Prakash M Vs, Sivakumar S, Dayal Ashutosh, Chitra A, Subramaniam Sudharshini
Department of Ophthalmology, Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai, Tamil Nadu, India.
Department of Community Medicine, Madras Medical College, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2017 Aug;65(8):733-737. doi: 10.4103/ijo.IJO_294_17.
To identify the morbidity patterns causing blindness in children attending schools for the blind in Chennai and comparing our data with similar studies done previously.
A cross-sectional prevalence study was carried out in two schools for the blind in Chennai. Blind schools were visited by a team of ophthalmologists and optometrists. Students with best-corrected visual acuity (BCVA) worse than 3/60 in the better eye were included and relevant history was noted. Every student underwent anterior segment evaluation and detailed fundus examination. Morbidity of the better eye was taken as cause of blindness. Health records maintained by the school were referred to wherever available.
The anatomical causes of blindness include optic nerve disorders in 75 (24.8%) cases, retinal disorders in 55 (18.2%), corneal disorders in 47 (15.6%), lens-related disorders in 39 (12.9%), congenital anomalies in 11 (3.6%), and congenital glaucoma in 20 (6.6%) cases. The whole globe was involved in six cases (1.99%). Among conditions causing blindness, optic atrophy seen in 73 (24.17%) cases was the most common, followed by retinal dystrophy in 44 (14.56%), corneal scarring in 35 (11.59%), cataract in 22 (7.28%), and congenital glaucoma in 20 (6.6%) cases.
It was found that avoidable causes of blindness were seen in 31% of cases and incurable causes in 45%. Optic nerve atrophy and retinal dystrophy are the emerging causes of blindness, underlining the need for genetic counseling and low vision rehabilitation centers, along with a targeted approach for avoidable causes of blindness.
确定钦奈盲人学校儿童失明的发病模式，并将我们的数据与之前进行的类似研究进行比较。
在钦奈的两所盲人学校开展了一项横断面患病率研究。一组眼科医生和验光师走访了盲人学校。纳入最佳矫正视力（BCVA）较差眼低于3/60的学生，并记录相关病史。每名学生均接受眼前节评估和详细的眼底检查。以较差眼的发病情况作为失明原因。如有学校保存的健康记录也会加以参考。
失明的解剖学原因包括75例（24.8%）视神经疾病、55例（18.2%）视网膜疾病、47例（15.6%）角膜疾病、39例（12.9%）晶状体相关疾病、11例（3.6%）先天性异常以及20例（6.6%）先天性青光眼。6例（1.99%）累及整个眼球。在导致失明的病症中，73例（24.17%）视神经萎缩最为常见，其次是44例（14.56%）视网膜营养不良、35例（11.59%）角膜瘢痕、22例（7.28%）白内障以及20例（6.6%）先天性青光眼。
发现31%的失明病例存在可避免的病因，45%为无法治愈的病因。视神经萎缩和视网膜营养不良是新出现的失明原因，这凸显了遗传咨询和低视力康复中心的必要性，以及针对可避免失明病因采取针对性措施的必要性。
