RESUMEN
ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.
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Trastornos de la Visión/prevención & control , Inteligencia Artificial , Odontólogos , Oftalmopatías/prevención & control , COVID-19/complicaciones , Microcomputadores , Síndrome del Túnel Carpiano , Prevalencia , Factores de Riesgo , Educación en Odontología , Tiempo de Pantalla , IndiaRESUMEN
OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children's visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital's campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.
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Errores de Refracción , Brasil , Niño , Preescolar , Estudios Transversales , Humanos , Prevalencia , Errores de Refracción/diagnóstico , Errores de Refracción/epidemiología , Errores de Refracción/terapia , Estudios Retrospectivos , Instituciones Académicas , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/epidemiología , Trastornos de la Visión/prevención & controlRESUMEN
OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children's visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital's campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.
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Humanos , Preescolar , Niño , Errores de Refracción/diagnóstico , Errores de Refracción/terapia , Errores de Refracción/epidemiología , Instituciones Académicas , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/prevención & control , Trastornos de la Visión/epidemiología , Brasil , Prevalencia , Estudios Transversales , Estudios RetrospectivosRESUMEN
Introducción: El glaucoma constituye un problema de salud pública que genera discapacidad visual evitable, sin embargo, se desconoce su prevalencia y factores de riesgo en el Departamento del Quindío. Objetivo: Describir características y comorbilidades del glaucoma en pacientes que consultaron a oftalmología en el Quindío durante el año 2018. Diseño del estudio: Estudio descriptivo de corte transversal. Métodos: Se tomaron las historias de los pacientes que consultaron a una institución especializada del Quindío durante el 2018. Se describieron las variables en promedio, desviación estándar e intervalos de confianza y se hizo comparación por sexo. Resultados: La prevalencia de glaucoma fue del 12.68% y el 57.71% tenía antecedente de hipertensión arterial. Conclusiones: El número de pacientes que consultan por enfermedades del ojo ha venido en aumento durante los últimos tres años en un centro especializado de la ciudad de Armenia
Background: Glaucoma constitutes a public health problem that generates avoidable visual impairment, however, its prevalence and risk factors in the Department of Quindío are unknown. Objective: To describe characteristics and comorbidities of glaucoma in patients who consulted ophthalmology in Quindío during 2018. Study design: Descriptive cross-sectional study. Methods: The histories of the patients who consulted a specialized institution in Quindío during 2018 were taken. The variables were described in mean, standard deviation and confidence intervals and a comparison was made by sex. Results: The prevalence of glaucoma was 12.68% and 57.71% had a history of arterial hypertension. Conclusions: The number of patients consulting for eye diseases has been increasing over the last 3 years in a specialized center in the city of Armenia.
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Humanos , Trastornos de la Visión/prevención & controlRESUMEN
Glaucoma is one of the most frequent causes of visual impairment worldwide, and involves selective damage to retinal ganglion cells (RGCs) and their axons. We analyzed the effect of enriched environment (EE) housing on the optic nerve, and retinal alterations in an induced model of ocular hypertension. For this purpose, male Wistar rats were weekly injected with vehicle or chondroitin sulfate (CS) into the eye anterior chamber for 10 weeks and housed in standard environment or EE. EE housing prevented the effect of experimental glaucoma on visual evoked potentials, retinal anterograde transport, phosphorylated neurofilament-immunoreactivity, axon number, microglial/macrophage reactivity (ionized calcium binding adaptor molecule 1-immunoreactivity), and astrocytosis (glial fibrillary acidic protein-immunostaining), as well as oligodendrocytes alterations (luxol fast blue staining, and myelin basic protein-immunoreactivity) in the proximal portion of the optic nerve. Moreover EE prevented the increase in ionized calcium binding adaptor molecule-1 levels, and RGC loss (Brn3a-immunoreactivity) in the retina from hypertensive eyes. EE increased retinal brain-derived neurotrophic factor levels. When EE housing started after 6 weeks of ocular hypertension, a preservation of visual evoked potentials amplitude, axon, and Brn3a(+) RGC number was observed. Taken together, these results suggest that EE preserved visual functions, reduced optic nerve axoglial alterations, and protected RGCs against glaucomatous damage.
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Ambiente , Glaucoma/complicaciones , Neuroprotección , Trastornos de la Visión/prevención & control , Animales , Toxina del Cólera/metabolismo , Sulfatos de Condroitina/farmacología , Modelos Animales de Enfermedad , Potenciales Evocados Visuales/fisiología , Glaucoma/patología , Glaucoma/fisiopatología , Vivienda para Animales , Masculino , Hipertensión Ocular/inducido químicamente , Hipertensión Ocular/complicaciones , Hipertensión Ocular/fisiopatología , Nervio Óptico/fisiopatología , Ratas , Ratas Wistar , Células Ganglionares de la Retina/fisiología , Trastornos de la Visión/etiologíaRESUMEN
Recent reports from different world regions suggest ocular syphilis is re-emerging, in parallel with an increasing incidence of the systemic infection globally. We conducted a large observational study of 127 persons consecutively treated for ocular syphilis at public medical centers in Brazil over a 2.5-year period ending July 2015. Of 104 individuals serologically tested for human immunodeficiency virus (HIV), 34.6% were positive. Ophthalmological evaluations included measurement of Snellen visual acuity and intraocular pressure, and assessment of inflammation by slit lamp examination and dilated posterior eye examination. Involvements in 214 eyes were anterior (6.1%), intermediate (8.4%), posterior (76.2%) and pan- (8.4%) uveitis, and scleritis (0.9%). Multiple anterior and posterior eye complications were observed, including cataract in the anterior eye (incidence rate, 0.18/eye-year) and epiretinal membrane in the posterior eye (incidence rate, 0.09/eye-year); incidence rates of reduction in best-corrected visual acuity to ≤20/50 and ≤20/200 were 0.10 and 0.06/eye-year, respectively. Rates of complications and visual acuity loss did not differ significantly between HIV- positive and negative individuals. In an era of re-emergence, syphilis has ocular complications that may compromise vision, despite treatment with appropriate anti-microbial drugs.
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Enfermedades Transmisibles Emergentes/complicaciones , Infecciones Bacterianas del Ojo/epidemiología , Sepsis/microbiología , Sífilis/complicaciones , Trastornos de la Visión/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Brasil/epidemiología , Enfermedades Transmisibles Emergentes/tratamiento farmacológico , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/microbiología , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Bacterianas del Ojo/microbiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Sepsis/epidemiología , Sífilis/tratamiento farmacológico , Sífilis/epidemiología , Sífilis/microbiología , Resultado del Tratamiento , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/microbiología , Trastornos de la Visión/prevención & control , Agudeza Visual , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the self-eye examination practice as a tool to promote the ocular self-evaluation. METHOD: Quasi-experimental study developed in a university of Piauí with sample of 324 students between January and May 2014. A team of thirteen researchers made observations during the self-examination followed by an ocular screening. RESULTS: There was no agreement on the hypothesis of defense that the ocular exam could help to observe the eyes health, p-value>0.3. However, the exam was considered as easy to accomplish (99.7%) and that not only the physician can perform the eye exam (99.4%). The awareness about eye care is identified as the main purpose of this booklet (97.6%), (χ2= 186.01; p=0.001). The results highlight the booklet can be used in the teaching process of self-eye examination (84.6%). Although the defense that its fulfilment can replace the consultation with the ophthalmologist (23.8%%) cannot be accepted (χ2= 46.34), the self-exam must be done routinely (82.4%). CONCLUSION: The results prove that the learning through virtual booklet is possible and supports self-care with the eyes by performing the self-exam.
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Promoción de la Salud/métodos , Autoexamen/métodos , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/prevención & control , Humanos , Estudios Prospectivos , Estudiantes , Adulto JovenRESUMEN
Introdução: Trauma ocular é o motivo mais frequente de atendimentos nas emergências oftalmológicas, sendo uma das principais causas de cegueira evitável no mundo e causando grande impacto socioeconômico no sistema de saúde e na população. Objetivo: Identificar o perfil epidemiológico dos traumas oculares decorrentes de acidentes de trabalho, as sequelas visuais e o impacto socioeconômico. Métodos: Estudo transversal, retrospectivo, por meio de revisão de prontuário dos pacientes portadores de trauma ocular ocupacional atendidos em emergência oftalmológica no período de abril a agosto de 2016. Resultados: Foram incluídos no trabalho 112 pacientes, todos do sexo masculino. A faixa etária mais acometida foi de 31 a 35 anos; mecânico foi a principal profissão; corpo estranho em superfície ocular representou 85% dos traumas; 72% dos pacientes levaram mais de 12 horas para procurar atendimento médico especializado; e 86% tiveram o primeiro atendimento na empresa. Metade dos pacientes usava equipamento de proteção. A acuidade final pós-trauma, na maioria dos pacientes, não sofreu impacto. Conclusão: Apesar de a maioria dos pacientes não ter apresentado sequelas visuais, o trauma ocular ocupacional levou à perda de dias de trabalho e a gastos com medicações. Estudos como este servem para mapear a problemática e traçar estratégias preventivas.
Background: Eye injury is the most frequent reason for visits to ophthalmological emergency departments, being one of the leading causes of avoidable blindness worldwide, with considerable socioeconomic impact on health systems and populations. Objective: To establish the epidemiologic profile of eye injury caused by work accidents, visual sequelae and socioeconomic impact. Methods: A retrospective, cross-sectional study was conducted by reviewing the medical records of patients with occupational eye injury treated at an ophthalmologic emergency department from April to August 2016. Results: A total of 112 patients were included, all of them male. The most affected age group was 31 to 35 years old, and the main professional category the one of mechanics; foreign bodies on the eye surface represented 85% of injuries; 72% of patients sought specialized treatment more than 12 hours after the accident; and for 86% this was their first treatment at the company. Half of the patients used personal protection equipment. In most cases the final visual acuity after injury was not impaired. Conclusion: Although most patients did not remain with visual sequelae, occupational eye injury resulted in loss of working days and expenses with medication. Studies such as the present one contribute to the mapping of the investigated problem and the formulation of preventive strategies.
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Trastornos de la Visión/prevención & control , Trastornos de la Visión/epidemiología , Accidentes de Trabajo , Absentismo , Brasil , Estudios Transversales , Estudios RetrospectivosRESUMEN
La diabetes es una de las mayores emergencias mundiales de salud, por lo que las complicaciones asociadas a estas requieren una atención especial. La retinopatía diabética constituye una de estas atenciones y la discapacidad visual por esta causa se convierte en un reto para todos. Se analizaron las principales barreras para el diagnóstico precoz y el tratamiento oportuno de la retinopatía. Además, realizamos consideraciones sobre el método de tamizaje de la retinopatía diabética en Cuba y el valor de la educación de los pacientes, familiares y de todos en general para combatir esta epidemia que crece y está fuera de control. Se desarrollaron programas de educación, detección y tratamiento de la retinopatía diabética para así prevenir la discapacidad visual por esta causa(AU)
The diabetes is one of the largest health emergencies worldwide since their associated complications require special attention. The diabetic retinopathy is one of these focuses of attention and the diabetes-related visual impairment becomes a challenge for all. We analyzed the main barriers to early diagnosis and timely treatment of the retinopathy. Additionally, we also made considerations on the screening method of the diabetic retinopathy in Cuba and the value of education of patients, family and of all individuals in general to fight this epidemic that grows and is out of control. Education, detection and treatment programs for diabetic retinopathy to prevent the visual impairment from this cause were developed(AU)
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Humanos , Trastornos de la Visión/prevención & control , Retinopatía Diabética/complicacionesRESUMEN
BACKGROUND: Ocular involvement in patients with Behçet disease represents a significant clinical morbidity in this disease, and the prevention of visual impairment is an important treatment goal. There are no randomized controlled trials for the treatment of ocular Behçet disease; however, clinicians must still make treatment decisions. OBJECTIVES: The goals of this study were to describe the treatment preferences of rheumatologists and ophthalmologists for the treatment of ocular Behçet disease and to identify factors that influence these decisions. METHODS: Eight hundred fifty-two rheumatologists and 934 ophthalmologists were surveyed via e-mail regarding their choice of therapy for a hypothetical patient with ocular Behçet disease. Respondents were asked to select first- and second-choice therapies and then reselect first and second choices assuming there would be no issues with cost or insurance prior authorization. RESULTS: One hundred thirty two physicians (7.4%) who were willing to recommend treatment completed the survey: 68 rheumatologists and 64 ophthalmologists. The most common first-choice therapy for both specialties was a biologic agent. Significantly more rheumatologists than ophthalmologists chose methotrexate (P < 0.025) and azathioprine (P < 0.005) as their first-choice therapy. After assuming there were no concerns with cost or prior authorization, rheumatologists were still more likely to choose azathioprine compared with ophthalmologists (P < 0.02), and ophthalmologists were more likely to choose local steroid implants (P < 0.02). Both rheumatologists and ophthalmologists increased their choice of an anti-tumor necrosis factor agent when cost and prior authorization issues were removed (P < 0.0001 and 0.008, respectively). CONCLUSIONS: Physician decision making is influenced by medical specialty and concerns regarding cost and prior authorization.
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Azatioprina/uso terapéutico , Síndrome de Behçet/complicaciones , Oftalmopatías , Glucocorticoides/uso terapéutico , Metotrexato/uso terapéutico , Oftalmólogos/estadística & datos numéricos , Reumatólogos/estadística & datos numéricos , Trastornos de la Visión , Administración Tópica , Toma de Decisiones Clínicas/métodos , Oftalmopatías/diagnóstico , Oftalmopatías/etiología , Oftalmopatías/terapia , Humanos , Inmunosupresores/uso terapéutico , Selección de Paciente , Pautas de la Práctica en Medicina/clasificación , Encuestas y Cuestionarios , Estados Unidos , Trastornos de la Visión/etiología , Trastornos de la Visión/prevención & controlAsunto(s)
Corticoesteroides/efectos adversos , Artralgia/inducido químicamente , Trastornos de la Lactancia/inducido químicamente , Trastorno de Pánico/inducido químicamente , Trastornos de la Visión/inducido químicamente , Corticoesteroides/administración & dosificación , Adulto , Antiinflamatorios/administración & dosificación , Antiinflamatorios/efectos adversos , Artralgia/diagnóstico , Artralgia/prevención & control , Femenino , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/efectos adversos , Inyecciones Intraarticulares , Trastornos de la Lactancia/diagnóstico , Trastornos de la Lactancia/prevención & control , Masculino , Persona de Mediana Edad , Trastorno de Pánico/diagnóstico , Trastorno de Pánico/prevención & control , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/prevención & controlAsunto(s)
Tamizaje Neonatal/legislación & jurisprudencia , Oftalmología/tendencias , Pediatría/tendencias , Trastornos de la Visión/prevención & control , Pruebas de Visión , Adolescente , Ambliopía/diagnóstico , Ambliopía/fisiopatología , Catarata/congénito , Catarata/diagnóstico , Niño , Diagnóstico Precoz , Neoplasias del Ojo/diagnóstico , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Cuidado Intensivo Neonatal/legislación & jurisprudencia , Cuidado Intensivo Neonatal/métodos , México/epidemiología , Oftalmología/educación , Oftalmología/legislación & jurisprudencia , Pediatría/educación , Pediatría/legislación & jurisprudencia , Retinoblastoma/diagnóstico , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/epidemiología , Retinopatía de la Prematuridad/prevención & control , Retinopatía de la Prematuridad/terapia , Estrabismo/diagnóstico , Estrabismo/fisiopatología , Trastornos de la Visión/congénito , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/epidemiología , Recursos HumanosRESUMEN
This study aimed to compare the visual attention performance of children newly diagnosed with migraine, children undergoing migraine prophylaxis, and a healthy control group. Eighty-two children aged 8 to 12 years were divided into 3 groups: untreated migraine (n = 30), migraine prophylaxis (n = 22), and control (n = 30). All were subjected to a visual attention assessment with the Trail Making Test parts A and B, Letter-Cancellation Test, and the Brazilian Visual Attention Test 3rd edition. Although performance in attention tasks was within the normal range in all groups, children with untreated migraine performed significantly worse in some visual attention tests than did the control children or children undergoing migraine prophylaxis. The migraine prophylaxis group performed as well as the control group. The deregulation of the neurochemical mechanisms underlying the physiopathology of migraine might induce visual attention deficits, but an effective prophylactic treatment might reverse migraine symptoms.
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Trastorno por Déficit de Atención con Hiperactividad/etiología , Trastornos Migrañosos/complicaciones , Trastornos de la Visión/etiología , Trastorno por Déficit de Atención con Hiperactividad/prevención & control , Niño , Femenino , Humanos , Masculino , Trastornos Migrañosos/tratamiento farmacológico , Pruebas Neuropsicológicas , Estudios Retrospectivos , Vasodilatadores/uso terapéutico , Trastornos de la Visión/prevención & controlRESUMEN
Introdução: a integridade da visão é indispensável para o desempenho escolar. Cerca de 7,5 milhões de crianças são portadoras de alguma deficiência visual e apenas 25% delas apresentam sintomas. Diante disso, ações de promoção de saúde assumem importância decisiva, o que justifica a realização deste projeto. Metodologia: o projeto realizou atriagem oftalmológica de 182 crianças, por meio do teste de Snellen, na Escola Estadual Ilídio Caixeta, em Patos de Minas, de acordo com os padrões exigidos pela OMS. Foram encaminhados para o serviço de Oftalmologia aqueles que possuíam acuidade visual ? 0,7.Diante da ausência de oftalmologistas na rede pública em Patos de Minas, três aceitaram participar voluntariamente, atendendo em seus consultórios sem cobrar honorários. Quando houve necessidade de aquisição de óculos, estes foram oferecidos por meio da parceriacom a entidade Rotary Guaratinga. Resultados e discussão: das 182 crianças avaliadas 20,87% tinham baixa acuidade visual. Percebeu-se também que 78,94% das crianças nunca realizaram consultas oftalmológicas anteriores, comprovando de fato o acesso restritoa poucos. Posteriormente às consultas, os resultados mostraram que 60% necessitaram de óculos. Conclusão: o reconhecimento do projeto fora tão marcante que a análise da acuidade visual de escolares de Patos de Minas foi inserida na grade curricular do 2° período do curso de Medicina do UNIPAM. Portanto, a prevenção e a detecção precoce dedeficiências visuais são os melhores recursos para combate à visão subnormal e devem ser feitas, preferencialmente, na infância, podendo ser corrigidas com terapêutica adequada.
Introduction: Vision integrity is essential for school performance. About 7.5 million children are visually impaired and only 25% of them present symptoms. Therefore, actions for health promotion take decisive importance, which justifies the realization of this project. Methodology:The project held ophthalmic screening of 182 children through the Snellen chart, on the School Escola Estadual Ilídio Caixeta in Patos de Minas, according to the standards required by WHO. Those presenting visual acuity ? 0.7 were referred to ophthalmologic service. Due to the absence of ophthalmologists working for public health system in Patos de Minas, three ophthalmologists agreed to participate voluntarily, attending medical consults without charging fees. When there was need to purchase glasses, they were offered by a partnership with the Rotary entity Guaratinga. Results and Discussion: Of the 182 children evaluated, 20.87% had low visual acuity. We also noticed that 78.94% of children never made previous ophthalmologic consultations, proving in fact the access is restricted to few. After the consultations, results showed that 60% needed glasses. Conclusion: The recognition of the project was so great that the analysis of visual acuity school Patos de Minas was included in the curriculum of 2nd period of the medical course of UNIPAM. Therefore, prevention and early detection of visual impairment are the best resourcesfor combating low vision and must be made, preferably, in childhood and can be corrected by appropriate treatment.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Trastornos de la Visión/prevención & control , Agudeza Visual , Salud Ocular , Técnicas de Diagnóstico Oftalmológico , Servicios de Salud Escolar , Niño , Baja VisiónRESUMEN
OBJECTIVE: Determine the prevalence of blindness and avoidable visual impairment in Argentina, its causes, the coverage of cataract surgery, and the barriers that hinder access to these services. METHODS: Cross-sectional population study conducted between May and November 2013 using the standard methodology for rapid assessment of avoidable blindness (RAAB), with a random cluster sampling of 50 people aged 50 years or more, -representative of the entire country. Participants' visual acuity (VA) was measured and the lens and posterior pole were examined by direct ophthalmoscopy. An assessment was made of the causes of having VA < 20/60, the coverage and quality of cataract surgery, and the barriers to accessing treatment. RESULTS: 3 770 people were assessed (92.0% of the projected number). The prevalence of blindness was 0.7% (confidence interval of 95%: 0.4-1.0%). Unoperated cataract was the main cause of blindness and severe visual impairment (44.0% and 71.1%, respectively), while the main cause of moderate visual impairment was uncorrected refractive errors (77.8%). Coverage of cataract surgery was of 97.1%, and 82.0% of operated eyes achieved VA ≥ 20/60. The main barriers to receiving this treatment were fear of the surgical procedure or of a poor result (34.9%), the cost (30.2%), and not having access to the treatment (16.3%). CONCLUSIONS: There is a low prevalence of blindness in the studied population and cataract is the main cause of blindness and severe visual impairment. Efforts should continue to extend coverage of cataract surgery, enhance preoperative evaluation, improve calculations of the intraocular lenses that patients need, and correct post-operative refractive errors with greater precision.
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Ceguera/epidemiología , Trastornos de la Visión/epidemiología , Anciano , Anciano de 80 o más Años , Argentina/epidemiología , Catarata/epidemiología , Extracción de Catarata/estadística & datos numéricos , Estudios Transversales , Retinopatía Diabética/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Errores de Refracción/epidemiología , Muestreo , Trastornos de la Visión/prevención & controlRESUMEN
OBJECTIVE: To conduct a comparative analysis of social inequalities in eye health and eye health care and generate baseline evidence for seven Latin American countries as a benchmarking exercise for monitoring progress toward three goals of the regional Plan of Action for the Prevention of Blindness and Visual Impairment: increasing eye health service coverage, minimizing barriers, and reducing eye health-related disease burden. METHODS: Results from cross-sectional eye health surveys conducted in six Latin American countries (Argentina, El Salvador, Honduras, Panama, Peru, and Uruguay) from 2011 to 2013 and recently published national surveys in Paraguay were analyzed. The magnitude of absolute and relative inequalities between countries in five dimensions of eye health across the population gradient defined by three equity stratifiers (educational attainment, literacy, and wealth) were explored using standard exploratory data analysis techniques. RESULTS: Overall prevalence of blindness in people 50 years old and older varied from 0.7% (95% CI: 0.4-1.0) in Argentina to 3.0% (95% CI: 2.3-3.6) in Panama. Overall prevalence of visual impairment (severe plus moderate) varied from 8.0% (95% CI: 6.5-11.0) in Uruguay to 14.3% (95% CI: 13.9-14.7) in El Salvador. The main reported cause of blindness was unoperated cataract and most cases of visual impairment were caused by uncorrected refractive error. Three countries had cataract surgical coverage of more than 90% for blind persons, and two-thirds of cataract-operated patients had good visual acuity. CONCLUSIONS: Blindness and moderate visual impairment prevalence were concentrated among the most socially disadvantaged, and cataract surgical coverage and cataract surgery optimal outcome were concentrated among the wealthiest. There is a need for policy action to increase services coverage and quality to achieve universality.
Asunto(s)
Ceguera/epidemiología , Trastornos de la Visión/epidemiología , Anciano , Anciano de 80 o más Años , Benchmarking , Catarata/epidemiología , Extracción de Catarata/estadística & datos numéricos , Atención a la Salud , Retinopatía Diabética/epidemiología , Femenino , Política de Salud , Encuestas Epidemiológicas , Disparidades en Atención de Salud , Humanos , América Latina/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Trastornos de la Visión/prevención & controlRESUMEN
OBJETIVO: Describir la justificación y metodología usadas en la Evaluación Rápida de Ceguera Evitable empleada para efectuar encuestas a nivel nacional entre 2011 y 2013 en Argentina, El Salvador, Honduras, Panamá, Perú y Uruguay. MÉTODOS: La encuesta se dirige a personas de 50 años o más, lo que reduce al mínimo los requisitos de tamaño de la muestra, que oscila entre 2 000 y 5 000 personas. Se emplean sistemas simples de muestreo y técnicas de examen; el análisis de datos es automático y no requiere de un experto en estadística. Es relativamente económica, ya que no toma mucho tiempo, no requiere equipos oftalmológicos costosos y puede ser llevada a cabo por el personal local. Los informes son generados mediante el propio programa informático de la evaluación. RESULTADOS: Los indicadores generados son la prevalencia de la ceguera y la deficiencia visual severa y moderada (discriminadas por causas evitables y cataratas); la prevalencia de afaquia o pseudofaquia; la cobertura de la cirugía de cataratas; el resultado visual de las cirugías de cataratas; las causas de resultados malos; las barreras de acceso a la cirugía de cataratas; y los indicadores de servicio de la cirugía de cataratas. Los resultados de cada una de las encuestas serán publicados de manera secuencial en números sucesivos de la revista, y en un artículo final de resumen se hará un análisis de los resultados en su conjunto y comparativo entre las encuestas y con aquellas publicadas anteriormente, que aportará un estado de la situación actual en ese grupo de países. CONCLUSIONES: La Evaluación Rápida de Ceguera Evitable es una metodología sólida, sencilla y económica para determinar la prevalencia de ceguera y deficiencia visual y la cobertura y calidad de los servicios de salud ocular, y representa una herramienta muy valiosa para medir el progreso de los programas de prevención de la ceguera y su impacto en la población.
OBJECTIVE: Describe the rationale and methodology of the Rapid Assessment of Avoidable Blindness applied in surveys at the national level in 2011-2013 in Argentina, El Salvador, Honduras, Panama, Peru, and Uruguay. METHODS: The survey includes individuals aged 50 years and older, minimizing required sample sizes, which vary from 2 000 to 5 000 people. It uses straightforward sampling and examination techniques, and data analysis is automatic and does not require a statistician. It is relatively inexpensive, as it does not take a long time, does not require expensive ophthalmic equipment, and can be carried out by local staff. Reports are generated by the assessment software package. RESULTS: Indicators measured are prevalence of blindness and of moderate and severe visual impairment (broken down into avoidable causes and cataracts); prevalence of aphakia or pseudophakia; cataract surgical coverage; visual outcome of cataract surgeries; causes of poor outcomes; access barriers to cataract surgery; and cataract surgery service indicators. Results of each survey will be published sequentially in successive issues of the Journal, and a final summary article will analyze results as a whole and in comparison with the other surveys in this group and with those previously published, which will provide a current picture of the situation in this group of countries. CONCLUSIONS: The Rapid Assessment of Avoidable Blindness is a robust, simple, and inexpensive methodology to determine prevalence of blindness and visual impairment as well as eye health service coverage and quality. It is a very valuable tool for measuring progress by blindness prevention programs and their impact on the population.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Encuestas Epidemiológicas/métodos , Trastornos de la Visión/epidemiología , Afaquia/epidemiología , Ceguera/epidemiología , Ceguera/prevención & control , Extracción de Catarata , América Central/epidemiología , Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Encuestas Epidemiológicas/economía , Implantación de Lentes Intraoculares , Prevalencia , Servicios Preventivos de Salud/provisión & distribución , Seudofaquia/epidemiología , Tamaño de la Muestra , Programas Informáticos , América del Sur/epidemiología , Trastornos de la Visión/prevención & controlRESUMEN
OBJECTIVE: To investigate and describe the prevalence and causes of blindness and moderate and severe visual impairment in older adults living in Uruguay. METHODS: All individuals aged ≥ 50 years old living in randomly selected clusters were eligible to participate. In each census enumeration unit selected, 50 residents aged 50 years and older were chosen to participate in the study using compact segment sampling. The study participants underwent visual acuity (VA) measurement and lens examination; those with presenting VA (PVA) < 20/60 also underwent direct ophthalmoscopy. Moderate visual impairment (MVI) was defined as PVA < 20/60-20/200, severe visual impairment (SVI) was defined as PVA < 20/200-20/400, and blindness was defined as PVA < 20/400, all based on vision in the better eye with available correction. RESULTS: Out of 3 956 eligible individuals, 3 729 (94.3%) were examined. The age- and sex-adjusted prevalence of blindness was 0.9% (95% confidence interval (CI): 0.5-1.3). Cataract (48.6%) and glaucoma (14.3%) were the main causes of blindness. Prevalence of SVI and MVI was 0.9% (95% CI: 0.5-1.3) and 7.9% (95% CI: 6.0-9.7) respectively. Cataract was the main cause of SVI (65.7%), followed by uncorrected refractive error (14.3%), which was the main cause of MVI (55.2%). Cataract surgical coverage was 76.8% (calculated by eye) and 91.3% (calculated by individual). Of all eyes operated for cataract, 70.0% could see ≥ 20/60 and 15.3% could not see 20/200 post-surgery. CONCLUSIONS: Prevalence of blindness in Uruguay is low compared to other Latin American countries, but further reduction is feasible. Due to Uruguay's high cataract surgical coverage and growing proportion of people ≥ 50 years old, the impact of posterior pole diseases as a contributing factor to blindness might increase in future.
OBJETIVO: Investigar y describir la prevalencia y las causas de la ceguera y de la discapacidad visual moderada y grave en los adultos mayores residentes en Uruguay. MÉTODOS: Todas las personas de 50 años o más que vivían en los agrupamientos seleccionados aleatoriamente reunían los requisitos para participar. En cada unidad de enumeración censal seleccionada, se escogieron 50 residentes de = 50 años de edad para participar en el estudio mediante el empleo de un muestreo por segmentos compactos. Los participantes fueron sometidos a una medición de la agudeza visual (AV) y a un examen del cristalino; los que mostraban una AV de presentación (AVP) < 20/60 también fueron sometidos a oftalmoscopia directa. La discapacidad visual moderada (DVM) se definió como una AVP < 20/6020/200, la discapacidad visual grave (DVG) como una AVP < 20/20020/400, y la ceguera como una AVP< 20/400, todas ellas basadas en la visión del ojo que obtuvo un mejor resultado con la corrección disponible. RESULTADOS: De las 3 956 personas que reunieron los requisitos, se examinaron 3 729 (94,3%). La prevalencia ajustada por edad y sexo de la ceguera fue de 0,9% (intervalo de confianza (IC) de 95%: 0,51,3). La catarata (48,6%) y el glaucoma (14,3%) fueron las principales causas de ceguera. La prevalencia de la DVG y la DVM fue de 0,9% (IC de 95%: 0,51,3) y 7,9% (IC de 95%: 6,09,7), respectivamente. La catarata fue la causa principal de DVG (65,7%), seguida del error de refracción no corregido (14,3%), que fue la principal causa de DVM (55,2%). La cobertura quirúrgica de la catarata fue de 76,8% (calculada por ojo) y de 91,3% (calculada por persona). De todos los ojos operados de catarata, 70,0% presentaba una agudeza visual de = 20/60 y 15,3% tenía una agudeza visual < 20/200 después de la intervención quirúrgica. CONCLUSIONES: En Uruguay, la prevalencia de la ceguera es baja en comparación con otros países latinoamericanos, pero es factible lograr una reducción adicional. Como consecuencia de la alta cobertura quirúrgica de la catarata y la creciente proporción de personas de = 50 años en Uruguay, la repercusión de las enfermedades de la cámara ocular posterior como factor contribuyente a la ceguera podría aumentar en el futuro.