Abstract
Aim: The aim of this study was to look into the causes of blindness by examination of blind students in a tertiary hospital.
Material and Methods: This was a hospital based cross sectional observational study carried out for a period of two years. A total of 349 patients were included in this study who attended our department for the purpose of demand of writer in their competitive entrance examination. Patients who had visual acuity less than 6/60 to 4/60 in better eye (VI disability percentage 100%) were included in this study. The subjects with visual acuity greater than 6/60 in better eye, mentally retarded patients and uncooperative patients were excluded. The main cause of blindness was noted according to age and cause. VI disability percentage as proposed by Indian Government was used to give percentage to all subjects. All patients underwent detailed ophthalmic examination including visual acuity, refraction, slit lamp examination and fundus evaluation.
Observations and Results: A total of 349 patients were included in our study out of which 62 percent were males. All of our patients were between 21-30 years. Nystagmus was the most common finding observed in our study in about 166 (47.56%) eyes. Microphthalmos and coloboma along with other globe conditions (146, 41.83%) were the most common cause of blindness in our patients. Anophthalmos and enophthalmos (58, 16.62%) was the second most important cause of blindness in this age group. Corneal scarring and opacity (56, 16.05%) was third in position in ranking list of cause of blindness. Retinal degenerations (30, 8.60%) and complicated pseudophakia (28, 8.03%) cases occupied fourth and fifth position repectively among causes of blindness. Optic atrophy (30, 8.59%) and buphthalmos (1, 0.28%) was other causes found in contributing to blindness in these subjects.
Conclusion: Childhood blindness remains one of the important causes of visual morbidity in young age individuals. Majority of our cases who came for visual disability certificate suffered from nystagmus and microcornea. Hence children should be treated at the earliest in order to prevent some of the avoidable causes of blindness and allow them to live an acceptable quality of life. Education of parents and society also should be taken into consideration.
Keywords: Blindness, Blind students, Disability Percentage, Visual Impairment.
References
- Dandona L, Dandona R, Naduvilath TJ, et al. Is current eye-care-policy focus almost exclusively on cataract adequate to deal with blindness in India? Lancet 1998;351:312–16.
- Thulasiraj RD, Nirmalan PK, Ramakrishnan R, et al. Blindness and vision impairment in a rural south Indian population: the Aravind Comprehensive Eye Survey. Ophthalmology 2003;110:1491–8.
- Dandona L, Dandona R, John RK. Estimation of blindness in India from 2000 through 2020: implications for blindness control policy. Nat Med J India 2001;14:327–34.
- Thulasiraj RD, Rahamathulla R, Saraswati A, et al. The Sivaganga eye survey: I. Blindness and cataract surgery. Ophthalmic Epidemiol 2002;9:299–312.
- Nirmalan PK, Thulasiraj RD, Maneksha V, et al. A population based eye survey of older adults in Tirunelveli district of south India: blindness, cataract surgery and visual outcomes. Br J Ophthalmol 2002;86:505–12.
- Murthy GVS, GuptaSanjeev, Ellwein LB, et al. A population-based eye survey of older adults in a rural district of Rajasthan. I. Central vision impairment, blindness and cataract surgery. Ophthalmology 2001;108:679–85.
- Thylefors B, et al. Global data on blindness. Bull World Health Organ 1995;73:115–21.
- Limburg H, Vaidyanathan K, Pampattiwar KN. Cataract blindness on the rise? results of a door-to-door examination in Mohadi. Indian J Ophthalmol 1996;44:241–4.
- Mohan M. National survey of blindness—India. NPCB-WHO report. New Delhi: Minsitry of Health and Family Welfare, Government of India, 1989.
- National programme for control of blindness. Government of Orissa; 2010. Available from: http://www.orissa.gov.in/health_portal/programme/ NPCB/main.html [accessed on 2010 Aug 10]
- Directorate general of health services. National programme for control of blindness. Chandhigarh: DGHS, Government of Punjab; 2010. Available from: pbhealth.gov.in/pdf/Blindness.pdf [accessed on 2010 Aug 12].
- Neena J, Rachel J, Praveen V, Murthy GV. Rapid assessment of avoidable blindness in India. PLoSOne 2008;3:e2867.
- Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: A systematic review and meta-analysis. Lancet Glob Health 2017;5:e888-97.
- Disabled Persons in India [Internet]. National Sample Survey Organisation, Ministry of Statistics and Programme Implementation Government of India; 2003. Available from: http:// mospi.nic. in/sites/default/fi les/publication_reports/485_fi nal.pdf. [Last accessed on 2017 Jun 08].
- Marmamula S, Keeffe JE, Rao GN. Rapid assessment methods in eye care: An overview. Indian J Ophthalmol 2012;60:416-22.
- Frick KD, Gower EW, Kempen JH, Wolff JL. Economic impact of visual impairment and blindness in the United States. Arch Ophthalmol 2007;125:544-50.
- Ghosh S, Mukhopadhyay S, Sarkar K, Bandyopadhyay M, Maji D, Bhaduri G. Evaluation of registered visually disabled individuals in a district of West Bengal, India.Indian J Community Med 2008;33:168-71.
- Kumar R. Disability Assessment and Certification Guidelines and Explanations, based on Gazette Notification (Committee under chairmanship of DGHS, GOI) issued by Ministry of Social Justice and Empowerment, GOI, Regd No. DL33004/99 (Extraordinary) Part II, Sec. 1, June 13, 2001.
- Ministry of Social Justice and Empowerment. Guidelines for evaluation of various disabilities and procedure for certification. Notification dated 1st June, 2001. The Gazette of India Part 1. Section 1. No 154.
- Ambastha A, Kusumesh R, Sinha S, Sinha BP, Bhasker G. Causes of visual impairment in applications for blindness certificates in a tertiary center of Bihar and its role in health planning. Indian J Ophthalmol 2019;67(2):204-8.
- Dandona R, Dandona L. Childhood blindness in India: A population based perspective. Br J Ophthalmol 2003;87:263-5.
- Bhalerao SA, Tandon M, Singh S, Dwivedi S, Kumar S, Rana J. Visual impairment and blindness among the students of blind schools in Allahabad and its vicinity: A causal assessment. Indian J Ophthalmol 2015;63:254-8.
- Gopinathan U, Fernandes M, Sharma S, Athmanathan S, Rao GN, Garg P. The epidemiological features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India. Indian J Ophthalmol 2014;62:240-5.
- Bunce C, Evans J, Fraser S, Wormald R. BD8 certification of visually impaired people. Br J Ophthalmol 1998;82:72-6.
- Neena J, Rachel J, Praveen V, Murthy GV; Rapid Assessment of avoidable blindness India Study Group. Rapid Assessment of avoidable blindness India study group. PLoS one 2008 ; 6:e 2867.
- Bunce C, Wormald R. Leading causes of certification for blindness and partial sight in England & Wales. BMC Public Health 2006;6:58.
Corresponding Author
Dr Deepak Mishra
Assistant Professor, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, UP, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.90
