International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Ophthalmology. 2012 Feb;119(2):355-61. doi: 10.1016/j.ophtha.2011.07.037. Epub 2011 Oct 27.
To estimate the prevalence of blindness in children in Vietnam and to assess the major causes.
A population-based study sampled children from 16 provinces across Vietnam. The second study examined children attending all blind schools in Vietnam.
In 16 provinces, 28 800 children aged 0-15 were sampled. In 28 blind schools, 569 children aged 0-15 were examined.
In children not seeing well according to the parents, presenting visual acuity (PVA) was assessed. If PVA was <3/60 in one or both eyes, the child was examined by an ophthalmologist. All children in blind schools were examined by a pediatric ophthalmologist.
Blindness was defined as PVA <3/60 in the better eye. Causes of visual loss were classified using the World Health Organization classification.
In the population-based study, 22 children had a PVA <3/60 in the better eye, a prevalence of 7.6/10 000 children (95% confidence interval [CI], 4.9-11.8/10 000). Fourteen children had a pinhole visual acuity <3/60 in the better eye, a prevalence of 4.9/10 000 (95% CI, 2.8-8.4/10 000). An estimated 16 400 (95% CI, 10 500-25 300), children were blind from all causes, with 36.4% from uncorrected refractive errors. In the blind schools, 411 children had a PVA <3/60 in the better eye and 55.5% were male. Conditions of the retina (24.6%) and cornea (24.0%) predominated. Retinopathy of prematurity (ROP) caused blindness in 32.6% of children younger than 10 years, but in only 6% of older children. The converse was true for corneal scarring and phthisis (14.0% and 27.3%, respectively). All other causes were similar between age groups (53.5% and 66.7%, respectively). More than half of all causes were avoidable.
Vietnam is developing very rapidly, and this is impacting health indices. The mortality rate of those younger than 5 years declined from 65/100 live births in 1980 to 14/100 in 2008. The findings of this study show these changes, because the childhood blindness prevalence was relatively low, and the causes show improved control of measles and vitamin A deficiency, as well as increased services for premature babies. Eye care services for children should now focus on refractive errors, cataract, and control of ROP.
估计越南儿童盲症的患病率，并评估主要病因。
一项基于人群的研究在越南 16 个省抽取了儿童作为样本。第二项研究调查了越南所有盲人学校的学生。
在 16 个省，共抽取了 28800 名 0-15 岁的儿童。在 28 所盲人学校中，有 569 名 0-15 岁的儿童接受了检查。
对于父母报告视力不佳的儿童，评估其视力（PVA）。如果双眼中一眼或两眼的 PVA<3/60，则由眼科医生进行检查。所有盲人学校的儿童均由儿科眼科医生检查。
盲症定义为较好眼的 PVA<3/60。使用世界卫生组织的分类方法对视力丧失的病因进行分类。
在基于人群的研究中，22 名儿童的较好眼 PVA<3/60，患病率为 7.6/10000 名儿童（95%置信区间[CI]，4.9-11.8/10000）。14 名儿童的较好眼针孔视力<3/60，患病率为 4.9/10000（95%CI，2.8-8.4/10000）。估计有 16400 名（95%CI，10500-25300）儿童患有各种病因导致的盲症，其中 36.4%由未矫正的屈光不正引起。在盲人学校，411 名儿童的较好眼 PVA<3/60，其中 55.5%为男性。视网膜（24.6%）和角膜（24.0%）疾病最为常见。早产儿视网膜病变（ROP）导致 10 岁以下儿童失明的比例为 32.6%，而年龄较大的儿童则为 6%。角膜混浊和眼球萎缩（分别为 14.0%和 27.3%）的情况则相反。两组年龄组的其他病因相似（分别为 53.5%和 66.7%）。超过一半的病因是可以预防的。
越南发展迅速，这对健康指标产生了影响。5 岁以下儿童的死亡率从 1980 年的每 100 例活产儿 65 例降至 2008 年的 14 例。本研究的结果表明了这些变化，因为儿童盲症的患病率相对较低，病因表明麻疹和维生素 A 缺乏症的控制有所改善，早产儿的治疗服务也有所增加。儿童眼保健服务现在应重点关注屈光不正、白内障和 ROP 的控制。
