Associação Médicos da Floresta, Sao Paulo, Brazil.
Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo - Paulista Medical School, Sao Paulo, Brazil.
Int J Equity Health. 2021 Aug 30;20(1):197. doi: 10.1186/s12939-021-01536-w.
Most estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations. We aimed to evaluate frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park.
Cross-sectional study performed at Xingu Indigenous Park, Brazil, from 2016 to 2017. Residents from 16 selected villages were invited to participate and underwent a detailed ocular examination, including uncorrected (UVA) and best-corrected visual acuity (BCVA). The main cause of UVA < 20/32 per eye was determined.
A total of 2,099 individuals were evaluated. Overall, the frequency of visual impairment and blindness was 10.00% (95% CI: 8.72-11.29%) when considering UVA, decreasing to 7.15% (95% CI: 6.04-8.25%) when considering BCVA. For each increasing year on age, the risk of being in the visually impaired or blind category increased by 9% (p < 0.001). Cataracts (39.1%) and uncorrected refractive errors (29.1%) were the most frequent causes of visual impairment and blindness in this population. The main causes among those aged 45 years and more were cataracts (54.5%) while refractive errors were the main cause in adults aged 18 to 45 years (50.0%) and children up to 18 years old (37.1%).
A higher frequency of visual impairment and blindness was observed in the indigenous population when compared to worldwide estimates with most of the causes being preventable and/or treatable. Blindness prevention programs should focus on accessibility to eye exam, cataract surgeries and eyeglass distribution.
全球大多数视力障碍和失明估计数都不包括来自特定少数民族群体的数据,如土著居民。我们旨在评估欣古土著人保护区内一个大型人群样本的视力障碍和失明的发生率和原因。
2016 年至 2017 年在巴西欣古土著人保护区进行了横断面研究。邀请来自 16 个选定村庄的居民参加,并进行详细的眼部检查,包括未矫正视力(UVA)和最佳矫正视力(BCVA)。确定了每只眼睛 UVA<20/32 的主要原因。
共评估了 2099 人。总体而言,当考虑 UVA 时,视力障碍和失明的频率为 10.00%(95%CI:8.72-11.29%),当考虑 BCVA 时,频率降低至 7.15%(95%CI:6.04-8.25%)。年龄每增加 1 岁,视力障碍或失明的风险增加 9%(p<0.001)。在该人群中,白内障(39.1%)和未矫正屈光不正(29.1%)是视力障碍和失明的最常见原因。45 岁及以上人群的主要原因是白内障(54.5%),而 18 至 45 岁的成年人和 18 岁以下的儿童的主要原因是屈光不正(50.0%和 37.1%)。
与全球估计数相比,土著居民的视力障碍和失明发生率较高,大多数原因是可预防和/或可治疗的。失明预防计划应侧重于提供眼部检查、白内障手术和眼镜分配的可及性。