|Year : 1979 | Volume
| Issue : 3 | Page : 16-19
Incidence of blindness around Miraj
DK Sindal, RB Bhat, CJ Shaligram
Department of Ophthalmology, Wanless Hospital, Miraj, India
D K Sindal
Department of Ophthalmology, Wanless Hospital, Miraj
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sindal D K, Bhat R B, Shaligram C J. Incidence of blindness around Miraj. Indian J Ophthalmol 1979;27:16-9
Blindness defined by W.H.O. is `Inability to do any kind of work, Industrial or otherwise, for which sight is essential: The visual standard for blindness differs from country to country. In U.S.A. the recognised standard is 6/60 (20/200), while in U.K. it is 3/60 with correction.
The causes of blindness are many, and in many cases it is difficult to pin point the cause even though the structural causes are seen. In most cases even this is not possible as specimens for histological studies are not available. Large number of cases go undiagnosed and untreated.
In the present study the main aim and the objects are (1) to evaluate the causes of blindness around Miraj, (2) to evaluate the causes of incurable blindness.
The visual standards of U.S.A. have been applied as the yardstick for the present study.
| Material And Methods|| |
The statistics for the present study have been collected from the eye camps conducted in villages around Miraj from January 1975 to June 1978, by the Mobile Eye Hospital Project of the Wanless Hospital, Miraj. Only those who came with eye complaints to the eye camps are considered, hence this constitutes a random sample survey and not a survey of any particular village.
Blindness due to refractive errors in cases of aphakics are excluded from this study as they had been using glasses, but refractive errors with vision 6/60 and less, who did not know that vision could be improved with glasses, are included in this study.
The method of examination used in camps were diffuse illumination examination, ophthalmoscopy, refractions, and tonometry, while slitlamp examination and field chartings were done in the Department. Most of the cases were diagnosed in camps itself. Those who required further examinations and investigations were called to the Wanless Hospital and necessary investigations were carried out.
| Observations|| |
From Jaunary 1975 to June 1978, a total of 7133 patients were examined, of which 2468 cases (34.60%) constituted blindness according to the yardstick applied in this study. Sex distribution is shown in [Table - 1] Of the 2468 cases of blindness, 1846 cases (74.80%) were curable blind, and 622 cases (25.20%) were incurable blind. [Table - 2] The 622 incurable cases constituted 8.72% of the total patients examined in the camps.
Conditions causing blindness that were seen in the camps are shown in [Table - 3] Cataracts: 1437 cases (58.23%) constituted the major cause of blindness, followed by Glaucoma: 322 cases (13.00%); corneal lesions: 303 cases (12.21%); and retinopathies: 136 causes (5.51%).
Table 4],[Table - 5],[Table - 6],[Table - 7] show various ophthalmic conditions causing blindness due to different structural involvement.
| Discussion|| |
Cataracts: of 1437 cases, 40 (2.78%) were of congenital origin. 99 cases (6.89%) were presenile in nature. Presenility incidence was found to be more in females: 79 cases (70.71%) than in males: 20 cases (29.910/). This probably may be due to malnutrition, heat from the 'Chula', and dry tropical heat in this area. The senile cataracts constituted the major percentage: 1244 cases (86.57%). The sex distribution in this group was almost equal. 54 cases (3.76%). Of complicated cataracts were of post iridocyclitis and traumatic in nature. [Table - 4]
On the whole, the incidence of cataract is 58.23%. [Table - 3].
Glaucomas: Of 321 cases, 6 cases (1.80%) were in acute congestive stage. Only this group could be treated effectively to restore useful vision. Remaining 315 cases were in incurable stage. 10 cases (3.10%) were of congenital origin but in an absolute stage. Ignorance of the parents was a major factor for this tragedy. 170 cases (50.00%) of the adults were also in the absolute stage. This again were preventable blindness but ignorance and low socio-economic factors had prevented these patients from seeking medical treatment. 106 cases (33.10%) were of chronic simple glaucoma which were detected for the first time, but the time factor had caused the loss of useful vision in these cases. Inspite of successful filteration surgery, there was no improvement in their vision beyond 6/60. Hence these cases, though preventable are included in the category of incurable blindness. 29 cases (9.00%) were secondary glaucomas, of which 9 cases were post traumatic; 17 cases of post iridocyclitis; and 3 cases of aphakic glaucomas: [Table - 5].
The over all incidence of glaucoma in this study is 13.00%. [Table - 3]
Retinopathies: In this category, out of 136 cases, 41 cases (30.15%) were of Retinitis Pigmentosa; 47 cases (34.55%) chorioretinitis; 18 cases (13.24%) albinism; and 18 cases (13.24%) were due to other causes. Total and long standing retinal detachment had caused blindness in 12 cases (8.82%). [Table - 6].
The incidence of blindness due to retinopathies was 5.51%. [Table - 3].
Corneal lesions: Of 303 cases of blindness due to the corneal lesions, corneal opacities and adherent leukomas were: 210 cases (69.30%), and form the major cause of blindness in this group. These lesions were mainly of traumatic nature as this is an agricultural area. Trauma from grass blades mainly of sugarcanes, are common here. Only few casts in the age group of 0-10 years had these lesions secondary to infections. 92 cases (30.70%) of corneal dystrophies had caused blindness.
Though cases of malnutrition are common in this area we have come across very few cases of keratomalacia in our camps. Probably the parents of these children seek medical aid directly from the Primary Health Centre.
The incidence of corneal lesions causing blindness was 12.28%. [Table - 3].
Refractive errors: These curable causes of blindness were a small percentage: 65 cases (3.53%). This was mainly due to the ignorance as these patients did not have an idea that glasses could improve their vision. Aphakics are not included in group as they had been wearing glasses, or had good vision in the unoperated eye. Those aphakics who had poor vision are included according to the structural involvement.
Optic nerve atrophy: Of 59 cases, 23 cases (39.00%) were due to post neuritis, and remaining 36 cases (61.00%) were cases of primary optic atrophy. Optic nerve atrophy due to retinopathies and glaucomas are discussed under respective headings.
Total incidence of optic nerve atrophy was 2.39% [Table - 3].
Phthisis and staphylomas: 59 cases of phthisis and 53 cases (2.15%) of staphylomas were found due to trauma and uveitis.
Vitamin A deficiency: 35 cases (1.42%) of vitamin A deficiency causing night blindness were detected.
Trachoma: We have not come across a single case of trachoma in any of our eye camps though this disease is very common in the northern parts of India.
| Summary|| |
Various incidences of blindness commonly seen around Miraj are discussed here. In 2468 cases, cataract (58.23%) was the major cause of blindness, followed by glaucoma: 13.00%; corneal lesion: 12.28%; and retinopathies: 5.51%. Glaucoma had caused incurable blindness for want of proper timely treatment due to ignorance and low socio-economic conditions of people. It is for this strata of population that frequent eye camps become a necessity and in turn bring down the number of curable blind in India.
Incidence of trachoma, was not found in this study.
| Acknowledgement|| |
We are grateful to the staff of the Mobile Eye Hospital Project, Wanless Hospital, Miraj, for compiling the relevant statistics. We are also thankful to the Director, and Medical Superintendent of Wanless Hospital for their valuable help.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7]