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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Kasturba Hospital in Sevagram, India, has helped to initiate an outreach health program for nearby villages. A health insurance scheme has evolved where the community contributes sorghum for a fund and participates in decision-making and the supervision of village health workers. Contributors are entitled to free primary care and subsidized referral care. Only villages where at least 75% of the poor community agreed to enroll in the health insurance scheme were adopted by the hospital. The hospital offers insured persons free inpatient treatment for unexpected illness and a 75% subsidy for care during normal pregnancy or with cataract and hernia operations. The mobile health team, comprising auxiliary nurse-midwife, social worker, and village health worker, provides maternal and child health services in the localities. The village health workers provide symptomatic drug treatment, exercise a preventive role with the help of visiting health team members, and refer patients to hospital. The auxiliary nurse-midwife and social workers organize visits for vaccination and provide maternal and child health care. The doctor in charge treats patients in the hospital and trains village health workers. More than 75% of the villages in the area have enrolled in the scheme over the last 10 years. No vaccine-preventable illness (measles, poliomyelitis, diphtheria, whooping cough, tetanus) was reported in children or mothers after mass immunization was instituted, no maternal deaths have occurred during the past 10 years, and perinatal mortality has fallen steeply. The village health teams are now regarded as counselors on health-related matters, among them drinking-water supplies, irrigation, and programs for income generation. It is necessary to regulate the private health sector, including professionals, the drug industry, and investors. If outpatient services are opened up to the private sector, a system of universal medical insurance, financed by local government, should operate.
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PMID:Risk-sharing in rural health care. 141 30

A total of 721 children in the six schools for the blind in Ethiopia were studied. In 1988-1989 histories were taken to ascertain the predisposing factors and ophthalmological examinations and records were used to determine the causes of blindness. Ninety-five per cent of those examined had bilateral blindness, 12% did not know how they had become blind and, of those who provided information on how they became blind, 21% knew that they were born blind, 30% implicated measles as being responsible, and 13% implicated 'mitch' which is an Amharic term used to describe a very wide range of nonspecific and vague illnesses of which measles probably constitutes a significant proportion. Seventy per cent of the blindness was due to either corneal opacity or phthisis bulbi. Of those with non-congenital bilateral corneal opacity or phthisis bulbi, 40% were preceded by measles and 17% by mitch. A study of 66 adults in the handicraft and skill-training centres attached to the blind schools indicated that the principal predisposing factors of blindness were mitch (30%), smallpox (15%), cataract (12%), and traditional eye medicine (11%). Seventy percent had corneal scars of phthisis bulbi and 14% cataract.
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PMID:Causes of blindness in children in the blind schools of Ethiopia. 149 6

A population-based survey of the prevalence of major blinding disorders was conducted in three villages in central Tanzania. Overall, 1827 people over the age of seven years old were examined. In those age seven and older, the prevalence of bilateral blindness (visual acuity in the better eye of less than 3/60) was 1.26% and monocular blindness (visual acuity of less than 3/60 in one eye) was 4.32% and the prevalence of visual impairment (visual acuity less than 6/18 but greater than or equal to 3/60 in both eyes was 1.04% and in one eye was 1.75%. Corneal opacities were responsible for 44% of bilateral and 39% of monocular blindness and resulted from trachoma, measles often in association with Vitamin A deficiency, keratoconjunctivitis, and the use of traditional eye medicines. Cataracts accounted for 22% of bilateral and 6% of monocular blindness. Readily preventable or reversible causes of blindness were responsible for 65% of cases of bilateral and 46% of monocular blindness.
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PMID:Prevalence and causes of vision loss in central Tanzania. 202 39

Problems of prevention and treatment of blindness in Africa are discussed with particular reference to Tanzania. Cataract accounts for fully half this blindness, and present measures to treat it are totally inadequate. The relationship between measles and vitamin A deficiency is discussed. Measles with its attendant corneal destruction accounts for most blindness in children. Blinding trachoma is seen as a community disease needing a community approach to factors such as waste disposal, water supply and cyclic reinfection. Primary eye care is seen as the key, through education at village level, to prevention and treatment of blindness. Training of village health workers is the essential first step.
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PMID:Ophthalmology in Africa. 407 58

About 1% of the population of Malawi is blind. The major contributors are cataract (40%), trachoma and other infections (15%) and measles/Vitamin A deficiency (15%). There are 3 ophthalmologists in government service. However, one serves as the director of medical services, and is therefore frequently burdened with administrative duties. In addition, one missionary ophthalmologist and 25 ophthalmic auxiliaries are available. Two of the ophthalmic auxiliaries are being trained to perform cataract surgery to aid the ophthalmologists in attacking the current backlog of approx. 24,000 blind cataract patients in the country. Trachoma and onchocerciasis are present regionally, although the latter by itself does not appear to be a major cause of vision loss. In children under age five, the major causes of blindness are measles and protein-energy-malnutrition (PEM) and its associated hypovitaminosis A. Previous surveys in Malawi have been either clinic/hospital-based or have been local population-based studies. In order to establish a realistic plan of preventive and therapeutic action, a comprehensive series of country-wide population-based ocular disease prevalence surveys is planned over the next five years. The information will enable the Ministry of Health to more equitably disperse trained ophthalmic personnel and to obtain appropriate supplies and drugs in a rational manner.
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PMID:Ocular disease and ophthalmic services in Malawi. 664 97

The causes of blindness in Sierra Leone were studied in 7286 new patients attending the eye clinic in the year 1981. Blindness, defined as an inability to count fingers at 3 meters with the better eye (WHO, 1973), was present in 762 persons, due to cataract (39%), ocular onchocerciasis (30%), primary glaucoma (8%), measles keratitis (3%), trachoma (3%) and other causes. The prevalence of blindness was estimated from simple field surveys covering 41 villages with an estimated population of 10,559. The average prevalence of blindness was found to be 1.3% of the total population.
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PMID:Causes and prevalence of blindness in the Northern Province of Sierra Leone. 666 98

Pupils attending 12 schools for the blind in Malawi, 3 schools in Kenya and 2 schools in Uganda were examined to determine the causes of severe visual impairment or blindness (visual acuity in the better eye of less than 6/60). A total of 491 pupils aged 3-22 years was examined. Visual acuity was measured in each eye using a Snellen E chart. The anatomical site of abnormality and underlying cause of visual loss were determined by clinical examination for each eye, and for the child. Information was recorded on a standard reporting form (the WHO/PBL Eye Examination Record for Children with Blindness and Low Vision). Data were analysed for those aged less than 16 years using a database which accompanies the form. Preventable and treatable causes were identified. 260 pupils aged 5-20 years were examined in Malawi, 163 pupils aged 3-19 years were examined in Kenya and 68 pupils aged 6-22 years were examined in Uganda. Of the 491 students included in the study 309 (62.9%) were blind (BL) and 69 (14.1%) were severely visually impaired (SVI). 244 were aged less than 16 years and had SVI/BL. In these 244 children 35.2% of visual loss was due to corneal pathology, 13.5% was due to cataract and 14.8% to diseases of the retina. Corneal pathology, attributed to vitamin A deficiency and measles infection in the majority, was responsible for proportionally more SVI/BL in students in Malawi than in Uganda or Kenya.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Causes of childhood blindness in east Africa: results in 491 pupils attending 17 schools for the blind in Malawi, Kenya and Uganda. 758 38

To provide baseline data for the planning, implementation, and evaluation of the National Program for Prevention of Blindness, a survey was conducted in Nigeria's Anambra State. A multistage cluster random sampling technique was used to enroll 1752 adults. Blindness was defined, according to World Health Organization criteria, as visual acuity in the better eye of less than 3/60 with spectacle correction or pinhole. Low vision was defined as visual acuity less than 6/18 to not better than 6/60 (category 1) or less than 6/60 to not better than 3/60 (category 2) in the better eye with best correction or pinhole. The estimated prevalence of blindness in the sample was 0.97% (1.54% among men and 0.64% among women). When adjusted to the age and sex structure of the Nnewi North Local Government Area, this prevalence became 0.33% (0.44% for men and 0.24% for women). For those above 50 years of age, the prevalence of blindness was 2.62% (3.27% for men and 2.02% for women). Cataract was the primary cause of blindness (70.57%), followed by glaucoma (17.65%). The prevalence of category 1 low vision was 0.67%, while that of category 2 low vision was 0.41%. Finally, the prevalence of monocular visual impairment was 1.20%. In this area, blindness associated with measles and other infectious causes has decreased substantially. At present, most visual impairment is due to progressive lesions associated with aging. These findings suggest that the priority needs in Anambra State are sight restorative surgery for the cataract blind, early diagnosis and treatment of glaucoma, and provision of low-cost spectacles for the correction of ametropia. A community outreach eye care service, integrated into primary health care, is recommended.
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PMID:Magnitude and causes of blindness and low vision in Anambra State of Nigeria (results of 1992 point prevalence survey). 930 79

Community ophthalmology requires a comprehensive approach for primary, secondary and tertiary prevention of all eye diseases like vitamin A deficiency, trachoma, measles, diabetic retinopathy, refractive errors, etc. Community ophthalmology is based on the principles of primary health care approach. Equitable distribution, community involvement, focus on prevention, appropriate technology and multisectorial approach are to name a few in primary health care approach. In India, National Programme for Trachoma Control was launched in 1963 and National Programme for Control of Blindness was launched in 1976. Prevention of blindness was included in 20-point plan in early 1980s. Increase in blindness was reassessed in 1986-89 and the strategy was changed. World Bank came to help in planning 11 million cataract operations in 7 years in 7 States where there was the highest prevalence of cataract. Departments of community ophthalmology have recently been developed in several institutions. If the problem of blindness is to be solved, extension of community-based approach including all strata of society is the need of the hour.
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PMID:Overview on community ophthalmology. 1064 80

Corneal disease is the second most common cause of blindness in tropical countries after cataract. It mainly strikes children who are exposed to numerous infectious agents against which they are unprotected due to the absence of basic health care. In high risk groups, the incidence of childhood corneal-related blindness is more than 20 times higher than in developed countries. There are many causes of corneal-related blindness. Endemic trachoma persists in some areas and inflammatory forms can lead to blindness. Eradication requires instillation of antibiotics in the eye, improvement of sanitary conditions, and campaigns against promiscuity. Xerophthalmia can induce blindness by perforation of the cornea in children with vitamin A deficiency. Measles, herpes simplex keratitis, and corneal ulcer that progresses to bacterial or fungal infections, or to amebic keratitis are also major causes of corneal-related blindness. The incidence of onchocerciasis is decreasing thanks to treatment with ivermectin and programs to control simulium. Neonatal gonococcal ophthalmia and leprosy-associated ocular disease can also lead to blindness. This overview of the various causes illustrates the close correlation between the level of life and living conditions and the occurrence of corneal-related blindness in tropical areas.
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PMID:[Corneal blindness in tropical areas]. 1090 81


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