，16.14%因可治疗的原因视力受损，总计64.21%的失明是可避免的。57名（28.22%）学生在进行近视力低视力评估后能够阅读小于2M字号的文字，33名（15.78%）学生通过远视力低视力望远镜试用受益。
在尼泊尔，需要重新关注通过适当的低视力评估和针对普通公众及社区卫生工作者的眼健康教育，在政府和机构的支持下，为视力受损儿童提供尽可能好的生活质量，以实现“视觉2020”减少儿童失明的目标。
