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Bale BI, Zeppieri M, Idogen OS, Okechukwu CI, Ojo OE, Femi DA, Lawal AA, Adedeji SJ, Manikavasagar P, Akingbola A, Aborode AT, Musa M. Seeing the unseen: The low treatment rate of eye emergencies in Africa. World J Methodol 2025; 15:102477. [DOI: 10.5662/wjm.v15.i3.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 01/11/2025] [Accepted: 01/21/2025] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality, especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.
AIM To assess the treatment rates of eye emergencies in Africa. Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.
METHODS This review examines the low treatment rates of eye emergencies in Africa, drawing on 96 records extracted from the PubMed database using predetermined search criteria.
RESULTS The epidemiology of ocular injuries, as detailed in the studies, reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age, gender, and occupation. The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks. Management approaches reported in the review include both surgical and non-surgical interventions, from medication to evisceration or enucleation of the eye. Preventive measures emphasize eye health education and the use of protective eyewear and facial protection. However, inadequate healthcare infrastructure and personnel, cultural and geographical barriers, and socioeconomic and behavioral factors hinder the effective prevention, service uptake, and management of eye emergencies.
CONCLUSION The authors recommend developing eye health policies, enhancing community engagement, improving healthcare personnel training and retention, and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
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Affiliation(s)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | | | | | | | | | | | | | - Pirakalai Manikavasagar
- Public Health for Eye Care, London School for Hygiene and Tropical Medicine, London CB21TN, United Kingdom
| | - Adewunmi Akingbola
- Department of Public Health, University of Cambridge, Cambridge CB2 1TN, Cambridgeshire, United Kingdom
| | | | - Mutali Musa
- Department of Optometry, University of Benin, Benin 300283, Nigeria
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Cushley LN, Leonard‐Hawkhead B, Jackson AJ, Peto T. Global certification of visual impairment registries: A scoping review. Acta Ophthalmol 2025; 103:7-15. [PMID: 39340236 PMCID: PMC11704824 DOI: 10.1111/aos.16763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Visual impairment is a global problem which is predicted to rise in the coming years. Some of the biggest causes of visual impairment globally include uncorrected refractive error, cataract and age-related macular degeneration. People with a visual impairment often require support and so many countries hold registers of visual impairment. These registers can sit at a national, regional or local level. This scoping review aims to identify which countries hold visual impairment registries and have published data from them. METHODS Medline All, Embase and EBSCOHost were searched using several search terms after consulting an information specialist. All papers after the year 2000 were included in the scoping review. All results are shown using a PRISMA diagram and presented narratively. RESULTS The total number of articles and papers identified was 1266; after screening and review, 57 articles were included in the review from 2000 to 2024. These articles came from 19 different countries and encompassed national, regional and local visual impairment databases. Many countries cited age-related macular degeneration as the major cause of blindness with diabetic retinopathy and glaucoma following. In less economically developed countries, refractive error was the main cause of sight loss. There were papers which focused on specific eye conditions such as glaucoma and diabetic retinopathy or on specific cohorts including working-age population and children. The leading causes of blindness in children appeared to be inherited retinal diseases, albinism and cerebral visual impairment. CONCLUSION Certification of visual impairment is held differently across the world. There is commonality among different countries regarding the major causes of visual impairment in both adults and children. The importance of holding visual impairment registers to support people with a visual impairment and to plan services is essential.
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Affiliation(s)
| | | | | | - Tunde Peto
- Centre for Public HealthQueen's University BelfastBelfastUK
- Department of OphthalmologyBelfast Health and Social Care TrustBelfastUK
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Vision Loss Expert Group of the Global Burden of Disease Study, Curran K, Peto T, Jonas JB, Friedman D, Kim JE, Leasher J, Tapply I, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Resnikoff S, Taylor HR, Sedighi T, Flaxman S, Bikbov MM, Braithwaite T, Bron A, Cheng CY, Del Monte MA, Ehrlich JR, Furtado JM, Gazzard G, Hartnett ME, Kahloun R, Kempen JH, Khairallah M, Khanna RC, Lansingh VC, Naidoo KS, Nangia V, Nowak M, Pesudovs K, Ramulu P, Topouzis F, Tsilimbaris M, Wang YX, Wang N, Bourne RRA, the GBD 2019 Blindness and Vision Impairment Collaborators, Curran K, Peto T, Bourne R, Leasher JL, Jonas JB, Friedman DS, Kim JE, Fernandes AG, Ahinkorah BO, Ahmadieh H, Ahmed A, Alfaar AS, Almidani L, Amu H, Androudi S, Arabloo J, Aravkin AY, Asemu MT, Azzam AY, Baghcheghi N, Bailey F, Baran MF, Bardhan M, Bärnighausen TW, Barrow A, Bhardwaj P, Bikbov M, Braithwaite T, Briant PS, Burkart K, Cámera LA, Coberly K, Dadras O, Dai X, Dehghan A, Demessa BH, Diress M, Do TC, Do THP, Dokova KG, Duncan BB, Ekholuenetale M, Elhadi M, Emamian MH, Emamverdi M, Farrokhpour H, Fatehizadeh A, Desideri LF, Furtado JM, Gebrehiwot M, Ghassemi F, Gudeta MD, Gupta S, Gupta VB, Gupta VK, Hammond BR, Harorani M, Hasani H, Heidari G, et alVision Loss Expert Group of the Global Burden of Disease Study, Curran K, Peto T, Jonas JB, Friedman D, Kim JE, Leasher J, Tapply I, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Resnikoff S, Taylor HR, Sedighi T, Flaxman S, Bikbov MM, Braithwaite T, Bron A, Cheng CY, Del Monte MA, Ehrlich JR, Furtado JM, Gazzard G, Hartnett ME, Kahloun R, Kempen JH, Khairallah M, Khanna RC, Lansingh VC, Naidoo KS, Nangia V, Nowak M, Pesudovs K, Ramulu P, Topouzis F, Tsilimbaris M, Wang YX, Wang N, Bourne RRA, the GBD 2019 Blindness and Vision Impairment Collaborators, Curran K, Peto T, Bourne R, Leasher JL, Jonas JB, Friedman DS, Kim JE, Fernandes AG, Ahinkorah BO, Ahmadieh H, Ahmed A, Alfaar AS, Almidani L, Amu H, Androudi S, Arabloo J, Aravkin AY, Asemu MT, Azzam AY, Baghcheghi N, Bailey F, Baran MF, Bardhan M, Bärnighausen TW, Barrow A, Bhardwaj P, Bikbov M, Braithwaite T, Briant PS, Burkart K, Cámera LA, Coberly K, Dadras O, Dai X, Dehghan A, Demessa BH, Diress M, Do TC, Do THP, Dokova KG, Duncan BB, Ekholuenetale M, Elhadi M, Emamian MH, Emamverdi M, Farrokhpour H, Fatehizadeh A, Desideri LF, Furtado JM, Gebrehiwot M, Ghassemi F, Gudeta MD, Gupta S, Gupta VB, Gupta VK, Hammond BR, Harorani M, Hasani H, Heidari G, Hosseinzadeh M, Huang JJ, Islam SMS, Javadi N, Jimenez-Corona A, Jokar M, Joshua CE, Kadashetti V, Kandel H, Kasraei H, Kaur RJ, Khanal S, Khorrami Z, Koohestani HR, Krishan K, Lim SS, El Razek MMA, Mansouri V, Maugeri A, Mestrovic T, Misganaw A, Mokdad AH, Momeni-Moghaddam H, Momtazmanesh S, Murray CJL, Negash H, Osuagwu UL, Pardhan S, Patel J, Pawar S, Petcu IR, Pham HT, Pourazizi M, Qattea I, Rahman M, Saeed U, Sahebkar A, Salehi MA, Shayan M, Shittu A, Steinmetz JD, Tan Y, Topouzis F, Tsatsakis A, Umair M, Vos T, Xiao H, You Y, Zastrozhin MS, Zhang ZJ, Zheng P. Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 2000 to 2020. Eye (Lond) 2024; 38:2047-2057. [PMID: 38937557 PMCID: PMC11269692 DOI: 10.1038/s41433-024-03101-5] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 04/06/2024] [Accepted: 04/19/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVES To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by diabetic retinopathy and their proportion of the total number of vision-impaired individuals. METHODS Data from population-based studies on eye diseases between 1980 to 2018 were compiled. Meta-regression models were performed to estimate the prevalence of blindness (presenting visual acuity <3/60) and moderate or severe vision impairment (MSVI; <6/18 to ≥3/60) attributed to DR. The estimates, with 95% uncertainty intervals [UIs], were stratified by age, sex, year, and region. RESULTS In 2020, 1.07 million (95% UI: 0.76, 1.51) people were blind due to DR, with nearly 3.28 million (95% UI: 2.41, 4.34) experiencing MSVI. The GBD super-regions with the highest percentage of all DR-related blindness and MSVI were Latin America and the Caribbean (6.95% [95% UI: 5.08, 9.51]) and North Africa and the Middle East (2.12% [95% UI: 1.55, 2.79]), respectively. Between 2000 and 2020, changes in DR-related blindness and MSVI were greater among females than males, predominantly in the super-regions of South Asia (blindness) and Southeast Asia, East Asia, and Oceania (MSVI). CONCLUSIONS Given the rapid global rise in diabetes and increased life expectancy, DR is anticipated to persist as a significant public health challenge. The findings emphasise the need for gender-specific interventions and region-specific DR healthcare policies to mitigate disparities and prevent avoidable blindness. This study contributes to the expanding body of literature on the burden of DR, highlighting the need for increased global attention and investment in this research area.
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Cheng YS, Hsiao CH, Hsia WP, Chen HJ, Chang CJ. Endoscopic Vitrectomy Combined with 3D Heads-Up Viewing System in Treating Traumatic Ocular Injury. J Ophthalmol 2024; 2024:9294165. [PMID: 39015210 PMCID: PMC11250702 DOI: 10.1155/2024/9294165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 07/18/2024] Open
Abstract
Purpose To investigate effects and complications of endoscopic vitrectomy combined with 3D heads-up viewing system in treating traumatic ocular injury. Patients and Methods. This is a retrospective interventional case series in a tertiary referral center in Taiwan, and we included patients of traumatic ocular injury, and they underwent endoscopic vitrectomy combined with a 3D heads-up viewing system. Results Fourteen eyes of traumatic globe injury from 14 patients were studied over a 30-month period. Preoperative VA ranged from no light perception (NLP) to 6/6. Postoperative visual acuity improved in 11 of the 14 eyes (79%). Until 6 months after surgery, all eyes had attached retina. The median logMAR BCVA was 2.4 at the first visit and 1.19 at the last visit (p = 0.0028). No subject suffered from retinal detachment, endophthalmitis, or other severe complications. Conclusions Vitrectomy using endoscopy combined with 3D heads-up viewing system allowed early evaluation and intervention in traumatic ocular injuries. Most of our cases showed both anatomical and visual acuity improvements.
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Affiliation(s)
- Yuan-Shao Cheng
- Department of OphthalmologyTaichung Veterans General Hospital, Taichung, Taiwan
| | - Chung-Hao Hsiao
- Department of OphthalmologyTaichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Ping Hsia
- Department of OphthalmologyTaichung Veterans General Hospital, Taichung, Taiwan
| | - Hung-Ju Chen
- Department of OphthalmologyTaichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Jen Chang
- Department of OphthalmologyTaichung Veterans General Hospital, Taichung, Taiwan
- Department of OptometryCentral Taiwan University of Science and Technology, Taichung, Taiwan
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Choi H, Kim CO, Kim TH, Jang SY, Jeon B, Han E. Influenza epidemiology and treatment in people with a visual disability: A retrospective cohort study. Disabil Health J 2024; 17:101613. [PMID: 38514295 DOI: 10.1016/j.dhjo.2024.101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Visual disabilities (VD) are expected to rise with an aging population. Persons with VD experience a higher prevalence of chronic and acute diseases. Despite the significance of influenza to this population, there is limited data comparing influenza care disparities between those with VD and those without. OBJECTIVE The study aimed to determine the influenza burden and associated healthcare utilization in individuals with VD compared to those without disabilities. METHODS A retrospective cohort study was conducted using the Korean National Health Information Database, encompassing three influenza seasons (2011-2012 to 2013-2014). The influenza incidence and incidence rate ratio (IRR) was calculated. Adjusted IRRs were calculated using a zero-inflated Poisson model. We assessed the risk of admissions and 30-day post-influenza mortality, employing logistic regression or survival analysis. RESULTS A total of 504,374 patients (252,964 patients with VD and 251,410 controls) were followed for 1,471,480 person-years. The influenza incidence was higher in the VD cohort than in the control (8.8 vs. 7.8 cases per 1000 person-years). VD cohort had a higher influenza IRR (adjusted IRR 1·13, 95% confidence interval [CI] 1·02-1·25). Severe VD exhibited higher hospitalization risk (adjusted odds ratio [OR] 1·29, 95% CI 1·10-1·20) and increased medical costs. Severe VD was a significant risk factor for mortality (adjusted Hazard Ratio 1·89, 95% CI 1·04-3·45). CONCLUSIONS People with VD have a higher influenza incidence, while their outcomes are comparable to those without. Nevertheless, severe VD significantly contributes more to hospitalization, mortality, and medical costs than controls.
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Affiliation(s)
- HeeKyoung Choi
- Department of Infectious Diseases, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Chang Oh Kim
- Division of Geriatrics and Integrated Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Boyoung Jeon
- Department of Health and Medical Information, Myongji College, Seoul, Republic of Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Seoul, Republic of Korea.
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Nuzzi A, Becco A, Boschiroli A, Coletto A, Nuzzi R. Blindness and visual impairment: quality of life and accessibility in the city of Turin. Front Med (Lausanne) 2024; 11:1361631. [PMID: 38576717 PMCID: PMC10991693 DOI: 10.3389/fmed.2024.1361631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Purpose Despite the increase in socio-health conditions and, in general, the focus on health worldwide, many diseases still adversely affect the quality of life (QoL), including those causing vision loss. The main purpose of this study was to evaluate the QoL of people with visual impairments through a questionnaire and identify issues concerning everyday life in the urban and extra-urban areas of Turin. Patients and methods A personalized questionnaire including 25 questions was distributed to 100 enrolled patients. It was designed by integrating the most widely used questionnaires related to the QoL of people with visual impairment with questions concerning the city of Turin. The inclusion criteria were any degree of visual impairment (from mild defect to complete blindness), according to Law n. 138/2001 classification. The exclusion criteria were mental disability and residence in care homes. Finally, statistical analysis was performed. Pearson's Chi-Square test was used to evaluate the strength of the association between two qualitative variables in different sections of the questionnaire. The results were classified as statistically significant with a p-value of ≤0.05 or borderline (0.05 < p-value<0.10). Results Based on responses to question 7 (Q7), 67% of selected patients stated that sight markedly influences their QoL. Moreover, 49% of patients responding to question 12 considered themselves almost completely dependent on other people regarding mobility and movement in and around Turin. In total, 57% used public transport (Q13); however, 50% of them found it challenging to access (Q14). Personal aids (e.g., white cane and magnifying glasses) were adopted only by 51% (Q15), and 63% of patients responding to question 18 suggested a refinement of urban aids (e.g., road signs). Of the 53 patients, 30 patients (56.6%) considered Turin a livable city for visually impaired people (Q19); however, 44 patients (84.6%) reported no significant improvements in Turin's urban logistics during the last 5 years and highlighted the urgent need to improve urban aids (Q21). Furthermore, the statistical associations studied showed that the loss of vision plays a significant role in influencing the perception of one's QoL (association of questions 7 and 8, X2 = 112.119, Cramer's V = 0.548, p-value <0.001). In addition, it is more difficult for visually impaired patients living outside the city to move outdoors (Chi-Square = 10.637, Cramer's V = 0.326, p - 245 value = 0.031) and to cross the street (Chi-Square = 14.102, Cramer's V = 0.376, p-250 value = 0.007). Finally, those who feel independent perceive their lives to be more fulfilling (Chi-Square = 268, X2 = 37.433; Cramer's V = 0.306, p value = 0.002). Conclusion Our study showed how vision loss plays a remarkable role in influencing the perception of one's QoL. Furthermore, it highlighted how the implementation of mobility and the use of personal aids for living in a city, such as Turin, were associated with a better perception of QoL by visually impaired patients. However, it is necessary to improve urban technological development according to the needs of people with visual disability.
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Affiliation(s)
- Alessia Nuzzi
- Eye Clinic, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Alice Becco
- Eye Clinic, Città della Salute e della Scienza University Hospital, University of Turin, Turin, Italy
| | - Andrea Boschiroli
- Eye Clinic, Città della Salute e della Scienza University Hospital, University of Turin, Turin, Italy
| | - Andrea Coletto
- Eye Clinic, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Raffaele Nuzzi
- Eye Clinic, Department of Neuroscience, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
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Deme TG, Mengistu M, Getahun F. Prevalence and associated factors of visual impairment among adults aged 40 and above in Southern Ethiopia, 2022. Sci Rep 2024; 14:2542. [PMID: 38291335 PMCID: PMC10828411 DOI: 10.1038/s41598-024-53056-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/27/2024] [Indexed: 02/01/2024] Open
Abstract
Visual impairment is a functional limitation of the eye caused by a disorder or disease that can reduce one's ability to perform daily activities. Many studies in Ethiopia have focused on childhood visual impairments. We assessed the prevalence and factors associated with visual impairment among adults aged 40 and above. Community-based cross-sectional study was done and a systematic sampling technique was used to select 655 participants. Data were collected by interviewer administered questionnaire, E-Snell chart, pinhole, torch light, and magnifying loupe. SPSS version 25 was used for analysis. Bivariate and multivariate analyses were performed to identify factors associated with outcome variable. The overall prevalence of visual impairment was found to be 36.95% (95% CI 33.2-40.8%). Factors associated with a higher odds of visual impairment included aged 51-60 years (AOR 2.37, 95% CI 1.29-4.44), aged 61 and above (AOR 8.9, 95% CI 4.86-16.3), low wealth index (AOR 1.91, 95% CI 1.14-3.2), divorced and widowed (AOR 4.67, 95% CI 2.77-7.86), no formal education (AOR 14.28, 95% CI 2.82-71.46), not utilizing eyeglass (AOR 3.94, 95% CI 1.65-9.40). The prevalence of visual impairment was relatively high compared to other studies. Age, marital status, occupation, educational status, wealth index, and not using eyeglasses were significantly associated with visual impairment. Refractory error is the leading cause of visual impairment. Early eye care service interventions are needed in this area.
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Affiliation(s)
- Tamiru Getachew Deme
- School of Medicine, Department of Human Anatomy, Arba Minch University, Arba Minch, Ethiopia.
| | - Masresha Mengistu
- Department of Ophthalmology, Arba Minch General Hospital, Arba Minch, Ethiopia
| | - Firdawek Getahun
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
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Getachew T, Mengistu M, Getahun F. Prevalence of Visual Impairment and Associated Factors Among Older Adults in Southern Ethiopia, 2022. CLINICAL OPTOMETRY 2024; 16:1-16. [PMID: 38197047 PMCID: PMC10773243 DOI: 10.2147/opto.s440423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/29/2023] [Indexed: 01/11/2024]
Abstract
Background Visual impairment is a functional limitation of the eye brought on by a disorder or disease that can make it more difficult to carry out daily tasks. Visual impairment causes a wide range of public health, social, and economic issues, particularly in developing nations, where more than 90% of the world's visually impaired people reside. Although many studies conducted in Ethiopia related with the topic, there were focused on childhood visual impairments. Objectives To assess the prevalence and factors associated with visual impairment among older adults. Methodology A community-based cross-sectional study design was conducted in Arba Minch Zuria District. Systematic sampling technique was employed to select 655 adults aged 40 and above. Data were gathered through face-to-face interviews and visual acuity measurements, and SPSS version 25 was used for analysis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with visual impairment. Results The overall prevalence of visual impairment was found to be 36.95% (95% CI=33.2-40.8%). Factors associated with a higher odds of visual impairment included aged 51-60 years (AOR=2.37,95%CI=1.29-4.44), aged 61 and above (AOR=8.9, 95%CI=4.86-16.3), low wealth index ((AOR=1.81, 95%CI: 1.14-3.2), divorced and widowed (AOR=4.67, 95%CI:2.77-7.86), no formal education (AOR=14.28, 95%CI: 2.82-71.46), not utilizing eyeglass (AOR=3.94, 95%CI (1.65-9.40). The most possible causes of visual impairment were found to be refractive error and cataract. Conclusions and Recommendations The prevalence of visual impairment among study population was relatively high, and more than three-fifths of participants had unilateral visual impairment. Age, marital status, occupation, educational status, wealth index, and not wearing of prescribed eyeglasses were significantly associated with visual impairment. Refractive error is the leading cause of visual impairment. Awareness of spectacle use and expanding cataract surgery coverage are urgently needed in this area.
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Affiliation(s)
- Tamiru Getachew
- Department of Human Anatomy, School of Medicine, Arba Minch University, Arba Minch, Ethiopia
| | - Masresha Mengistu
- Department of Ophthalmology, Arba Minch General Hospital, Arba Minch, Ethiopia
| | - Firdawek Getahun
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
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Sherief ST, Tesfaye S, Eshetu Z, Ali A, Dimaras H. Child eye health in Ethiopia: a mixed methods analysis of policy and commitment to action. BMJ Open 2023; 13:e075622. [PMID: 37940160 PMCID: PMC10632828 DOI: 10.1136/bmjopen-2023-075622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Child eye health is a serious public health issue in Ethiopia, where children under the age of 15 account for over half of the population. Our aim was to review Ethiopian health policy and practice to reveal approaches and commitment to promotion and delivery of child eye health services. METHODS We conducted a mixed-methods situational analysis employing documentary analysis and key informant interview methods. Government publications touching on any element of child eye health were included. Key informants were eligible if they were leaders, authorities, researchers or clinicians involved in child health. Data was combined and analysed by narrative synthesis, using an adaptation of the Eye Care Situation Analysis Tool as a framework. FINDINGS Eleven documents developed by the Ministries of Health and Education were included and interviews with 14 key informants were conducted. A focus on child eye health was lacking in key health policy documents, demonstrated by limited allocation of funds, a shortage of human resources, and a subpar referral system across all levels of child eye care. CONCLUSION The study identified several gaps and limitations in child eye health in Ethiopia. There is a need for health policies that strengthen ownership, finance and partnerships for improved coordination, and collaboration with line ministries and other stakeholders to improve child eye health services in Ethiopia.
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Affiliation(s)
- Sadik Taju Sherief
- Ophthalmology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
- Ophthalmology and Visual Science, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Zelalem Eshetu
- Biruh Vision Speciality Eye Center, Addis Ababa, Ethiopia
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Helen Dimaras
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- SickKids Research Institute, Toronto, Ontario, Canada
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Sherief ST, Tesfaye S, Eshetu Z, Ali A, Dimaras H. Exploring the knowledge, attitudes, and practice towards child eye health: A qualitative analysis of parent experience focus groups. PLoS One 2023; 18:e0293595. [PMID: 37922264 PMCID: PMC10624311 DOI: 10.1371/journal.pone.0293595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/17/2023] [Indexed: 11/05/2023] Open
Abstract
BACKGROUND The majority of childhood blindness causes in low-income countries are treatable or avoidable. Parents or guardians are responsible for making decisions regarding a child's eye care. Understanding parents' awareness and perception of eye problems in crucial in helping to know parents' eye care-seeking behavior. OBJECTIVE To determine parental knowledge, attitudes and practice regarding child eye health. METHODS Seven focus groups were carried out in Northwest Ethiopia on knowledge, attitude and practice of parents towards child eye health. Their responses were tape-recorded and later transcribed. A thematic phenomenological approach was used for the analysis. RESULT Seventy-one parents participated in the focus groups. Participants were aware of common eye problems like trachoma, trauma, and glaucoma. However, they were unaware of the causes and etiologies of childhood blindness. Participants perceived that eye problems could be treated with hygiene and food, and often held misconceptions about the cause of strabismus and utilization of wearing spectacles. CONCLUSION The study revealed that parents are often unaware of the causes and etiologies of common childhood eye diseases, which has downstream effects on health-seeking behavior. Health promotion efforts, potentially through mass and social media, could be helpful to raise awareness, coupled with training of health professionals at primary and secondary health facility levels.
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Affiliation(s)
- Sadik Taju Sherief
- Department of Ophthalmology, Addis Ababa University, Addis Ababa, Ethiopia
- Child Health Evaluative Sciences Program and Centre for Global Child Health, Sickkids Research Institute, Toronto, Canada
| | | | - Zelalem Eshetu
- Biruh Vision Speciality Eye Center, Addis Ababa, Ethiopia
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Helen Dimaras
- Child Health Evaluative Sciences Program and Centre for Global Child Health, Sickkids Research Institute, Toronto, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Canada
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11
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Caceres J, Zhang Y, Boe L, Zhou Y, Besirli C, Paulus YM, Rosenthal JM. Diabetic Retinopathy Screening Using a Portable Retinal Camera in Vanuatu. Clin Ophthalmol 2023; 17:2919-2927. [PMID: 37814638 PMCID: PMC10560479 DOI: 10.2147/opth.s410425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/30/2023] [Indexed: 10/11/2023] Open
Abstract
Background and Objective Proof-of-concept study to test the feasibility of using an all-in-one portable retinal camera for the screening of diabetic retinopathy in the Pacific Island of Vanuatu, which has a high rate of diabetes and its associated complications and a dearth of ophthalmologists. Study Design/Materials and methods From February 10, 2020, through February 28, 2020, 49 patients with diabetes mellitus from three islands in Vanuatu were recruited to participate in the study. Demographics, basic health data and retinal photography were obtained. A non-mydriatic, handheld camera was used (Volk Pictor Plus). Results Eleven participants (24%) had referral-warranted diabetic retinopathy. There was moderately high inter-rater reliability for our dependent variables: referral status (κ = 0.62, 95% CI 0.42-0.83), retinopathy severity (κ = 0.76, 95% CI 0.55-0.96), and clinically significant macular edema (κ = 0.50, 95% CI 0.25-0.74). Conclusion Our study confirms that portable handheld cameras can be used to obtain retinal images of sufficient quality for diabetic retinopathy screening even in resource limited environments like Vanuatu. Among this cohort, a relatively high (24%) prevalence of referral-warranted diabetic retinopathy was found in Vanuatu.
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Affiliation(s)
- Juan Caceres
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Yibing Zhang
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Lawrence Boe
- Penama Provincial Health, Godden Memorial Hospital, Ambae, Vanuatu
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Cagri Besirli
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Yannis M Paulus
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Julie M Rosenthal
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
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12
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Lanca C, Pang CP, Grzybowski A. Editorial: Refractive errors: public health challenges and interventions. Front Public Health 2023; 11:1289173. [PMID: 37849718 PMCID: PMC10577413 DOI: 10.3389/fpubh.2023.1289173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Carla Lanca
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznań, Poland
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13
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Lim HW, Pershing S, Moshfeghi DM, Heo H, Haque ME, Lambert SR. Causes of Childhood Blindness in the United States Using the IRIS® Registry (Intelligent Research in Sight). Ophthalmology 2023; 130:907-913. [PMID: 37037315 PMCID: PMC10524509 DOI: 10.1016/j.ophtha.2023.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/12/2023] Open
Abstract
PURPOSE To investigate causes of childhood blindness in the United States using the IRIS® Registry (Intelligent Research in Sight). DESIGN Cross-sectional study. PARTICIPANTS Patients ≤ 18 years of age with visual acuity (VA) 20/200 or worse in their better-seeing eye in the IRIS Registry during 2018. METHODS Causes of blindness were classified by anatomic site and specific diagnoses. MAIN OUTCOME MEASURES Percentages of causes of blindness. RESULTS Of 81 164 children with 2018 VA data in the IRIS Registry, 961 (1.18%) had VA 20/200 or worse in their better-seeing eye. Leading causes of blindness were retinopathy of prematurity (ROP) in 301 patients (31.3%), nystagmus in 78 patients (8.1%), and cataract in 64 patients (6.7%). The retina was the leading anatomic site (47.7%) followed by optic nerve (11.6%) and lens (10.0%). A total of 52.4% of patients had treatable causes of blindness. CONCLUSIONS This analysis offers a unique cross-sectional view of childhood blindness in the United States using a clinical data registry. More than one-half of blind patients had a treatable cause of blindness. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Han Woong Lim
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
- Department of Ophthalmology, Hanyang University School of Medicine, Seoul, Republic of Korea
| | - Suzann Pershing
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
- Ophthalmology and Eye Care Services, VA Palo Alto Health Care System, Palo Alto, CA
| | - Darius M. Moshfeghi
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
| | - Hwan Heo
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Md Enamul Haque
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
| | - Scott R. Lambert
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
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14
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Sabhapandit S, Gella V, Shireesha A, Thankachan L, Ismail M, Rao R, Talukdar R. Ethambutol optic neuropathy in the extended anti-tubercular therapy regime: A systematic review. Indian J Ophthalmol 2023; 71:729-735. [PMID: 36872667 PMCID: PMC10229994 DOI: 10.4103/ijo.ijo_1920_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/06/2022] [Accepted: 12/26/2022] [Indexed: 03/07/2023] Open
Abstract
The extended use of ethambutol beyond 2 months for treating tuberculosis has increased risk of optic neuropathy. We performed a systematic review of studies evaluating optic neuropathy in extended ethambutol use since 2010 and compared the outcome with a similar systematic review (1965-2010) by Ezer et al. Literature search was conducted in PubMed, Medline, EMBASE, and Cochrane databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Main outcome measures were visual acuity, color vision, visual field defects, optical coherence tomography (OCT), and visual evoked potential (VEP). The JBI Critical Appraisal Checklists were used for quality assessment. Twelve studies were selected (out of 639 studies) for analysis of ethambutol optic neuropathy. Visual acuity improvement after stopping ethambutol was statistically significant. Similar improvement was not noted for other outcome measures. On comparing the results of this review with those by Ezer et al., significant improvement was noted in visual acuity, color vision, and visual field defects. Moreover, more patients reported increased optic nerve toxicity, color vision defects, and visual field defects in the present review. Hence, we conclude that the extended use of ethambutol beyond 2 months results in significant optic nerve toxicity. Further randomized controlled trials with different populations are needed to understand the magnitude of this issue.
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Affiliation(s)
- Swapnali Sabhapandit
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Vishwanath Gella
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Anumula Shireesha
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Ledo Thankachan
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Mohamad Ismail
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Raghava Rao
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
| | - Rupjyoti Talukdar
- Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
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Li Z, Guo X, Zhang J, Liu X, Chang R, He M. Using deep leaning models to detect ophthalmic diseases: A comparative study. Front Med (Lausanne) 2023; 10:1115032. [PMID: 36936225 PMCID: PMC10014566 DOI: 10.3389/fmed.2023.1115032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/03/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose The aim of this study was to prospectively quantify the level of agreement among the deep learning system, non-physician graders, and general ophthalmologists with different levels of clinical experience in detecting referable diabetic retinopathy, age-related macular degeneration, and glaucomatous optic neuropathy. Methods Deep learning systems for diabetic retinopathy, age-related macular degeneration, and glaucomatous optic neuropathy classification, with accuracy proven through internal and external validation, were established using 210,473 fundus photographs. Five trained non-physician graders and 47 general ophthalmologists from China were chosen randomly and included in the analysis. A test set of 300 fundus photographs were randomly identified from an independent dataset of 42,388 gradable images. The grading outcomes of five retinal and five glaucoma specialists were used as the reference standard that was considered achieved when ≥50% of gradings were consistent among the included specialists. The area under receiver operator characteristic curve of different groups in relation to the reference standard was used to compare agreement for referable diabetic retinopathy, age-related macular degeneration, and glaucomatous optic neuropathy. Results The test set included 45 images (15.0%) with referable diabetic retinopathy, 46 (15.3%) with age-related macular degeneration, 46 (15.3%) with glaucomatous optic neuropathy, and 163 (55.4%) without these diseases. The area under receiver operator characteristic curve for non-physician graders, ophthalmologists with 3-5 years of clinical practice, ophthalmologists with 5-10 years of clinical practice, ophthalmologists with >10 years of clinical practice, and the deep learning system for referable diabetic retinopathy were 0.984, 0.964, 0.965, 0.954, and 0.990 (p = 0.415), respectively. The results for referable age-related macular degeneration were 0.912, 0.933, 0.946, 0.958, and 0.945, respectively, (p = 0.145), and 0.675, 0.862, 0.894, 0.976, and 0.994 for referable glaucomatous optic neuropathy, respectively (p < 0.001). Conclusion The findings of this study suggest that the accuracy of this deep learning system is comparable to that of trained non-physician graders and general ophthalmologists for referable diabetic retinopathy and age-related macular degeneration, but the deep learning system performance is better than that of trained non-physician graders for the detection of referable glaucomatous optic neuropathy.
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Affiliation(s)
- Zhixi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, United States
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Robert Chang
- Department of Ophthalmology, Byers Eye Institute at Stanford University, Palo Alto, CA, United States
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- *Correspondence: Mingguang He,
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16
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Gyllensten H, Humayun J, Sjöbom U, Hellström A, Löfqvist C. Costs associated with retinopathy of prematurity: a systematic review and meta-analysis. BMJ Open 2022; 12:e057864. [PMID: 36424118 PMCID: PMC9693652 DOI: 10.1136/bmjopen-2021-057864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To review and analyse evidence regarding costs for retinopathy of prematurity (ROP) screening, lifetime costs and resource use among infants born preterm who develop ROP, and how these costs have developed over time in different regions. DESIGN Systematic review and meta-analysis DATA SOURCES: PubMed and Scopus from inception to 23 June 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included studies presented costs for ROP screening and the lifetime costs (including laser treatment and follow-up costs) and resource use among people who develop ROP. Studies not reporting on cost calculation methods or ROP-specific costs were excluded. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened for inclusion and extracted data, including items from a published checklist for quality assessment used for bias assessment, summary and random-effects meta-analysis for treatment costs. Included studies were further searched to identify eligible references and citations. RESULTS In total, 15 studies reported ROP screening costs, and 13 reported lifetime costs (either treatment and/or follow-up costs) for infants with ROP. The range for screening costs (10 studies) was US$5-US$253 per visit, or US$324-US$1072 per screened child (5 studies). Costs for treatment (11 studies) ranged from US$38 to US$6500 per child. Four studies reported healthcare follow-up costs (lifetime costs ranging from US$64 to US$2420, and 10-year costs of US$1695, respectively), and of these, three also reported lifetime costs for blindness (range US$26 686-US$224 295) using secondary cost data. Included papers largely followed the quality assessment checklist items, thus indicating a low risk of bias. CONCLUSION The costs of screening for and treating ROP are small compared with the societal costs of resulting blindness. However, little evidence is available for predicting the effects of changes in patient population, screening schedule or ROP treatments. PROSPERO REGISTRATION NUMBER CRD42020208213.
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Affiliation(s)
- Hanna Gyllensten
- Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care, University of Gothenburg, Goteborg, Sweden
| | - Jhangir Humayun
- Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care, University of Gothenburg, Goteborg, Sweden
| | - Ulrika Sjöbom
- Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Ann Hellström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Chatarina Löfqvist
- Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care, University of Gothenburg, Goteborg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
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17
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Li S, Ye E, Huang J, Wang J, Zhao Y, Niu D, Yue S, Huang X, Liu J, Hou X, Wu J. Global, regional, and national years lived with disability due to blindness and vision loss from 1990 to 2019: Findings from the Global Burden of Disease Study 2019. Front Public Health 2022; 10:1033495. [PMID: 36388337 PMCID: PMC9650182 DOI: 10.3389/fpubh.2022.1033495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 01/29/2023] Open
Abstract
Purpose This study aimed to provide a comprehensive assessment of burden estimates and the secular trend of blindness and vision loss, as measured by years lived with disability (YLDs), at the global, regional, and national levels. Methods The age-standardized YLD rates (ASYRs) due to blindness and vision loss and its subtypes, including moderate vision loss, severe vision loss, blindness, and presbyopia, from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in the ASYRs due to blindness and vision loss. Results In 2019, the global ASYRs per 100,000 population was 327.98 for blindness and vision loss, specifically, 85.81 for moderate vision loss, 74.86 for severe vision loss, 95.03 for blindness, and 62.27 for presbyopia. From 1990 to 2019, the ASYRs due to blindness and vision loss slightly decreased. Females showed higher ASYRs than males in 2019. The global highest ASYRs were observed in South Asia and sub-Saharan Africa. Negative associations were found between the burden estimates of blindness and vision loss and the sociodemographic index levels. The EAPCs of ASYRs in blindness and vision loss were significantly negatively correlated with the ASYRs in 1990 and positively correlated with human development indices in 2019. Conclusions Globally, blindness and vision loss continue to cause great losses of healthy life. Reasonable resource allocation and health-service planning are needed for the prevention and early intervention of disabilities caused by vision loss.
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Affiliation(s)
- Shasha Li
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Enlin Ye
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiasheng Huang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jia Wang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yumei Zhao
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Dongdong Niu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Suru Yue
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xueying Huang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jie Liu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xuefei Hou
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiayuan Wu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,*Correspondence: Jiayuan Wu
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18
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Ma Q, Chen M, Li D, Zhou R, Du Y, Yin S, Chen B, Wang H, Jiang J, Guan Z, Qiu K. Potential productivity loss from uncorrected and under-corrected presbyopia in low- and middle-income countries: A life table modeling study. Front Public Health 2022; 10:983423. [PMID: 36304252 PMCID: PMC9592832 DOI: 10.3389/fpubh.2022.983423] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/23/2022] [Indexed: 01/25/2023] Open
Abstract
Objective To estimate the burden of potential productivity losses due to uncorrected and under-corrected presbyopia in LMICs among the working-age population in both the cross-sectional and longitudinal manner. Methods We extracted data for the prevalence of presbyopia from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019. Data for the gross domestic product (GDP) per capita were extracted from the World Bank database and Central Intelligence Agency's World Factbook. We introduced life table models to construct age cohorts (in 5-year age groups) of the working-age population (aged from 40 to 64 years old) in LMICs, with simulated follow-up until 65 years old in people with and without uncorrected presbyopia. The differences in productivity-adjusted life years (PALYs) lived and productivity between these two cohorts were calculated. The potential productivity loss was estimated based on GDP per capita. The WHO standard 3% annual discount rate was applied to all years of life and PALYs lived. Results In 2019, there were 238.40 million (95% confidence interval [CI]: 150.92-346.78 million) uncorrected and under-corrected presbyopia cases in LMICs, resulting in 54.13 billion (current US dollars) (95% confidence interval [CI]: 34.34-79.02 billion) potential productivity losses. With simulated follow-up until retirement, those with uncorrected and under-corrected presbyopia were predicted to experience an additional loss of 155 million PALYs (an average loss of 0.7 PALYs per case), which was equivalent to a total loss of US$ 315 billion (an average loss of US$ 1453.72 per person). Conclusions Our findings highlight the considerable productivity losses due to uncorrected and under-corrected presbyopia in LMICs, especially in a longitudinal manner. There is a great need for the development of enabling eye care policies and programs to create access to eye care services, and more healthcare investment in the correction of presbyopia in the working-age population in LMICs. This study could provide evidences for some potential health-related strategies for socio-economic development.
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19
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Wong B, Singh K, Khanna RK, Ravilla T, Shalinder S, Sil A, Dole K, Jain E, Chase H. The economic and social costs of visual impairment and blindness in India. Indian J Ophthalmol 2022; 70:3470-3475. [PMID: 36190029 PMCID: PMC9789807 DOI: 10.4103/ijo.ijo_502_22] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To provide a current estimate of the economic and social costs (or welfare costs) of visual impairment and blindness in India. Methods Using evidence from the recently conducted Blindness and Visual Impairment Survey across India, the Lancet Global Health Commission on Global Eye Health and other sources, we developed an economic model that estimates the costs of reduced employment, elevated mortality risk, education loss for children, productivity loss in employment, welfare loss for the unemployed, and caregiver costs associated with moderate and severe visual impairment (MSVI) and blindness. Probabilistic sensitivity analyses were also conducted by varying key parameters simultaneously. Results The costs of MSVI and blindness in India in 2019 are estimated at INR 1,158 billion (range: INR 947-1,427 billion) or $54.4 billion at purchasing power parity exchange rates (range: $44.5-67.0 billion), accounting for all six cost streams. The largest cost was for the loss of employment, whereas the the second largest cost was for caregiver time. A more conservative estimate focusing only on employment loss and elevated mortality risk yielded a cost of INR 504 billion (range: INR 348-621 billion) or $23.7 billion (range: $16.3-29.2 billion). Conclusion Poor eye health imposes a non-trivial recurring cost to the Indian economy equivalent to 0.47% to 0.70% of GDP in the primary scenario, a substantial constraint on the country's growth aspirations. Furthermore, the absolute costs of poor eye health will increase over time as India ages and becomes wealthier unless further progress is made in reducing the prevalence of MSVI and blindness.
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Affiliation(s)
- Brad Wong
- Mettalytics, New South Wales, Australia,Correspondence to: Dr. Brad Wong, 23 Philip St South Golden Beach, New South Wales - 2483 Australia. E-mail:
| | | | - Rohit K Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India,Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia,University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | | | | | - Asim Sil
- Vivekananda Mission Asram Netra Niramay Niketan, West Bengal, India
| | - Kuldeep Dole
- PBMA’s HV Desai Eye Hospital, Pune, Maharashtra, India
| | - Elesh Jain
- Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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Yahalom C, Braun R, Patal R, Saadeh I, Blumenfeld A, Macarov M, Hendler K. Childhood visual impairment and blindness: 5-year data from a tertiary low vision center in Israel. Eye (Lond) 2022; 36:2052-2056. [PMID: 34426656 PMCID: PMC9500002 DOI: 10.1038/s41433-021-01743-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 07/21/2021] [Accepted: 08/03/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To assess the main causes leading to childhood visual impairment/blindness in a center for low vision in Israel and to analyze the literature on pediatric blinding diseases in developed countries. METHODS Retrospective study based on observational case series. Data were obtained from medical records of visually impaired children, seen at a national referral low vision center. Children were divided into two groups: moderate visual impairment (6/18 to 6/60) and severe visual impairment (SVI)/blindness (<6/60). Inherited eye diseases (IED) were grouped together for analysis. Data from the Israeli blind registry from the same period of time were analyzed for comparison. A review of literature on childhood blindness in developed countries since 2000 was conducted. RESULTS A total of 1393 children aged 0-18 years were included in the study. Moderate visual impairment was seen in 1025 (73.6%) and SVI/blindness in 368 (26.4%) of the studied children. Among blind children, IED accounted for at least 51% of all diagnoses, including mainly albinism and retinal dystrophies. IED prevalence was equally high in both main ethnic groups (Jewish and Arab Muslims). Non-IED (22.6%) included mainly patients with cerebral visual impairment and retinopathy of prematurity. CONCLUSIONS The leading cause of childhood visual impairment and blindness in our patient cohort was IED. Analyses of the literature from the last two decades show that IED are a major cause for SVI/childhood blindness in other developed countries as well. Updated patterns of global childhood blindness may suggest a need for new approach for screening programs and modern tactics for prevention.
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Affiliation(s)
- Claudia Yahalom
- Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Ron Braun
- Department of Genetics and Metabolic Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rani Patal
- Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ibrahim Saadeh
- Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Anat Blumenfeld
- Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Macarov
- Department of Genetics and Metabolic Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Karen Hendler
- Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Abstract
BACKGROUND Eye health has widespread implications across many aspects of life, ranging from the individual to the societal level. Vision 2020: The Right to Sight is an initiative that was conceptualised in 1997 and launched in 1999. It was led by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) in response to the increasing prevalence of blindness. Approximately 80% of the causes of blindness were avoidable. Hence, the initiative set out to eliminate the major causes of avoidable blindness. These included cataract, uncorrected refractive error, trachoma, onchocerciasis, and childhood blindness. METHODS An electronic literature search was performed using PubMed, MEDLINE and Embase databases to assess the impacts of the Vision 2020 initiative. RESULTS AND CONCLUSION The Vision 2020 initiative was ambitious and was essential in catapulting the issue of avoidable blindness in the spotlight and putting it on the global health agenda. The causes of avoidable blindness remain and have not been eliminated. However, there have been noticeable changes in the distribution of the causes of avoidable blindness since the conception of Vision 2020, and this is mainly due to demographic shifts globally. We highlight some of the remaining challenges to acheiving avoidable blindness including, population size, gender disparities in access to eyecare services, and the professional workforce.
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Affiliation(s)
- Dalia Abdulhussein
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, NW1 5QH, UK
| | - Mina Abdul Hussein
- Faculty of Medicine, Imperial College London, Exhibition Road, London, UK
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22
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Sagemüller F, Bruns S, Mußhoff O. The effect of poor vision on economic farm performance: Evidence from rural Cambodia. PLoS One 2022; 17:e0274048. [PMID: 36083987 PMCID: PMC9462746 DOI: 10.1371/journal.pone.0274048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/21/2022] [Indexed: 11/24/2022] Open
Abstract
Roughly one-fifth of the global population is affected by poor visual acuity. Despite the fact that inhabitants of rural areas in low-income countries are most distressed by this, no prior research has studied the impact of poor visual acuity on the economic performance of farms. We conduct a standardized eye test with 288 farm managers in rural Cambodia and find that around 30 percent of our sample suffers from poor visual acuity in terms of nearsightedness (myopia). Our analyses indicate a statistically significant and economically meaningful association of poor visual acuity with economic farm performance. Our results show that gross margins for cropping activities per year could be, on average, around 630 USD higher if farm managers were able to correct for poor vision. Our results suggest that poor visual acuity impairs farm managers from tapping the full potential of their business, which in turn decreases their chance to break the vicious cycle of poverty.
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Affiliation(s)
- Frederik Sagemüller
- Department of Agricultural Economics and Rural Development, University of Göttingen, Göttingen, Germany
| | - Selina Bruns
- Department of Agricultural Economics and Rural Development, University of Göttingen, Göttingen, Germany
| | - Oliver Mußhoff
- Department of Agricultural Economics and Rural Development, University of Göttingen, Göttingen, Germany
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23
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Kulkarni SK, Veer AB, Gaikwad A, Deshpande M. The impact of early intervention on a child with vision loss in infancy - A parental perspective. Indian J Ophthalmol 2022; 70:3377-3381. [PMID: 36018125 DOI: 10.4103/ijo.ijo_412_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose : To assess the impact of early intervention services provided to children with visual loss and to report how parents perceive them in terms of a child's development and the family dynamics. Methods : A qualitative descriptive study was conducted on a purposively selected sample of 15 children with severe visual impairment, availing early intervention services at a tertiary care facility in Pune, Maharashtra. Data were collected by conducting in-depth interviews of the parents with the help of a semi-structured interview topic guide. Participants were asked in detail about how and whether various components of the early intervention program (EIP) had an impact on their child. The interviews were audio-recorded, transcribed, and translated into English, and the resultant textual data were analyzed using the qualitative research software NVIVO 12 to identify themes and sub-themes under each domain. Results : A total of 15 children were included in the study, with ages ranging from 13 months to 5 years. All the children included in the study suffered from severe visual impairment in infancy (Vision 3/60 - PL). In the course of this EIP, the majority of the children showed consistent progress in various aspects of child development. According to the parents, the most beneficial components of EIP were visual stimulation exercises, an improvised teaching methodology, and counseling services. Conclusion : Almost all the parents included in the study reported a positive change in the behavior and development of the child as well as improved family dynamics after implementation of EIP.
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Affiliation(s)
- Sucheta K Kulkarni
- Department of Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Amrapali B Veer
- Department of Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Ashwini Gaikwad
- Department of Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Madan Deshpande
- Department of Retina, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
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Marques AP, Ramke J, Cairns J, Butt T, Zhang JH, Jones I, Jovic M, Nandakumar A, Faal H, Taylor H, Bastawrous A, Braithwaite T, Resnikoff S, Khaw PT, Bourne R, Gordon I, Frick K, Burton MJ. The economics of vision impairment and its leading causes: A systematic review. EClinicalMedicine 2022; 46:101354. [PMID: 35340626 PMCID: PMC8943414 DOI: 10.1016/j.eclinm.2022.101354] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
Vision impairment (VI) can have wide ranging economic impact on individuals, households, and health systems. The aim of this systematic review was to describe and summarise the costs associated with VI and its major causes. We searched MEDLINE (16 November 2019), National Health Service Economic Evaluation Database, the Database of Abstracts of Reviews of Effects and the Health Technology Assessment database (12 December 2019) for partial or full economic evaluation studies, published between 1 January 2000 and the search dates, reporting cost data for participants with VI due to an unspecified cause or one of the seven leading causes globally: cataract, uncorrected refractive error, diabetic retinopathy, glaucoma, age-related macular degeneration, corneal opacity, trachoma. The search was repeated on 20 January 2022 to identify studies published since our initial search. Included studies were quality appraised using the British Medical Journal Checklist for economic submissions adapted for cost of illness studies. Results were synthesized in a structured narrative. Of the 138 included studies, 38 reported cost estimates for VI due to an unspecified cause and 100 reported costs for one of the leading causes. These 138 studies provided 155 regional cost estimates. Fourteen studies reported global data; 103/155 (66%) regional estimates were from high-income countries. Costs were most commonly reported using a societal (n = 48) or healthcare system perspective (n = 25). Most studies included only a limited number of cost components. Large variations in methodology and reporting across studies meant cost estimates varied considerably. The average quality assessment score was 78% (range 35-100%); the most common weaknesses were the lack of sensitivity analysis and insufficient disaggregation of costs. There was substantial variation across studies in average treatment costs per patient for most conditions, including refractive error correction (range $12-$201 ppp), cataract surgery (range $54-$3654 ppp), glaucoma (range $351-$1354 ppp) and AMD (range $2209-$7524 ppp). Future cost estimates of the economic burden of VI and its major causes will be improved by the development and adoption of a reference case for eye health. This could then be used in regular studies, particularly in countries with data gaps, including low- and middle-income countries in Asia, Eastern Europe, Oceania, Latin America and sub-Saharan Africa.
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Key Words
- AMD, Age- related macular degeneration
- DALYs, Disability Adjusted Life Years
- DR, Diabetic Retinopathy
- EU, European
- GBD, Global Burden of Disease
- Health economics
- ICD 11, International Statistical Classification of Diseases, Injuries and Causes of Death 11th revision
- LMICs, Low Middle Income Countries
- MSVI, Moderate and Severe Vision Impairment
- NR, Not reported
- Ophthalmology
- PPP, Purchasing power parity
- Public health
- QALYs, Quality Adjusted Life Years
- RE, Refractive Error
- Systematic review
- USD, United States Dollars ($)
- VI, Vision Impairment
- WHO, World Health Organization
- anti-VEGF, antivascular endothelial growth factor
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Affiliation(s)
- Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - John Cairns
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Thomas Butt
- University College London, London, United Kingdom
| | - Justine H. Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
- Royal Free Hospital, London, United Kingdom
| | - Iain Jones
- Sightsavers, Haywards Heath, United Kingdom
| | | | - Allyala Nandakumar
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Hannah Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria
- Africa Vision Research Institute, Durban, Kwa-Zulu Natal, South Africa
| | - Hugh Taylor
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Tasanee Braithwaite
- The Medical Eye Unit, Guy's and St Thomas' Hospital, London, United Kingdom
- School of Immunology and Microbiology and School of Life Course Sciences, Kings College, London, United Kingdom
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVS, University of New South Wales, Sydney, NSW, Australia
| | - Peng T. Khaw
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Rupert Bourne
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Kevin Frick
- Johns Hopkins Carey Business School, Baltimore, MD, United States
| | - Matthew J. Burton
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Kolli A, Mozaffarian RS, Kenney EL. Food Insecurity and Vision Impairment Among Adults Age 50 and Older in the United States. Am J Ophthalmol 2022; 236:69-78. [PMID: 34653357 DOI: 10.1016/j.ajo.2021.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To test the hypothesis that food insecurity is associated with greater prevalence of vision impairment (VI). DESIGN Cross-sectional, nationally representative survey of US adults. METHODS Adults 50 years and older were included. Food security category (ie, full, marginal, low, or very low) was assessed by the US Household Food Security Survey Module. Objective presenting VI (PVI) and self-reported VI (SRVI) were assessed by examination and survey, respectively. Separate logistic regression models were constructed with food insecurity category as a predictor of PVI or SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Age-stratified analyses (age 50 through 64 years vs 65 years and older) were also conducted. RESULTS Mean age of participants (n = 10,078) was 63.4 years; 8,518 (89.9%) were fully food secure, 1,033 (7.2%) had PVI, and 2,633 (20.1%) had SRVI. Compared with full food security, adjusting for sociodemographic confounders, those with marginal (adjusted odds ratio [aOR], 1.31; 95% CI, 0.97-1.76), low (aOR, 1.61; 95% CI, 1.17-2.23), and very low (aOR, 2.71; 95% CI, 1.75-4.20) food security had higher odds of PVI. Compared with full food security, those with marginal (aOR, 1.58; 95% CI, 1.23-2.02), low (aOR, 1.46; 95% CI, 1.11-1.92), and very low (aOR, 1.85; 95% CI, 1.41-2.41) food security had higher odds of SRVI. The associations between food insecurity and PVI were greater in magnitude in those 65 years and older compared with those age 50 through 64 years. CONCLUSIONS In this nationally representative sample of US adults 50 years and older, severe food insecurity was increasingly associated with greater prevalence of VI in a dose-response manner.
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Affiliation(s)
- Ajay Kolli
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA.
| | - Rebecca S Mozaffarian
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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26
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Muhit M, Karim T, Jahan I, Al Imam MH, Das MC, Khandaker G. Epidemiology of eye diseases among children with disability in rural Bangladesh: a population-based cohort study. Dev Med Child Neurol 2022; 64:209-219. [PMID: 34468025 DOI: 10.1111/dmcn.15041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
AIM To describe the epidemiology of eye diseases among children with disability in rural Bangladesh. METHOD We established a population-based cohort of children with disability using the key informant method. Children younger than 18 years with disability (i.e. physical, visual, hearing, speech, epilepsy) were included. We used detailed ophthalmological assessments following World Health Organization (WHO) protocols by a multidisciplinary team including an ophthalmologist, optometrist, physician, and physiotherapist. Visual impairment, blindness, and severe visual impairment (SVI) were defined by following WHO categories. RESULTS Between October 2017 and February 2018, 1274 children were assessed (43.6% female; median [interquartile range] age 9y 10mo [6y -13y 7mo]). Overall, 6.5% (n=83) had blindness/SVI, and 5.6% (n=71) had visual impairment. In the group with blindness/SVI, 47% (n=39) had cortical blindness; of those, 79.5% (n=31) had cerebral palsy (CP). The other main anatomical sites of abnormalities in this group included lens (13.3%, n=11), cornea (10.8%, n=9), and optic nerve (9.6%, n=8). In the group with visual impairment, 90.1% (n=64) had refractive error. Overall, 83.1% (n=69) and 78.8% (n=56) of those with blindness/SVI and visual impairment had avoidable causes. Most children with blindness/SVI and visual impairment lacked access to education. INTERPRETATION The burden of blindness/SVI/visual impairment is high among children with disability in rural Bangladesh, mostly due to avoidable causes. Overrepresentation of CP and cortical blindness in the group with blindness/SVI and refractive error in the group with visual impairment highlights the need for integration of ophthalmology assessment, eye care, and refraction services in comprehensive health care for children with disability including CP in rural Bangladesh.
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Affiliation(s)
- Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Tasneem Karim
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
| | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
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Ezeh E, Nkanga E, Okonkwo S, Agweye C, Ibanga A, Nkanga D. Paediatric cataracts in a tertiary eye centre in South-South Nigeria: An initial audit of surgical outcome. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_40_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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28
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Tan Z, Zhu Z, He Z, He M. Artificial Intelligence in Ophthalmology. Artif Intell Med 2022. [DOI: 10.1007/978-981-19-1223-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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29
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Tousignant B, Brûlé J. Refractive error, risk of amblyopia and eye care services utilisation among Nunavik Inuit in Northern Canada. Clin Exp Optom 2021; 105:872-877. [PMID: 34763614 DOI: 10.1080/08164622.2021.1993057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Nunavik Inuit patients, in Northern Canada, have a significant burden of refractive error. The frequency at which they access eye care is insufficient. This exposes children of this population to a substantial risk of refractive amblyopia. BACKGROUND No data are available on eye health and services among Nunavik Inuit in Quebec, Canada. This study aims to describe the prevalence of ametropias, risk of refractive amblyopia, and eye health services uptake amongst a sample of Nunavik Inuit. METHODS Retrospective cohort using data from electronic records of the sole government-contracted eye team travelling to all 14 Nunavik villages, from 2006 to 2018. RESULTS Some 26,541 examinations were analysed, with data from 6,341 patients (median age 27 years (IQR 30); 32% aged under 19 years; 60.3% female) representing 48% of the census population. Population weighted prevalence of ametropias was myopia 46.5% (95% CI 45.3 - 47.6), hyperopia 17.1% (95% CI 16.2 - 18.1), astigmatism 39.6% (95% CI 38.4 - 40.8) and presbyopia 30.0% (95% CI 28.9 - 31.0). Some 5.9% of patients aged 0-9 years present a risk of refractive amblyopia. Mean frequency of examinations for all ages was once per 4 years (95% CI 4.0 - 4.0) and for children aged 5 - 19 years, frequency was once per 4.8 years (95% CI 4.8 - 5.0). In 2018, 74% of patients who were prescribed spectacles purchased them, with a median time of procurement of 21 days (IQR 247, skewness 2.7). CONCLUSION There is a high prevalence of ametropias amongst the clinical population of Nunavik Inuit. Most patients needing spectacles obtain them within a few weeks. Frequency of eye health services is insufficient to meet recommended guidelines, especially in children, for whom the risk of refractive amblyopia is pervasive.
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Affiliation(s)
- Benoit Tousignant
- School of Optometry, University of Montreal, Montreal, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - Julie Brûlé
- School of Optometry, University of Montreal, Montreal, Canada
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30
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Chaves ILC, Padovani CR, Zornoff DDCM, Ferreira ASSBS, Jorge EN, Schellini SA. Ophthalmological knowledge of Family Health Network physicians working as first care providers in Brazil. Rev Assoc Med Bras (1992) 2021; 67:795-799. [PMID: 34709319 DOI: 10.1590/1806-9282.20200866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/13/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE First care providers working in the Brazilian Unified Health System are often physicians from the Family Health Program. Their knowledge on ophthalmology could indicate whether there is a need for training to decrease ophthalmological demands to secondary or tertiary health levels. METHODS A cross-sectional observational study based on an electronic questionnaire was conducted to evaluate the ophthalmological knowledge of Family Health Program physicians working at the VI Regional Health Department, Sao Paulo, Brazil. All Family Health Program physicians from this regional health department were invited, and the study included those who responded to the full questionnaire (115 physicians). The data were evaluated using descriptive analysis. RESULTS There was no difference in the ophthalmological knowledge between sexes or in relation to undergraduate schools. Only 20% of the interviewees were specialized in Family and Community Medicine, which did not influence the number of correct answers. Only 22 (19.1%) physicians reported having enough knowledge about the main eye disorders, and 82 (71.3%) physicians considered themselves capable of treating ophthalmological emergencies. However, acute glaucoma was recognized by only 51 (44.3%) physicians, and eye perforations could only be handled by 65 (56.5%) of them. In addition, only 47 (40.9%) participants correctly answered that congenital cataracts should be operated right after diagnosis. CONCLUSIONS Family Health Program physicians working as first care providers in the Health System in Brazil presented poor ophthalmological knowledge. Providing training on ophthalmology may improve the ophthalmological care at the primary level within SUS and reduce the case demands at other healthcare levels.
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Affiliation(s)
| | - Carlos Roberto Padovani
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Instituto de Biociências - Botucatu (SP), Brazil
| | - Denise de Cássia Moreira Zornoff
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Núcleo de Educação a Distância e Tecnologia de Informação em Saúde - Botucatu (SP), Brazil
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31
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Tousignant B, Brûlé J. [Visual Impairment and Eye Diseases in St. Louis, Senegal]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2021; 1:mtsibulletin.2021.112. [PMID: 35586591 PMCID: PMC9022752 DOI: 10.48327/mtsibulletin.2021.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 06/14/2021] [Indexed: 12/03/2022]
Abstract
Background Few epidemiological data describe the prevalence of blindness and visual impairment in Senegal. Data from West African studies estimate blindness prevalence between 1.2 - 3.4% and that of visual impairment between 10.4 - 17.1%. IRIS Mundial (IM) is a non-governmental organization collaborating with l'Association St-Louisienne pour la Vue (ASV) to develop eye care in Senegal. Objective Describe the relative importance of and causes of blindness and visual impairment in a population consulting for vision problems in the Senegalese region of St. Louis, to assist in planning of relevant eye care programs. Methods Results from eye exams carried out by a team from IM in 2018 have been complied and analyzed. Results In all, 1944 patients were examined (56.5% female). Some 25.7% of patients presented a visual impairment (22.5% moderate; 3.2% severe). Regarding refractive error, 15.3% of patients had myopia, 10.7% had hyperopia, 54.8% had astigmatism and 55.8% were presbyopic. Clinically significant cataracts is present in 17.4% of patients and glaucoma in 2.5%. Conclusion Our data give a glimpse of the prevalence of visual impairment and ocular disease in St. Louis, Senegal. Uncorrected refractive error, cataracts and glaucoma are present in this population and may guide the planning of relevant eye care interventions.
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Affiliation(s)
- B. Tousignant
- École d'optométrie, Université de Montréal, Québec, Canada
- École de santé publique, Université de Montréal, Québec, Canada
| | - J. Brûlé
- École d'optométrie, Université de Montréal, Québec, Canada
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Marques AP, Ramke J, Cairns J, Butt T, Zhang JH, Muirhead D, Jones I, Tong BA, Swenor BK, Faal H, Bourne RR, Frick KD, Burton MJ. Global economic productivity losses from vision impairment and blindness. EClinicalMedicine 2021; 35:100852. [PMID: 33997744 PMCID: PMC8093883 DOI: 10.1016/j.eclinm.2021.100852] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In the absence of accessible, good quality eye health services and inclusive environments, vision loss can impact individuals, households and communities in many ways, including through increased poverty, reduced quality of life and reduced employment. We aimed to estimate the annual potential productivity losses associated with reduced employment due to blindness and moderate and severe vision impairment (MSVI) at a regional and global level. METHODS We constructed a model using the most recent economic, demographic (2018) and prevalence (2020) data. Calculations were limited to the working age population (15-64 years) and presented in 2018 US Dollars purchasing power parity (ppp). Two separate models, using Gross Domestic Product (GDP) and Gross National Income (GNI), were calculated to maximise comparability with previous estimates. FINDINGS We found that 160.7 million people with MSVI or blindness were within the working age and estimated that the overall relative reduction in employment by people with vision loss was 30.2%. Globally, using GDP we estimated that the annual cost of potential productivity losses of MSVI and blindness was $410.7 billion ppp (range $322.1 - $518.7 billion), or 0.3% of GDP. Using GNI, overall productivity losses were estimated at $408.5 billion ppp (range $320.4 - $515.9 billion), 0.5% lower than estimates using GDP. INTERPRETATION These findings support the view that blindness and MSVI are associated with a large economic impact worldwide. Reducing and preventing vision loss and developing and implementing strategies to help visually impaired people to find and keep employment may result in significant productivity gains. FUNDING MJB is supported by the Wellcome Trust (207472/Z/17/Z). JR's appointment at the University of Auckland is funded by the Buchanan Charitable Foundation, New Zealand. The Lancet Global Health Commission on Global Eye Health was supported by grants from The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity (GR001061), NIHR Moorfields Biomedical Research Centre, The Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The SEVA Foundation, The British Council for the Prevention of Blindness and Christian Blind Mission. The funders had no role in the design, conduct, data analysis of the study, or writing of the manuscript.
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Affiliation(s)
| | - Jacqueline Ramke
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - John Cairns
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Thomas Butt
- University College London, London, United Kingdom
| | - Justine H. Zhang
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Debbie Muirhead
- The Fred Hollows Foundation, Melbourne, Australia
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Iain Jones
- Sightsavers, Haywards Heath, United Kingdom
| | | | - Bonnielin K Swenor
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Hannah Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria
- Africa Vision Research Institute, Durban, Kwa-Zulu Natal, South Africa
| | - Rupert R.A. Bourne
- Vision & Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
- Department of Ophthalmology, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Kevin D. Frick
- Carey Business School, Johns Hopkins University, Baltimore, United States
| | - Matthew J. Burton
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
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Hajek A, Wolfram C, Spitzer M, König HH. Association of vision problems with psychosocial factors among middle-aged and older individuals: findings from a nationally representative study. Aging Ment Health 2021; 25:946-953. [PMID: 32054296 DOI: 10.1080/13607863.2020.1725806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives: Little is known about the specific association of vision loss and psychosocial outcome measures in contrast to other health limitations. The aim of this study was to identify whether vision problems are associated with psychosocial outcomes among middle-aged and older adults and to compare it with the association between other chronic health conditions and psychosocial factors.Method: Cross-sectional data came from wave 5 (2014) of the German Ageing Survey which is a representative sample of non-institutionalized individuals ≥ 40 years in Germany. Psychosocial outcomes (life satisfaction, positive affect, negative affect, depressive symptoms, optimism, general self-esteem, and social isolation) were assessed using well-established and widely used scales. Self-rated trouble reading the newspaper due to vision problems and self-rated difficulties recognizing known people on the street due to vision problems were used as independent variables of interest.Results: Regressions showed that both 'vision problems: reading the newspaper' and 'vision problems: difficulties recognizing people' are consistently associated with worse psychosocial outcomes (decreased life satisfaction, decreased positive affect, increased negative affect, increased depressive symptoms, decreased optimism, decreased self-esteem and increased social isolation). In contrast, none of the physical illnesses was consistently associated with all psychosocial outcome measures.Conclusion: Adjusting for various potential confounders and in contrast to various chronic diseases, our findings emphasize an association between vision problems and worse psychosocial outcomes in middle-aged and older adults. Future longitudinal studies are needed to validate our findings.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Wolfram
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Spitzer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Fung MM, Yap MK, Cheng KK. Correctable visual impairment among people with diabetes in Hong Kong. Clin Exp Optom 2021; 93:453-7. [DOI: 10.1111/j.1444-0938.2010.00539.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Mavis My Fung
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
E‐mail:
| | - Maurice Kh Yap
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
E‐mail:
| | - Karen Ky Cheng
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
E‐mail:
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Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomão SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, Faal HB. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health 2021; 9:e489-e551. [PMID: 33607016 PMCID: PMC7966694 DOI: 10.1016/s2214-109x(20)30488-5] [Citation(s) in RCA: 694] [Impact Index Per Article: 173.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rupert R A Bourne
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK; Department of Ophthalmology, Cambridge University Hospitals, Cambridge, UK
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | | | - Simon Arunga
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Damodar Bachani
- John Snow India, New Delhi, India; Ministry of Health and Family Welfare, New Delhi, India
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Peek Vision, London, UK
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Tasanee Braithwaite
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; The Medical Eye Unit, St Thomas' Hospital, London, UK
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - John Cairns
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Chimgee Chuluunkhuu
- Orbis International, Ulaanbaatar, Mongolia; Mongolian Ophthalmology Society, Ulaanbaatar, Mongolia
| | | | | | - William H Dean
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Alastair K Denniston
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Ophthalmology Department, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Health Data Research UK, London, UK
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Paul M Emerson
- International Trachoma Initiative and Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kevin D Frick
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - João M Furtado
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | | | - Reeta Gurung
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Esmael Habtamu
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Eyu-Ethiopia Eye Health Research, Training, and Service Centre, Bahirdar, Ethiopia
| | - Peter Holland
- International Agency for the Prevention of Blindness, London, UK
| | - Jost B Jonas
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas and Panda, Heidelberg, Germany; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Pearse A Keane
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rohit C Khanna
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Peng Tee Khaw
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Fatima Kyari
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Van C Lansingh
- Instituto Mexicano de Oftalmologia, Queretaro, Mexico; Centro Mexicano de Salud Visual Preventiva, Mexico City, Mexico; Help Me See, New York, NY, USA
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Milka M Mafwiri
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Priya Morjaria
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Lizette Mowatt
- University Hospital of the West Indies, Kingston, Jamaica
| | - Debbie Muirhead
- The Fred Hollows Foundation, Melbourne, Australia; Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Indian Institute of Public Health, Hyderabad, India
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Kenya Medical Training College, Nairobi, Kenya
| | - Daksha B Patel
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Bernadetha R Shilio
- Department of Curative Services, Ministry of Health Community Development, Gender, Elderly, and Children, Dodoma, Tanzania
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Bonnielin K Swenor
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hugh R Taylor
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Aubrey Webson
- Permanent Mission of Antigua and Barbuda to the United Nation, New York, NY, USA
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Duke-NUS Medical School, Singapore
| | - Richard Wormald
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | | | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Brien Holden Vision Institute, University of New South of Wales, Sydney, Australia
| | | | - Clare E Gilbert
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah B Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria; Africa Vision Research Institute, Durban, South Africa
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Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. Lancet Glob Health 2021; 9:e130-e143. [PMID: 33275950 PMCID: PMC7820390 DOI: 10.1016/s2214-109x(20)30425-3] [Citation(s) in RCA: 575] [Impact Index Per Article: 143.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/24/2020] [Accepted: 09/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050. METHODS We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision FINDINGS In 2020, an estimated 43·3 million (95% UI 37·6-48·4) people were blind, of whom 23·9 million (55%; 20·8-26·8) were estimated to be female. We estimated 295 million (267-325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147-179) were female; 258 million (233-285) to have mild vision impairment, of whom 142 million (55%; 128-157) were female; and 510 million (371-667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205-365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (-29·4 to -27·7) and prevalence of mild vision impairment decreased slightly (-0·3%, -0·8 to -0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia. INTERPRETATION Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages. FUNDING Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
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Sun Y, Xiong L, Wang X, Wang L, Chen B, Huang J, Huang M, Chen J, Wu J, Huang S, Liu Y. Autophagy inhibition attenuates TGF-β2-induced epithelial-mesenchymal transition in lens epithelial cells. Life Sci 2020; 265:118741. [PMID: 33181173 DOI: 10.1016/j.lfs.2020.118741] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/23/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022]
Abstract
AIMS Autophagy has been reported to play an essential role in fibrotic disorders. Known as fibrotic cataract, posterior capsular opacification (PCO) result from pathological epithelial-mesenchymal transition (EMT) of lens epithelial cells (LECs). This study aims to identify the role and potential mechanism of autophagy in TGF-β2-induced EMT in LECs. MAIN METHODS Primary rabbit LECs were treated with TGF-β2 to induce EMT as a model of fibrotic cataract in vitro. 3-methyladenine, chloroquine, bafilomycin A1, and gene silencing of autophagy-related protein 7 (ATG7) were treated in LECs for autophagy inhibition, while rapamycin was utilized for autophagy activation. The expression levels of EMT/autophagy-associated markers were analyzed by qRT-PCR, western blotting, immunofluorescence and transmission electron microscopy. We additionally examined cell migration ability with transwell migration assay and wound healing assay. KEY FINDINGS TGF-β2 promoted autophagy flux during EMT progression of LECs in a time-dependent manner. Autophagy activation by rapamycin enhanced TGF-β2-triggered fibrogenic responses and cell migration in LECs, whereas pharmacological inhibition of autophagy alleviated TGF-β2-induced increases of EMT markers and cell migration of LECs. In addition, the phosphorylation of Smad2/3 induced by TGF-β2 was suppressed through autophagy inhibition, while it was promoted upon autophagy activation, indicating that TGF-β2/Smad signaling was involved in the modulation of autophagy on EMT in LECs. Furthermore, ATG7-silenced LECs exerted anti-fibrosis effect induced by TGF-β2 through downregulation of autophagy. SIGNIFICANCE Intervention/inhibition of autophagy could attenuate TGF-β2-induced EMT in LECs, which provides autophagy-related insights on preventing and treating the fibrotic cataract or other fibrotic diseases.
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Affiliation(s)
- Yan Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Lang Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiaoran Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Liping Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Baoxin Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Jingqi Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Mi Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Jieping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Jing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Shan Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
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Shrestha A, Khatri B, Naito T. A Unique Experience of Retinal Diseases Screening in Nepal. Clin Ophthalmol 2020; 14:2037-2042. [PMID: 32764869 PMCID: PMC7382583 DOI: 10.2147/opth.s259274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background Recently, the number of retinal patients is increasing in Nepal. The retinal problems are the second common cause of blindness in Nepal. Retinal diseases are challenging to manage due to the lack of simple and cost-effective screening methods, limited human resources, poverty, and lack of awareness in Nepal. Hospital for Children, Eye, ENT & Rehabilitation Services (CHEERS), Nepal conducted retina screening camps and education in communities through Retina Eye Care of Nepal project (RECON) in the years 2017 and 2018. Materials and Methods We screened retinal patients with an indirect ophthalmoscope coupled with plus 20 Dioptre lens and portable fundus camera. We referred the patients needing interventions to the base hospital (CHEERS) using a screening algorithm, where they received retinal laser and surgery. Besides, we also provided on-site educational programs for retinal disease awareness to the community. Results Retinal problems found from two static outreach clinics (SORC) and a day screening and treatment service (DSTS) were 18.3%, 20%, and 20%, respectively, while from a remote rural health camp (RRHC) was 2.61%. Likewise, patients referred to CHEERS for retinal laser or other retinal interventions were 15%, 16.6%, 16%, and 1.96% from 2 SORCs, 1 DSTS, and 1 RRHC, respectively. Conclusion Retina camp is a cost-effective approach to early detection and referral for retinal-related vision impairment patients. It is also one opportunity to educate the community. The purpose of the project was to provide retina care to the community who otherwise could not afford it. We recommend a similar screening model on a large scale in a low-resource setting for the maximum benefits to the rural community.
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Affiliation(s)
- Arjun Shrestha
- Department of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT & Rehabilitation Services, Bhaktapur, Bagmati Province, Nepal
| | - Bijay Khatri
- Academic and Research Department, BP Eye Foundation, Hospital for Children, Eye, ENT & Rehabilitation Services, Bhaktapur, Bagmati Province, Nepal
| | - Takeshi Naito
- Department of Ophthalmology, Tokushima University Hospital, Tokushima, Japan
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Xulu-Kasaba ZN, Mashige KP, Mthembu MG, Mazibuko NS, Mabunda NA, Randeree AS, Parsad A. A profile of patients presenting at a low vision clinic in a resource-limited setting. AFRICAN VISION AND EYE HEALTH 2020. [DOI: 10.4102/aveh.v79i1.500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: The university-based low vision clinic is one of the few low vision clinics in South Africa.Aim: To describe demographic and clinical profiles of patients who attended this clinic from 2010 to 2017.Setting: The university low vision clinic, South Africa.Methods: The record cards of all patients seen at the low vision clinic over 8 years were examined and the following information was extracted: age, gender, presenting visual acuity (VA), VA following low vision assessment, cause of visual impairment and types of low vision devices recommended.Results: A total of 621 patients were examined, comprising 45.1% males and 55.9% females aged 36.0 ± 18.2 years (range: 4–93 years). Many of these patients (33.7%) had presenting VA worse than 1.3 logarithm of the Minimum Angle of Resolution (logMAR) ( 6/120) at 4 m in the better eye, and 196 (31.6%) had presenting VA of worse than 1.3 logMAR at near distance. Following optical low vision assessment, 62.4% had distance VA of 0.9 LogMAR (6/48) to −0.2 logMAR (6/3.8) and 58.4% had near VA of 0.9 logMAR (6/48) to −0.2 logMAR (6/3.8). Albinism (22.7%), unknown causes (18.2%), cataract (15.5%) and macular diseases (12.2%) were the most common causes of low vision. Amblyopia (80.7%) was the most common cause of low vision in patients aged 20 years and younger, followed by albinism (68.1%) and corneal diseases (41%). Cataract (78.1%), macular diseases (64.4%) and glaucoma (55.9%) were the most common causes of low vision in patients aged more than 60 years. Telescopes (33.8%) were the most commonly recommended form of intervention, followed by magnifiers (29.6%) and protective measures (24.5%).Conclusion: Albinism, cataract and macular diseases are the predominant causes of low vision in patients attending this low vision clinic. There was a significant improvement in VA after low-vision assessment, particularly for patients with presenting VA of better than 1.3 logMAR (6/120).
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Buchan JC, Dean WH, Ramke J, Burton MJ. Response to: Comment on: 'The inverse-research law of global eye health'. Eye (Lond) 2020; 34:2350. [PMID: 32071403 DOI: 10.1038/s41433-020-0808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- John C Buchan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK. .,Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - William H Dean
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.,School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.,Moorfields Eye Hospital, London, UK
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Choi HR, Rim TH, Lee JH, Lee SW, Baek J, Kim K, Youm Y, Kim HC. Prevalence of and factors related with abnormal fundoscopic findings among the elderly population in a rural community in South Korea. Semin Ophthalmol 2020; 35:41-49. [PMID: 32026733 DOI: 10.1080/08820538.2020.1722182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We aimed to report the results of fundus photography ophthalmic examinations among older adults in a rural community in South Korea. We used data from the Korean Social Life, Health, and Aging Project cohort study, which was designed to examine the entire population of individuals aged 60 years or older and their spouses living in a rural Village K of Ganghwa Island, South Korea. At baseline, a total of 860 people was targeted as the study population. From December 2011 to January 2019, five health examinations were conducted, including baseline and follow-up tests. During the fifth wave of the study, we performed fundus photography to assess eye health. Ophthalmic and physical examinations were conducted for 387 people who participated in the fifth wave by trained researchers. Systemic factors were evaluated via blood and diagnostic tests. After excluding eight people who did not undergo follow-up fundoscopy, a total of 379 participants was included for analysis. We classified the participants into two groups with either no (zero) or one or more suspicious ophthalmic diseases. The abnormalities included media opacity, suspected glaucoma, and suspicion of retinal disease as diagnosed by a trained specialist. We further categorized ophthalmic conditions as clinically insignificant, follow-up needed, semi-urgent, and urgent conditions. We included 379 participants, of which 225 (59.4%) were women. The mean age of the participants was 76.4 ± 6.2 years. Among all participants, 81% (n=307) had one or more abnormalities on fundus screening. Older age, living alone, high blood pressure, and high fasting insulin were associated with an increased risk of having ≥ one eye disease. In terms of triage, 3.7% (n= 14) of the observed conditions were urgent, and 25.9% (n= 98) were semi-urgent. Therefore, we documented fundoscopy results among the elderly population in a rural community in South Korea. Elderly people living alone were more likely to have eye disease. Policies to improve eye health are needed to prevent vision loss in this population.
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Affiliation(s)
- Hye Rin Choi
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Seoul, Republic of Korea
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Bukit Merah, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Bukit Merah, Singapore.,Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Hyun Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jongmin Baek
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwanghyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Sociology, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Seoul, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Bastawrous A, Suni AV. Thirty Year Projected Magnitude (to 2050) of Near and Distance Vision Impairment and the Economic Impact if Existing Solutions are Implemented Globally. Ophthalmic Epidemiol 2019; 27:115-120. [PMID: 31810404 DOI: 10.1080/09286586.2019.1700532] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Recent global, regional and country-level prevalence estimates for blindness and vision impairment will be important when designing future public health policies. The aim of this paper is to contribute to this discussion by estimating the productivity impact of known effective interventions to treat all preventable cases of vision impairment at the global, regional and country-level up to 2050. We also provide estimates of potential reduction in the number of people with vision impairment, as well as averted vision-impaired years up to 2050.Methods: We combined recent estimates of the prevalence of blindness, distance and near vision impairment with the World Bank's World Development Indicators (WDI) and estimated the global, regional and country-level productivity gains up to 2030, 2040 and 2050 from known effective interventions, primarily cataract surgery and treated uncorrected refractive errors. The magnitude of productivity gains relative to baseline depended on population size, estimated current and future prevalence of vision impairment, level of economic development, long-term wage growth, and long-term real interest rates.Results: Globally, we estimate that the number of people affected by blindness could be reduced from the estimated 114.6 million by 2050 to 58.3 million. This would be associated with over one billion blind life-years averted and US$ 984 billion in global productivity gains. These numbers are dwarfed by the impact of interventions to reduce the prevalence of Moderate and Severe Vision Impairment (MSVI) [Presenting Acuity <20/60 to 20/400 in the better-seeing eye]. We estimate that the number of people affected by MSVI could be reduced by 435.8 million people to 147.9 million by 2050. This reduction would translate to over 9 billion MSVI -life-years avoided and US$ 17 trillion in productivity gains by 2050. While other causes of VI would not be possible to eliminate completely based on current known effective treatments, low-cost interventions to eliminate VI from uncorrected presbyopia would avert 1.2 billion presbyopia life-years and achieve US$ 1.05 trillion in productivity gains by 2050. In total, the global productivity gains for all three categories are estimated to be US$ 19 trillion by 2050. East Asia makes up the greatest share of productivity gains due to the high number of people affected by VI and the region's continuing economic growth.Conclusion: Implementation of currently known and effective treatments of avoidable blindness, MSVI and presbyopia would be expected to contribute significant productivity gains to the global economy at a fraction of the estimated costs to deliver them.
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Affiliation(s)
- Andrew Bastawrous
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Antti-Ville Suni
- Department of Political Science, Fordham University London Centre, London, UK
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Demonstration of technical feasibility and viability of whole eye transplantation in a rodent model. J Plast Reconstr Aesthet Surg 2019; 72:1640-1650. [PMID: 31377202 DOI: 10.1016/j.bjps.2019.05.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 04/17/2019] [Accepted: 05/02/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Whole eye transplantation (WET) holds promise for vision restoration in devastating/disabling visual loss (congenital or traumatic) not amenable to surgical or neuroprosthetic treatment options. The eye includes multiple tissues with distinct embryonic lineage and differential antigenicity. Anatomically and immunologically, the eye is unique due to its avascular (cornea) and highly vascular (retina) components. Our goal was to establish technical feasibility, demonstrate graft viability, and evaluate histologic changes in ocular tissues/adnexae in a novel experimental model of WET that included globe, adnexal, optic nerve (ON), and periorbital soft tissues. METHODS Outbred Sprague-Dawley rats (n = 5) received heterotopic vascularized WET from donors. Each WET included the entire globe, adnexa, ON, and periorbital soft tissues supplied by the common carotid artery and external jugular vein. Viability and perfusion were confirmed by clinical examination, angiography and magnetic resonance imaging (MRI). Globe, adnexal, and periorbital tissues were analyzed for histopathologic changes, and the ON was examined for neuro-regeneration at study endpoint (30 days) or Banff Grade 3 rejection in the periorbital skin (whichever was earlier). RESULTS Gross examination confirmed transplant viability and corneal transparency. Average operative duration was 64.0 ± 5.8 min. Average ischemia time was 26.0 ± 4.2 min. MRI revealed loss of globe volume by 36.0 ± 2.8% after transplantation. Histopathology of globe and adnexal tissues showed unique and differential patterns of inflammatory cell infiltration. The ON revealed a neurodegeneration pattern. CONCLUSION The present study is the first in the literature to establish an experimental model of WET. This model holds significant potential in investigating mechanistic pathways, monitoring strategies or developing management approaches involving ocular viability, immune rejection, and ON regeneration after WET.
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Atowa UC, Hansraj R, Wajuihian SO. Visual problems: a review of prevalence studies on visual impairment in school-age children. Int J Ophthalmol 2019; 12:1037-1043. [PMID: 31236365 DOI: 10.18240/ijo.2019.06.25] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/17/2019] [Indexed: 11/23/2022] Open
Abstract
Childhood visual impairment (VI) have a significant impact on the educational achievement, career choices and social life of affected individual, and in children, is mainly due to either preventable or treatable causes. Reliable data on the prevalence and causes of VI in children will guide the development of a systematic vision screening program for its early detection and successful treatment of possible causes. The purpose of this literature review is to summarize the available data on prevalence and causes of VI in school-age children from various regions globally. A discussion on the major findings highlighting the definition criteria, classifications and limitations for further studies is also presented.
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Affiliation(s)
- Uchenna C Atowa
- Discipline of Optometry, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Rekha Hansraj
- Discipline of Optometry, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Samuel O Wajuihian
- Discipline of Optometry, University of KwaZulu-Natal, Durban 4000, South Africa
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Wang W, Yan W, Müller A, Keel S, He M. Association of Socioeconomics With Prevalence of Visual Impairment and Blindness. JAMA Ophthalmol 2019; 135:1295-1302. [PMID: 29049446 DOI: 10.1001/jamaophthalmol.2017.3449] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Vision loss is the third most common impairment worldwide. Although cost-effective interventions are available for preventing or curing most causes of vision loss, availability of these interventions varies considerably between countries and districts. Knowledge of the association between vision loss and socioeconomic factors is informative for public health planning. Objectives To explore correlations of the prevalence of visual impairment with socioeconomic factors at country levels and to model and estimate a socioeconomic-adjusted disease burden based on these data. Design, Setting, and Participants In this cross-sectional study, the following data were collected from 190 countries and territories: the age-standardized prevalence of moderate to severe visual impairment (MSVI) and blindness from January 1 to December 31, 2010, across countries, human development index (HDI), gross domestic product (GDP) per capita, total health expenditure, total health expenditure as percentage of GDP (total health expenditure/GDP), public health expenditure as percentage of total health expenditure (public/total health expenditure), and out-of-pocket expenditure as percentage of total health expenditure (out-of-pocket/total health expenditure). Countries were divided into 4 levels (low, medium, high, and very high) by HDI. Data analysis was conducted from September 1, 2016, to July 1, 2017. Main Outcomes and Measures The correlations between prevalence data and socioeconomic indices were assessed. Results A strong negative association between prevalence rates of MSVI and blindness and socioeconomic level of development was observed. The mean (SD) age-standardized prevalence of MSVI decreased from 4.38% (1.32%) in low-HDI regions to 1.51% (1.00%) in very-high-HDI regions (P < .001). The national HDI level was attributable to 56.3% of global variation in prevalence rates of MSVI and 67.1% of global variation in prevalence rates of blindness. Higher prevalence rates were also associated with lower total health expenditure per capita, total health expenditure/GDP (β = −0.236 [95% CI, −0.315 to −0.157] for prevalence of MSVI; β = −0.071 [95% CI, −0.100 to −0.042] for prevalence of blindness), public/total health expenditure (β = −0.041 [95% CI, −0.052 to −0.031] for prevalence of MSVI; β = −0.014 [95% CI, −0.018 to −0.010] for prevalence of blindness), and higher percentage of out-of-pocket/total health expenditure (β = 0.044 [95% CI, 0.032-0.055] for prevalence of MSVI; β = 0.013 [95% CI, 0.009-0.017] for prevalence of blindness). Countries with increased burden of visual impairment and blindness can be easily identified by the results of the linear models. Socioeconomic factors could explain 69.4% of the global variations in prevalence of MSVI and 76.3% of the global variations in prevalence of blindness. Conclusions and Relevance Burden of visual impairment and socioeconomic indicators were closely associated and may help to identify countries requiring greater attention to these issues. The regression modeling described may provide an opportunity to estimate appropriate public health targets that are consistent with a country’s level of socioeconomic development.
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Affiliation(s)
- Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - William Yan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia,Department of Ophthalmology, University of Melbourne, Parkville, Victoria, Australia
| | - Andreas Müller
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia,World Health Organization Collaborating Center for Prevention of Blindness, Center for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Stuart Keel
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia,Department of Ophthalmology, University of Melbourne, Parkville, Victoria, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia,Department of Ophthalmology, University of Melbourne, Parkville, Victoria, Australia,World Health Organization Collaborating Center for Prevention of Blindness, Center for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
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46
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Affiliation(s)
- Santosh G Honavar
- Editor, Indian Journal of Ophthalmology, Editorial Office: Centre for Sight, Road No 2, Banjara Hills, Hyderabad - 500 034, Telangana, India
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Bronsard A, Geneau R, Duke R, Kandeke L, Nsibirwa SG, Ulaikere M, Courtright P. Cataract in children in sub-Saharan Africa: an overview. EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1555037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Annie Bronsard
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert Geneau
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Roseline Duke
- Calabar Children Eye Centre, Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
| | - Lévi Kandeke
- Department of Ophthalmology, University of Burundi, Bujumbura, Burundi
| | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
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Yan W, Wang W, Wijngaarden P, Mueller A, He M. Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices. Clin Exp Ophthalmol 2018; 47:453-460. [DOI: 10.1111/ceo.13430] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 10/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- William Yan
- Centre for Eye Research AustraliaThe Royal Victorian Eye and Ear Hospital Melbourne Australia
- World Health Organization Collaborating Center for Prevention of Blindness, Centre for Eye Research Australia (CERA)University of Melbourne Melbourne Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐Sen University Guangzhou China
| | - Peter Wijngaarden
- Centre for Eye Research AustraliaThe Royal Victorian Eye and Ear Hospital Melbourne Australia
- Ophthalmology, Department of SurgeryUniversity of Melbourne Melbourne Australia
| | - Andreas Mueller
- Centre for Eye Research AustraliaThe Royal Victorian Eye and Ear Hospital Melbourne Australia
- World Health Organization Collaborating Center for Prevention of Blindness, Centre for Eye Research Australia (CERA)University of Melbourne Melbourne Australia
- Ophthalmology, Department of SurgeryUniversity of Melbourne Melbourne Australia
| | - Mingguang He
- Centre for Eye Research AustraliaThe Royal Victorian Eye and Ear Hospital Melbourne Australia
- World Health Organization Collaborating Center for Prevention of Blindness, Centre for Eye Research Australia (CERA)University of Melbourne Melbourne Australia
- Ophthalmology, Department of SurgeryUniversity of Melbourne Melbourne Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐Sen University Guangzhou China
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Beharry KD, Cai CL, Siddiqui F, Chowdhury S, D'Agrosa C, Valencia GB, Aranda JV. Comparative Effects of Coenzyme Q10 or n-3 Polyunsaturated Fatty Acid Supplementation on Retinal Angiogenesis in a Rat Model of Oxygen-Induced Retinopathy. Antioxidants (Basel) 2018; 7:E160. [PMID: 30423931 PMCID: PMC6262377 DOI: 10.3390/antiox7110160] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 12/27/2022] Open
Abstract
Neonatal intermittent hypoxia (IH) or apnea afflicts 70% to 90% of all preterm infants <28 weeks gestation, and is associated with severe retinopathy of prematurity (ROP). We tested the hypotheses that coenzyme Q10 (CoQ10) or omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplementation during neonatal IH reduces the severity of oxygen-induced retinopathy (OIR). Newborn rats were exposed to two IH paradigms: (1) 50% O₂ with brief hypoxia (12% O₂); or (2) 21% O₂ with brief hypoxia, until postnatal day 14 (P14), during which they received daily oral CoQ10 in olive oil, n-3 PUFAs in fish oil, or olive oil only and compared to room air (RA) treated groups. Pups were examined at P14, or placed in RA until P21. Retinal angiogenesis, histopathology, and morphometry were determined. Both IH paradigms produced severe OIR, but these were worsened with 50/12% O₂ IH. CoQ10 and n-3 PUFAs reduced the severity of OIR, as well as ocular growth factors in both IH paradigms, but CoQ10 was more effective in 50/12% O₂ IH. Supplementation with either CoQ10 or n-3 PUFAs targeting IH-induced retinal injury is individually effective for ameliorating specific characteristics consistent with ROP. Given the complexity of ROP, further studies are needed to determine whether combined CoQ10 and n-3 PUFAs supplementation would optimize their efficacy and result in a better outcome.
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Affiliation(s)
- Kay D Beharry
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
- Department of Ophthalmology; State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
- State University of New York Department of Ophthalmology Eye Institute, New York, NY 10062, USA.
| | - Charles L Cai
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Faisal Siddiqui
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Sara Chowdhury
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Christina D'Agrosa
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Gloria B Valencia
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Jacob V Aranda
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
- Department of Ophthalmology; State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
- State University of New York Department of Ophthalmology Eye Institute, New York, NY 10062, USA.
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Li Z, Keel S, Liu C, He M. Can Artificial Intelligence Make Screening Faster, More Accurate, and More Accessible? Asia Pac J Ophthalmol (Phila) 2018; 7:436-441. [PMID: 30556381 DOI: 10.22608/apo.2018438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Diabetic retinopathy, glaucoma, and age-related macular degeneration are leading causes of vision loss and blindness worldwide. They tend to be asymptomatic in the early phase of disease and therefore require active screening programs to identify the patients requiring referral and treatment. Deep learning-based artificial intelligence technology has recently become a major topic in the field of ophthalmology. This paper aimed to provide a general view of the major findings on the application of deep learning for the classification of eye diseases from common imaging modalities. In the future, it is expected that these technologies will be applied in real-world screening programs to improve their efficiency and affordability.
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Affiliation(s)
- Zhixi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Stuart Keel
- Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Chi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
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