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An Survey of Blindness and Low Vision among Adults Aged 50 Years and Above in Tengzhou of Shandong Province

Author: FangZuo
Tutor: XuLingZhong;LongHao
School: Shandong University
Course: Social Medicine and Health Management
Keywords: Blindness Low Vision Prevalence Presenting Visual Criteria Cataract
CLC: R77
Type: Master's thesis
Year: 2009
Downloads: 8
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Abstract

Backgrounds:Blindness and low vision is a worldwide serious public health and socio-economic problem. Currently the world’s visual impairment population is about 180 million, of which 4 to 4.5 million are blind, estimated that by 2020 the number will fold doubly. In recent years, many countries conduct population-based epidemiology of blindness and low vision survey. Shandong Province conducted a blindness and low vision epidemiological investigations in 1987.But demographic composition and socio-economic situation has undergone tremendous change in the past 20 years, so we should conduct another epidemiological survey to know the prevalence of blindness and low vision, and also major causes of blindness. The survey results will surely be helpful to effectively prevent and control blindness in Tengzhou.Objective:To investigate the prevalence of blindness and low vision eye;the causes of blindness and low vision among adults aged 50 years and above in Tengzhou of Shandong province.Methods:The sampling size was estimated with an error bound of 25% with 95% confidence interval, 1.8 sampling effect coefficient and 90% response rate.During April to July,2008,cluster sampling was used in randomly selecting individuals aged 60 years and above in 27 basic sampling uints. Before the field work,the smpling population were enumerated.Vision acuity was measured by logarithm visual chart. The prevalence of blindness and low vision were calculated according to the pinhole vision with WHO and presenting visual criterion respectively. A diagnosis of the principal cause for all the eyes with vision acuity less than 0.3 was made. The survey was preceded by a pilot study and quality assurance evaluation was carried out.The quality assurance were carried out before the field work,during the field work period,and after the field work.Main Results: 5557 individuals were enumerated,4916 individuals were examined. The response rate was88.46%. (1)According to WHO criterion :77cases were blind in both eyes (the prevalence is 1.57%),117 cases were blind in one eye(the prevalence is 2.38%),126 cases were low vision in both eyes(the prevalence is 2.56%),260 cases were low vision in one eye(the prevalence is 5.29%); among them, the prevalence of blindness and low vision increase with the age; the prevalence of population in marriage were 1.1%、2.0%、1.8%、4.5% in turn, the prevalence of solitary ones(including the unmarried ,divorced,and widowed) were 3.7%、4.4%、6.4%、9.1%;the prevalence of sampling ones with an average annual income of 0- Yuan were 3.3%、3.9%、5.6%、9.5% in turn, the prevalence of sampling ones with an average annual income of 1000- Yuan were 1.7%、2.4%、3.4%、5.2% in turn, the prevalence of sampling ones with an average annual income of 3000- Yuan were 0.7%、1.8%、1.5%、3.8% in turn, the prevalence of sampling ones with an average annual income of 5000- Yuan were 1.2%、1.9%、0.6%、3.9% ; the prevalence of sampling ones whose kins with blindness and low vision were 1.9%、6.6%、5.7%、16.0% in turn,the prevalence of sampling ones whose kins without blindness and low vision were 1.5%、2.1%、2.3%、4.5%.The output of multivariate logistic regression shows the prevalence of blindness and low vision was related with age、ecnomic status and whether there were blindness and low vision in kins or not.The top five cause leading to blindness and low vision were, in descending sequence, cataract(48.53%), ametropia(14.94%),macular degeneration (7.41%) ,corneal scar/opacity(3.96%) and amblyopia(3.70%). (2) According to presenting visual criterion :472 cases were visual impairment (the prevalence is 9.6%),332 cases were blind in one eye(the prevalence is 6.8%),27 cases were mildly blind in both eyes(the prevalence is 0.5%),85 cases were severely blind in both eyes(the prevalence is 1.7%);among them, the prevalence of blindness and low vision increase with the age; the prevalence of population in marriage were 8.2%、5.2%、0.3%、1.2% in turn, the prevalence of solitary ones(including the unmarried ,divorced,and widowed) were 16.5%、14.5%、1.5%、4.3%;the prevalence of sampling ones with an average annual income of 0- Yuan were 18.7%、11.7%、1.0%、3.6% in turn, the prevalence of sampling ones with an average annual income of 1000-Yuan were 10.0%、7.3%、0.7%、1.9% in turn, the prevalence of sampling ones with an average annual income of 3000-Yuan were 6.6%、5.3%、0.5%、0.7% in turn, the prevalence of sampling ones with an average annual income of 5000-Yuan were 5.8%、4.1%、0.1%、1.3% ; the prevalence of sampling ones whose kins with blindness and low vision were 16.7%、15.1%、1.6%、1.9% in turn,the prevalence of sampling ones whose kins without blindness and low vision were 9.1%、6.2%、0.5%、1.7%.The output of multivariate logistic regression shows the prevalence of blindness and low vision was related with age、ecnomic status、marriage status and whether there were blindness and low vision in kins or not.The top five cause leading to blindness and low vision were , in descending sequence, cataract (48.34%) ,ametropia (21.28%) ,macular degeneration (4.94%) ,corneal scar/opacity (4.34%) andamblyopia (4.34%) .Conclusions: 1. The prevalence of blindness and low vision among adults aged 50 and above in Tengzhou of Shandong: (1)according to WHO criteria:blindness in both two eyes, 1.57%;blindness in one eye, 2.38%; low vision in both two eyes, 2.56%; low vision in one eye,5.29%; (2) according to presenting visual criteria: visual impairment prevalence, 9.60%; blindness in one eye, 6.75%; mild binocular blindness prevalence ,0.59%, severe binocular blindness prevalence, 1.73%. As the long-term effective prevention of blindness in the conduct, the prevalence of binocular blindness had a slight decline compared with that in 1986.2. The prevalence of blindness and low vision is related with age, marital status and ecnomic status; but it is irrelevant with gender and educational level.Additionally, the survey also finds that the prevalence rate of citizen whose kins with blindness and low vision, is higher than not.3. The cause leading to blindness and low vision were , in descending sequence, (1)according to WHO criterion sort order of the top five: cataract (48.53%), refractive error (14.94%), macular degeneration (7.41%), corneal opacity / scarring (3.96%), amblyopia (3.70%); (2)according to presenting visual criterion sort order of the top five: cataract (48.34%), refractive errors (21.28%), macular degeneration (4.94%), corneal opacity / scarring (4.34%), amblyopia (3.23%).Prompted by the survey to prevent and control of blindness more effectively in Tengzhou,we should focus on increasing the rate of cataract surgery and refractive correction.

An Survey of Blindness and Low Vision among Adults Aged 50 Years and Above in Tengzhou of Shandong Province

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