Causes and anatomical site of blindness and severe visual loss in Isfahan, Islamic Republic of Iran

Abstract

This study in 2005 evaluated the causes and major anatomical site of blindness and severe visual loss at a school for blind children in Isfahan province, Islamic Republic of Iran. All 211 students were examined according to the modified WHO/PBL eye examination record: 70.4% were blind, 24.3% had severe visual loss and 5.3% were visually impaired. The major causes of abnormality were hereditary factors (42.7%), prenatal/ neonatal (18.5%) and unknown etiology (35.5%). The main sites of abnormality were the retina (62.6%), whole globe (17.5%), lens (7.1%) and optic nerve (7.1%). A high proportion of parents were in a consanguineous marriage (49.2%). The pattern of blindness in Isfahan encompasses characteristics of both developed and developing countries. Causes et localisation anatomique de la cécité et des pertes de vision sévères à Ispahan (République islamique d'Iran) RÉSUMÉ La présente étude, conduite en 2005, évaluait les causes et les principales localisations anatomiques de la cécité et des pertes de vision sévères dans une école pour enfants aveugles de la province d'Ispahan en République islamique d'Iran. Les 211 écoliers ont tous été examinés suivant les indications de la fiche OMS/ PBL d'examen oculaire modifiée : 70,4 % étaient aveugles, 24,3 % avaient une perte de vision sévère, et 5,3 % souffraient de déficience visuelle. Les principales causes d'anomalie étaient des facteurs héréditaires (42,7 %), d'origine prénatale ou néonatale (18,5 %) et d'étiologie inconnue (35,5 %). Les anomalies étaient localisées essentiellement au niveau de la rétine (62,6 %), de l'ensemble du globe oculaire (17,5 %), du cristallin (7,1 %) et du nerf optique (7,1 %). Parmi les parents, une forte proportion avait contracté un mariage consanguin (49,2 %). À Ispahan, les caractéristiques de la cécité recouvrent aussi bien celles des pays développés que celles des pays en développement.

An update on progress and the changing epidemiology of causes of childhood blindness worldwide

“…5,6 Training more ophthalmologists and reinforcing ROP screening programs are important VISION 2020 targets for medium-income countries. 6 Hereditary factors, ranging from 23% to 44% (albinism, congenital cataracts with family history, retinitis pigmentosa) predominate in the Americas, Europe, Asia, and Western Pacific region (including Uzbekistan, 10 Finland, 11 Sri Lanka, 12 Cambodia, 13 India, 12,14-17 and China [18][19][20][21]. Most childhood blindness occurs after the perinatal period, that is, between 1 month and 15 years of age in the African (38%) and Eastern Mediterranean (43%) regions (Table 2).…”

Global challenges in the management of congenital cataract: proceedings of the 4th International Congenital Cataract Symposium held on March 7, 2014, New York, New York

“…Additionally, the cultural issue of consanguinity in the region contributes to high rates of congenital cataract and other ocular anomalies. In the Eastern Mediterranean region, lens pathology is responsible for 7%-20% of visual impairment in children, according to studies performed in Iran, 30,31 Yemen, 32 and Sudan. 33 Groups invested in strengthening eye care services for children with congenital cataracts include the Middle East Africa Council of Ophthalmology (MEACO) and its subspecialty organization, the Middle East Africa Pediatric Ophthalmology and Strabismus Society (MEAPOSS).…”

“…However, the region is not homogenous with regard to how ophthalmology is practiced, and the standards of care between urban and rural areas vary greatly. There have been two studies of the use of KIs in case finding in the region, 30,34 and proactive approaches to case finding appear to be few.…”