Ayed S, Négrel A D, Nabli M, Kamel N, Jebri A M, Siddhom M
Institut Hedi-Raïs d'ophtalmologie de Tunis, Tunisie.
Sante. 1998 Jul-Aug;8(4):275-82.
to estimate the prevalence of visual impairment and blindness; to identify the major causes of visual impairment and blindness and to estimate their overall impact, particularly on cataracts.
We used a population-based method. A cluster sample was selected, with the number of households randomly selected from a community depending on the size of the population. Examinations and data collection were carried out using the procedures recommended by the WHO.
We included 3,981 individuals, 3,547 of whom were given a medical examination (89% participation). The structure of the sample differed from that of the Tunisian population, with people over the age of 60 years over represented in the sample. The crude prevalence of blindness was 1.2% (adjusted prevalence 0.8%) and that for bilateral visual impairment was 3% (adjusted prevalence 2%). There were 225,000 individuals with severely impaired vision, of whom 64,500 were blind (including 2,100 children under the age of 15 years) and 160,000 were visually impaired (including 8,700 children). Individuals over the age of 60 were eight times more likely to become blind and 6.7 times more likely to suffer visual impairment than those below the age of 60. Cataracts, particularly associated with aging, were the main cause of blindness (66%) and bilateral visual impairment (54.6%). Uncorrected aphakia accounted for a significant fraction of the visual deficiencies identified in this survey (6.4% of cases of blindness and 11.8% of cases of bilateral visual impairment). 1.7% of the individuals examined (135,000 people) had ocular surgery and 80,000 had undergone surgery for cataracts. Only 41% of those individuals who had cataracts had undergone surgery. The provision of cataract surgery was therefore inadequate.
About 80% of the cases of blindness registered were preventable or treatable. The development of appropriate strategies for dealing with cataract blindness should significantly reduce the incidence of blindness.
评估视力损害和失明的患病率；确定视力损害和失明的主要原因，并评估其总体影响，特别是对白内障的影响。
我们采用基于人群的方法。选取整群样本，根据社区人口规模随机选择家庭数量。使用世界卫生组织推荐的程序进行检查和数据收集。
我们纳入了3981人，其中3547人接受了医学检查（参与率89%）。样本结构与突尼斯人口结构不同，60岁以上人群在样本中占比过高。失明的粗患病率为1.2%（校正患病率0.8%），双侧视力损害的粗患病率为3%（校正患病率2%）。有22.5万人视力严重受损，其中6.45万人失明（包括15岁以下儿童2100人），16万人视力受损（包括儿童8700人）。60岁以上的人失明的可能性是60岁以下人群的8倍，视力受损的可能性是60岁以下人群的6.7倍。白内障，尤其是与年龄相关的白内障，是失明（66%）和双侧视力损害（54.6%）的主要原因。本次调查中发现的视力缺陷有很大一部分是未矫正的无晶状体眼（失明病例的6.4%，双侧视力损害病例的11.8%）。接受检查的个体中有1.7%（13.5万人）接受了眼科手术，8万人接受了白内障手术。白内障患者中只有41%接受了手术。因此，白内障手术的供应不足。
登记的失明病例中约80%是可预防或可治疗的。制定应对白内障失明的适当策略应能显著降低失明发病率。
