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China, a country with about one fifth of the world's population, has been gaining a rapid economic growth since 1980s. This country has around 5 million blind people, accounting for 18% of the blind in the world. The major causes of blindness include cataract, corneal diseases, trachoma, glaucoma, vitreoretinopathy and a number of factors contributing to blindness in children. The principal cause of blindness in China was no longer trachoma but cataracts. Vitamin A deficiency remains a public health problem in the under-developed areas. Age-related conditions in China, such as vision loss due to cataract and retinal disorders, will increase accordingly if no preventive meaunes are taken. Glaucoma and diabetic retinopathy appear to be predominant induction of the devastating blind. In this fast developing country blindness is not only a medical or health, but also a social problem. Developed strategies have been adopted simultaneously by national efforts under the leadership of the government, international agencies, nongovernmental organizations, as well as private sectors in their every-day work to prevent and treat blindness.
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PMID:Blindness as a challenging medical and social problem in China. 1551 Jun 66

The aim of the study was to assess the prevalence and identify the causes of blindness and visual impairment in school children of Ilesa-East Local Government Area of Osun State, Nigeria. A total of 1144 school children in primary and secondary schools were selected using a 2-stage random sampling method and examined to determine the prevalence and causes of blindness and visual impairment. A total of 17 (1.48%) children were blind or visually impaired. These comprised of 11 (0.96%) children who were visually impaired and 4 (0.3%) who were severely visually impaired. Only 2 (0.15%) school children were blind. The causes of visual impairment were refractive error 10 (0.87%) and immature cataract 1 (0.08%), causes of severe visual impairment included corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and 1 cataract 1 (0.08%). The causes of blindness in school children were corneal scars presumed to be due to vitamin A deficiency 1 (0.08%) and keratoconus 1 (0.08%). Causes of blindness and visual impairment in children attending regular schools in Nigeria were treatable. Prevention, early recognition and prompt treatment of these diseases by regular screening of school children would definitely reduce unnecessary visual handicap in Nigerian school children so that they can attain their full potential in the course of their education. Also, information from this study is relevant for the purpose of planning eye care programmes for the prevention of blindness in Nigerian school children. This will go a long way in the prevention of unnecessary blindness and visual impairment in school children.
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PMID:Prevalence and causes of blindness and visual impairment among school children in south-western Nigeria. 1720 Jul 95

Human and ecosystem health converge around biological diversity issues. Cultivated and wild plants as food and medicine make essential contributions to human health, which in turn provides rationales for conservation. While wild and cultivated plant diversity reasonably facilitates dietary diversity and positive health outcomes, the challenges of demonstrating this relationship limit its impact in concept, policy, and practice. We present a rationale for testing the dietary contribution of biological diversity to improved eye health as a case study based on existing phytochemical, pharmacological, and clinical knowledge. We consider the empirical evidence needed to substantiate, interpret, and apply this relationship at a population and ecosystem level within a unified research framework. Epidemiological data strongly support the prevention of childhood vitamin A deficiency blindness, cataract, and age-related macular degeneration by fruit and vegetable consumption. Phytonutrients, including the carotenoids lutein and zeaxanthin, protect the eye from oxidative stress and harmful light exposure. Laboratory, community, and population level research should prioritize food composition of dietary plants from both agriculture and the wild. Intervention studies, focus groups, and transmission of knowledge of local species and varieties within communities will further interpretation of epidemiological data. Population-based studies combining clinical data and measures of access and consumption of biological diversity are key to demonstrating the important relationships among biodiversity, dietary diversity, and health outcomes.
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PMID:Biological diversity, dietary diversity, and eye health in developing country populations: establishing the evidence-base. 1868 94

Myopia, or nearsightedness, is the most common human eye disorder in the world, and is a significant global public health concern. Along with cataract, macular degeneration, infectious disease, and vitamin A deficiency, myopia is one of the most important causes of visual impairment worldwide. Severe or high-grade myopia is a leading cause of blindness because of its associated ocular morbidities of retinal detachment, macular choroidal degeneration, premature cataract, and glaucoma. Ample evidence documents the heritability of the non-syndromic forms of this condition, especially for high-grade myopia, commonly referred to as myopic spherical refractive power of 5 to 6 diopters or higher. Multiple high-grade myopia genetic loci have been identified, and confirmatory studies identifying high-grade and moderate myopia loci have also occurred. In general, myopia susceptibility genes are unknown with few association studies performed, and without confirmation in other research laboratories or testing of separate patient cohorts.
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PMID:Molecular genetics of human myopia: an update. 1910 67

Reducing visual impairment and blindness in children in resource-poor countries is one of the key components of the major global prevention of blindness initiative, VISION 2020 the Right to Sight. Although visual impairment and blindness among children is much less common than among adults, the potential lifespan of a child means that the lifelong impact of such impairment is very large. Over 10 years ago, it was estimated that, globally, 1.4 million children were blind. Much has changed in the past 10-20 years and there is a need to reassess both the magnitude and causes of global childhood blindness and visual impairment. While the widespread implementation of vitamin A supplementation and measles immunisation programmes have led to a reduction in vitamin A deficiency-related blindness in many poor countries, retinopathy of prematurity is now undergoing a third wave of endemicity, particularly in newly industrialising countries in Latin America and Asia. Childhood cataract is better recognised as an important potentially avoidable problem, as is paediatric glaucoma and refractive error in some populations. Trained paediatric ophthalmologists, although still too few, are growing in number in poor countries. A programmatic approach with a multidisciplinary team is essential to reducing childhood blindness. The elements of such programmes and the need for planning are discussed.
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PMID:Visual impairment in children in middle- and lower-income countries. 2186 4

Vitamin A deficiency is one of the most prevalent deficiency disorders in the world. As shown by many studies plant food based approaches have a real potential on prevention of vitamin A deficiency in a sustainable way. Carotenoids are important as precursors of vitamin A as well as for prevention of cancers, coronary heart diseases, age-related macular degeneration, cataract etc. Bioaccessibility and bioefficacy of carotenoids are known to be influenced by numerous factors including dietary factors such as fat, fiber, dosage of carotenoid, location of carotenoid in the plant tissue, heat treatment, particle size of food, carotenoid species, interactions among carotenoids, isomeric form and molecular linkage and subject characteristics. Therefore even when carotenoids are found in high quantities in plant foods their utilization may be unsatisfactory because some factors are known to interfere as negative effectors.
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PMID:A review on factors influencing bioaccessibility and bioefficacy of carotenoids. 2616 11

Globally, 32.4 million individuals are blind and 191 million have moderate or severe visual impairment (MSVI); 80% of cases of blindness and MSVI are avoidable. However, great efforts are needed to tackle blindness and MSVI, as eye care in most places is delivered in isolation from and without significant integration with general health sectors. Success stories, including control of vitamin A deficiency, onchocerciasis, and trachoma, showed that global partnerships, multisectoral collaboration, public-private partnerships, corporate philanthropy, support from nongovernmental organizations-both local and international-and governments are responsible for the success of these programs. Hence, the World Health Organization's universal eye health global action plan for 2014-2019 has a goal of reducing the public health problem of blindness and ensuring access to comprehensive eye care; the plan aims to integrate eye health into health systems, thus providing universal eye health coverage (UEHC). This article discusses the challenges faced by low- and middle-income countries in strengthening the six building blocks of the health system. It discusses how the health systems in these countries need to be geared toward tackling the issues of emerging noncommunicable eye diseases, existing infectious diseases, and the common causes of blindness and visual impairment, such as cataract and refractive error. It also discusses how some of the comprehensive eye care models in the developing world have addressed these challenges. Moving ahead, if we are to achieve UEHC, we need to develop robust, sustainable, good-quality, comprehensive eye care programs throughout the world, focusing on the areas of greatest need. We also need to develop public health approaches for more complex problems such as diabetic retinopathy, glaucoma, childhood blindness, corneal blindness, and low vision. There is also a great need to train high-level human resources of all cadres in adequate numbers and quality. In addition to this, we need to exploit the benefits of modern technological innovations in information, communications, biomedical technology, and other domains to enhance quality of, access to, and equity in eye care.
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PMID:International Vision Care: Issues and Approaches. 2893 49

Globally, approximately 75% of blind children live in low-income countries (LICs). Almost half of blindness and low vision in LICs is due to avoidable causes such as corneal scarring from measles infection, vitamin A deficiency disorders, use of harmful traditional eye remedies, ophthalmia neonatorum and cataract.
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PMID:Integrating primary eye care into global child health policies. 2898 14


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