Sia David I T, Muecke James, Hammerton Michael, Ngy Meng, Kong Aimee, Morse Anna, Holmes Martin, Piseth Horm, Hamilton Carolyn, Selva Dinesh
South Australian Institute of Ophthalmology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia.
Ophthalmic Epidemiol. 2010 Aug;17(4):225-33. doi: 10.3109/09286586.2010.489250.
To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending four schools for the blind in Cambodia and to provide spectacles, low vision aids, orientation and mobility training and ophthalmic treatment.
Children < 16 years of age were recruited from all 4 schools for the blind in Cambodia. Causes of visual impairment and blindness were determined and categorized using World Health Organization methods.
Of the 95 children examined, 54.7% were blind (BL) and 10.5% were severely visually impaired (SVI). The major anatomical site of BL/SVI was the lens in 27.4%, cornea in 25.8%, retina in 21% and whole globe in 17.7%. The major underlying etiologies of BL/SVI were hereditary factors (mainly cataract and retinal dystrophies) in 45.2%, undetermined/unknown (mainly microphthalmia and anterior segment dysgenesis) in 38.7% and childhood factors in 11.3%. Avoidable causes of BL/SVI accounted for 50% of the cases; 12.9% of the total were preventable with measles being the commonest cause (8.1% of the total); 37.1% were treatable with cataracts and glaucoma being the commonest causes (22.6% and 4.8% respectively). More than 35% of children required an optical device and 27.4% had potential for visual improvement with intervention.
Half of the BL/SVI causes were potentially avoidable. The data support the need for increased coverage of measles immunization. There is also a need to develop specialized pediatric ophthalmic services for the management of surgically remediable conditions, to provide optometric, low vision and orientation and mobility services. Genetic risk counseling services also may be considered.
确定柬埔寨四所盲人学校儿童失明及严重视力损害（BL/SVI）的原因，并提供眼镜、低视力辅助器具、定向与移动训练及眼科治疗。
从柬埔寨所有4所盲人学校招募16岁以下儿童。使用世界卫生组织的方法确定并分类视力损害和失明的原因。
在95名接受检查的儿童中，54.7%为失明（BL），10.5%为严重视力损害（SVI）。BL/SVI的主要解剖部位为晶状体，占27.4%；角膜，占25.8%；视网膜，占21%；全眼球，占17.7%。BL/SVI的主要潜在病因是遗传因素（主要为白内障和视网膜营养不良），占45.2%；未确定/不明（主要为小眼球和前段发育异常），占38.7%；儿童期因素，占11.3%。BL/SVI的可避免原因占病例的50%；其中12.9%总体上是可预防的，最常见原因是麻疹（占总数的8.1%）；37.1%是可治疗的，最常见原因是白内障和青光眼（分别占22.6%和4.8%）。超过35%的儿童需要光学器具，27.4%的儿童通过干预有视力改善的潜力。
一半的BL/SVI原因可能是可避免的。这些数据支持扩大麻疹免疫接种覆盖率的必要性。还需要发展专门的儿科眼科服务来管理可通过手术治疗的病症，提供验光、低视力及定向与移动服务。也可考虑遗传风险咨询服务。
