To Investigate The Prevalence Of Blindness And Low Vision In Children Aged From3to6Years Old In Huiji District Of Zhengzhou City

BackgroundVisual impairment will not only bring great pain to the patients, but also bringa heavy financial burden to the family and society. Currently, blindness and lowvision is not only a serious public health problem worldwide,but also a serious socialand economic problem that every country will confront. In order to reduce theburden of the blind all over the world and decrease the incidence of blindness assoon as possible. In1999,the WHO (World Health Organization) and some otherinternational governmental organizations launched the "Vision2020, the right tosight" action, which is the world’s largest action about prevention of blindness.Inthis action,the blindness and low vision of children was considered as the mostimportant thing and the eradication of avoidable blindness in the world would becompleted in2020. To reach this goal,the researchers in the fields of prevention andtreatment of blindness in China have worked hard for many years. Our country havestarted a series of projects and taken plenty of measures on the prevention andtreatment of blindness since the action being launched.Although we have made someachievements, there are still some problems need to be solved. Such as,the lagging information work has caused the lack of reliable and timely information aboutprevention of blindness and the current limites of economic conditions have causedthe serious shortage of funding for prevention of blindness and unequal distributionof health resources and service conditions between urban and rural areas has causedthe progress in the prevention of blindness in China slowly because of the project notreally being implemented into the rural and remote areas. According to a nationalsurvey results on disabled people in2006, there are12.33million vision disabledpeople in China, among them the total of low vision is8.24million, the prevalenceof low vision of children under the age of14is0.43%and altogether5million.Chinaas the most serious damaged country by the blindness and low vision in the worldwill face great challenges in the field of treatment and prevention and rehabilitationof blindness and low vision.Henan province with a large population of the country is restricted bygeographical and economical conditions and has a great number of blindness andlow vision patients. Although through continuous efforts it has led to a lot of patientswith low vision being rehabilitated and has made remarkable achievements,there arestill some problems worthy of attention. For the promises of implementation of"Vision2020" action, according to the specific situation of our province,with thehelp of Zhengzhou FIMITIC,we have designed a set of ophthalmopathy surveyservices. Now I will give a report on the investigation of blindness and low vision ofchildren aged from3to6years old in Huiji District of Zhengzhou city.ObjectiveThe purpose of this study is to investigate and analysis the prevalence ofblindness and low vision and the leading causes of blindness in children aged from3to6years old in Huiji District of Zhengzhou city, and evaluate the status quo andgrasp the epidemiological situation of blindness and low vision in this area,and alsoprovide a certain theoretical basis to prevent and cure the blindness of children agedfrom3to6years old in this area and Henan Province and even the whole country.The specific objective is as follows:1. To understand the prevalence of blindness and low vision of children agedfrom3to6years old in Huiji District of Zhengzhou city. 2. To understand and analysis the major causes and constitutions of blindnessand low vision of children aged from3to6years old in Huiji District of Zhengzhoucity.3. To provide a certain reference about the prevention of blindness and lowvision of children aged from3to6years old in Henan province and even the wholecountry.Methods1. A survey on blindness and low vision was carried out among9637childrenaged from3to6years old in Huiji District of Zhengzhou city from July2012toJune2013.2.Vision screening was used to identify the children aged from3to6years old.Presenting visual acuity(PVA) and best corrected visual acuity(BCVA)(Using1%Atropine Sulfate Eye Ointment to put into two eyes for5days) are based onautorefraction and subjective refraction were measured separately in each eye．Ifvisual acuity of the best eye was less than0.3, further examinations such asintraocular pressure,anterior segment,visual field and ocular fundus beingneeded.Also additional examinations such as VEP and ERG and FFA are needed forspecial purposes. According to the visual impairment standards of the World HealthOrganization, blindness or low vision is established.3. To classify the grade of children being checked out with blindness and lowvision and analyse the leading causes blindness and low vision.4. A statistical analysis was performed between city and countryside andbetween boys and girls.The Chi square test was used between the groups of ratecomparison of the screening outcomes.ResultsThe9246subjects aged from3to6years old were examined(95.94％)． Among them (average age,4.20±1.05)are4950boys (53.54%) and4296girls (46.46%) and4869children (52.66%) from city and4377(47.34%) childrenfrom countryside.The prevalence of binocular blindness(Including3cases ofretinopathy of prematurity,1case of optic atrophy and retinal pigment degenerationand congenital aniridia respective.) and bilateral low vision (Including4cases of congenital cataract,2cases of ametropia amblyopia and2cases of pigmentarydegeneration of retina,1cases of optic nerve atrophy and congenital glaucoma andocular trauma respective.) were0.06％(6/9246) and0.12％(11/9246) respectivelyaccording to the visual impairment standards of the World Health Organization．Theprevalence of monocular blindness(Including4cases of ocular trauma,3cases ofstrabismic amblyopia,2cases of ametropia amblyopia,1case of retinopathy ofprematurity and optic atrophy and pigmentary degeneration of retina and retinaldetachment and Coats disease and hyperplastic primary vitreous respective.) andunilateral low vision (Including5cases of ocular trauma,3cases of ametropiaamblyopia,2cases of optic atrophy and retinal detachment and congenital nystagmusand congenital cataract and strabismic amblyopia respective,1case of hyperplasticprimary vitreous.) were0．16％(15/9246) and0.21％(19/9246) respectivelyaccording to the visual impairment standards of the World Health Organization．Theprevalence of binocular blindness were0.07％and0.06％respectively betweencountryside and city while the prevalence of bilateral low vision were0.08％and0.16％. The prevalence of monocular blindness were0.21％and0.12％respectivelybetween countryside and city while the prevalence of unilateral low vision were0.27％and0.14％. The prevalence of binocular blindness were0.08％and0.05％respectively between boys and girls while the prevalence of bilateral low visionwere0.12％and0.02％. The prevalence of monocular blindness were0.20％and0.12％respectively between countryside and city while the prevalence ofunilateral low vision were0.22％and0.19％.In this population，the leading causesof binocular blindness are retinopathy of prematurity and congenital and hereditaryretinal degeneration.While Congenital cataract and amblyopia and retinal pigmentepithelial degeneration are the reasons of bilateral low vision. The leading causes ofmonocular blindness and unilateral low vision are mainly led by ocular trauma.Conclusions1. The prevalence of blindness and low vision in children aged from3to6years old in Huiji District of Zhengzhou city is different from other areas,but theleading causes of visual impaired are the same as other developed countries.2. The prevalence of blindness and low vision in children aged from3to6 years old in Huiji District of Zhengzhou city has no statistically significantdifferences between rural and urban.3. The prevalence of blindness and low vision in children aged from3to6years old in Huiji District of Zhengzhou city has no statistically significantdifferences between boys and girls.4. The establishment of retinopathy of prematurity screening mechanism canreduce the incidence of blindness.5. The establishment of blind and low vision data files in this area canvigorously promote the work of low vision rehabilitation.