|
|
ARTICLE |
|
Year : 1965 | Volume
: 13
| Issue : 2 | Page : 50-54 |
|
Causes of blindness in Poland in ophthalmology as basis for researches
L Rostkowski
Warsaw, Poland
Date of Web Publication | 21-Feb-2008 |
Correspondence Address: L Rostkowski Warsaw Poland
Source of Support: None, Conflict of Interest: None | Check |
How to cite this article: Rostkowski L. Causes of blindness in Poland in ophthalmology as basis for researches. Indian J Ophthalmol 1965;13:50-4 |
The basis of prevention of blindness ought to be based on rational statistics. It should be clear and thus enable an analysis of causes of blindness and the anatomic disease changes caused by these reasons. The following statistics are based on the cards of blind people filled in from 1949 to 1954 by physicians---oculists in hospitals, out-patient-departments and mobile columns working in the countryside. Although the statistics apply only to part of the blind in Poland, research carried out in several countries and town environments and the number of cases which this material includes, these statistics can be considered as competent to determine the causes of blindness in Poland.
Our statistics concern 4,009 persons blind in both eyes (8018 eyes) and 10,390 blind in one eye.
The statistics were worked out with a slight modification on the crossed method according to Marquez. The causes of blindness are shown in the vertical columns, in the horizontal columns however are placed the site and type of affection. This system is clear and includes the merits of etiogical and topographical statistics and enables not only the valuation of frequency of several particular causes of blindness but also the frequency of site and type of affection of eyes, determining blindness caused by these reasons (see charts).
In our statistics the most frequent causes of blindness in both eyes are trauma -26.6 per cent. From these, the largest group is trauma caused by war. More than 10 per cent of all the blind lost their sight as a result of war either directly by the military action -(6.1 per cent) or by injuries caused by explosive postwar material-4.3 per cent (children 2,5 per cent and adults 1,8 per cent).
The second group concerning the frequency of causes of blindness are contagious diseases - 23,7 per cent. In consequence of the rational preventive measures against these diseases and their modern and early cure the incidence in these diseases leading to blindness, declines every year. There is no doubt that the suitable fight against contagious diseases will greatly reduce blindness in Poland.
As an example of such a decline is trachoma, which in comparison to other causes of blindness was before the war 7.1 per cent and at present as a consequence of the planned fight against this disease is only 3.3 per cent.
Among several particular diseases the most frequent cause of blindness is glaucoma-12.1 per cent. My statistics of 1936 showed the same percentage of blindness caused by glaucoma.
A good deal of blindness is of congenital origin-12 per cent. Till now science does not know and cannot be precise in their causes. In the group of congenital defects are included all the causes of children born with defective sight leading to blindness. Most of them are disturbances in the mother's organism, influencing the development on the unborn child, It is known that the presence of contagious diseases in mothers, like toxoplasmosis, syphilis, rubella are the causes of disease changes in the eye of the unborn child. Nevertheless there are still a number of undetermined disease changes. Therefore to gain a more precise idea of congenital blindness, further physiological and physiopathological researches and also more exact classification of congenital changes are required.
From our statistics are excluded some diseases with unknown etiology owing to their small number among them, as: multiple sclerosis, retinitis pigmentosa, general haemorrhage, neoplasm, nephritis with hypertension and others. The most frequent site and type of affection leading to blindness is atrophy of optic nerve--2,213 cases (27.7 per cent) caused mostly by glaucoma (761 cases).
The second in frequency of site and type of affection is leucoma of cornea 1,447 cases (17.1 per cent) caused mostly by contagious diseases, - 857 eyes,-from which the most frequent cause is trachoma-234 cases. Leucoma of cornea caused by trauma was confirmed in 387 eyes. Atrophy of the eyeball comes next in frequency in the site and type of affection--1,260 cases (15.8 per cent) including 624 cases caused by trauma and 332 cases caused by contagious diseases.
As regards the particular type of affection of the figures arrived at in this study correspond with my observation of 1936, where leucoma of cornea, atrophy of optic nerve and atrophy of eyeball were the most frequent type of affections of sight leading to blindness.
This statistics of several countries do not show one eye blindness as they do not consider this a social problem. However for the research of causes of blindness and for frequency of particular causes the statistic of one eye blinds is very important because the frequency of the causes of one eye blinds differs from the causes in two eyes. The missing of one eye statistics will cause an inaccuracy in frequency of particular causes, and the danger of some causes evoking one eye blindness will not be sufficiently exposed. For example trauma causes blindness of both eyes in 26.6 per cent and in one eye in 59.7 per cent which shows the importance of considering the one eye blind as well.
Among the one eye blind due to trauma the most frequent cause was mechanical trauma--31.1 per cent. The traumas caused by war amounted to 23.4 per cent in one eye blindness. In them 18 per cent were caused by direct war action and 5.4 per cent caused by postwar explosive material, of which half the number were in children.
The most frequent site and type of affection in one eye blindness is abscence of eyeball--24.2 per cent, then atrophy of eyeball-18.4 per cent, leucoma of cornea-18 per cent and atrophy of optic nerve-13 per cent.
So indeed the frequency of one eye blindness is different from that of both the eyes; as an example we can take atrophy of optic nerve; in blindness in both eyes this type of affection appears at the head of all types of affection of blindness of both eyes 27.7 per cent; blindness in one eye takes a modest fourth place among other types of affection of eyes-1.3 per cent.
The unknown causes at blindness in both eyes account for 8.5 per cent, one eye blindness 9.1 per cent. In these columns are shown cases in which the cause of blindness was not recognised or not given by the examining physician. Undoubtedly this percentage among blindness of both eyes as well as one eye is too high and lowers the value of our statistics to a certain extent.[3]
References | | |
1. | Rostkowski L. (1936) Sur la lutte contre la ceciteen Pologne. Folia Opht. Orientalia Nr. 2. |
2. | Rostkowski L.. Wolter H. (1952) Przyczyny slepoty w Polsce (Causes of blindness in Poland) Klinika Oczna Nr. 4. |
3. | Rostkowski L., Wolter H., Zarzycka M. (1954) Przyczyny slepoty jednoocznej (Causes of one eye blindness). Report delivered at the meeting of the Polish Ophthalmological Society in Warsaw, 1954. |
[Table - 1], [Table - 2]
|
|
|
Article Access Statistics | | Viewed | 2029 | | Printed | 50 | | Emailed | 2 | | PDF Downloaded | 0 | | Comments | [Add] | |
|
|