|Year : 1961 | Volume
| Issue : 4 | Page : 77-81
Etiology of blindness in south India
G Venkataswamy, AV Rajagopalan
Government Ershine Hospital, Madurai, India
|Date of Web Publication||7-Apr-2008|
Government Ershine Hospital, Madurai
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Venkataswamy G, Rajagopalan A V. Etiology of blindness in south India. Indian J Ophthalmol 1961;9:77-81
Recently a survey was done by the Ophthalmic department of the Government Erskine Hospital, Madurai on the Etiology and incidence of blindness in South India. The term "blindness" implies inability to perceive light. In Great Britain, visual acuity of 3/60 or less in one eye, or alternatively a visual field reduced to a small area around the fixation point is considered as blind for the purpose of including in the blind register. For our purpose, vision of 1/60 or less in each eye was taken as blind. People with
tubular fields were not included in the list. Cataract cases are excluded from this survey as this condition is curable.
During the period commencing from 5th October, 1959 upto 8th January, 1960, 110 blind cases were seen in the out-patient department of the Ophthalmic section of the Government Erskine Hospital, Madurai. During this period, the attendence of new cases in the department was 8566.
This table gives the incidence of blindness in one or both eyes, classified according to age and sex.
This table indicates that there is higher incidence in males (65%). It is difficult to say whether this higher incidence of blindness in males occurs in general population also.
(i) In infants (below 5 years) there are 11 cases of blindness and [Table - 3]. gives the causes of blindness at this age.
(ii) [Table - 4] gives the incidence of blindness in the age group 6 to 15 years.
(iii) [Table - 5] gives the incidence of blindness in the age group 16 to 35 years.
(iv) [Table - 6] gives the incidence of blindness in 36 to 50 years
(v) [Table - 7] gives the incidence of blindness in 51and above years.
In [Table - 8] the incidence of blindness according to the various causes are given:-
| Discussion|| |
It will be seen that there are 8 cases of Keratomalacia (about 7%). This is a very high figure and the problem of Keratomalacia is a major one in South India. Mostly, children between the age of 2 and 4 are affected by this disease. Our observations show that all these children suffer from "Kwashiorkar".
Corneal ulcers and leucomas have caused blindness in 11 people. When compared to the Western countries, this figure is relatively high. The main cause is due to infections of conjunctiva and cornea with or without associated injuries. Villagers getting injured in their eyes while harvesting or in other occupations, do not have opportunities for proper eye treatment. They either apply irritant remedies or neglect it till a total ulceration occurs.
Small pox was responsible for 3 cases of blindness. The incidence of Small pox is still very high and still continues to be a major disabling disease in South India.
Trachoma was responsible for blindness in 2 cases. Fortunately the incidence of Trachoma in South India is very low when compared to certain areas in North India. The incidence of Trachoma in general population may be of the order of 5 per 1000, and the type of the disease is of a mild one.
Other etiological factors like Optic Atrophies and glaucomas are like in any other part of the world.
[Table - 9],[Table - 10] will show the causes and types of Optic Atrophy in various age groups. Out of a total 47 cases, 7 were of Syphilitic origin.
According to Breutsch, syphilitic Optic Atrophy was responsible for 10 to 15% of all blindness. In 31 cases, causes could not be determined. In 2 cases there was increased intracranial pressure. 6 cases were of the consequetive Optic Atrophy type, there was one case which we thought may be due to Toxoplasmosis in a child.
It will be seen that 42% of blindness was due to Optic Atrophy. Most of the cases came quite late for treatment, because of two factors namely the poverty of the people and the non-availability of qualified Ophthalmologists in their nearby places. Lots of cases of tuberculous meningitis, which used to be fatal some years back, unfortunately live, but with blindness. The incidence of Syphilis as a cause of optic atrophy (6% of blindness) is relatively a high number. They are all adults between 35 to 60 years, 4 being males and 3 females.
Glaucoma forms the next common cause of blindness which is responsible for about 21% of cases of blindness.
It will be found that in the younger age group of 16 to 35 years there were 4 cases of blindness and there are 14 cases, between 36 to 50 years. There is no incidence of that type of glaucoma which occurs in Bengal due to mustard oil (Epidemic Dropsy).
There were 5 cases of blindness due to Iridocyclitis where the cause could not be detected.
Prospects:- This part of India is getting industrialised rapidly. In our series, we have never had cases of blindness due to industrial injuries and accidents. In future we have to expect cases of blindness due to injuries. In the preventable causes, Keratomalacia, Small pox and irritant remedies are the important ones. Proper nutrition of children during post weaning period is very essential for the prevention of Keratomalacia which occurs at such a high percentage (7%).
Syphilis which was responsible for blindness in 7 cases is also preventable.
| Summary|| |
An analysis of 110 cases of blindness in South India in one year with respect to the causes has been made. The frequency of causes is of the following order:
All optic atrophies - 42%
Glaucoma - 13%
Corneal ulcers - 10%
Keratomalacia - 7%
Iridocyclitis - 4.5 %
Small pox, retinitis pigmentose, microphpthalmos - 3%
| References|| |
Breut.ch W. L.B. (1953) Syphilitic Optic Atrophy, Blackwell Sc. Publications, Oxford.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8], [Table - 9], [Table - 10], [Table - 11]