ABSTRACT
ABSTRACT OBJECTIVE To evaluate the effectiveness of mobile ophthalmic unit screenings and to investigate barriers between community care and resolution of the problem at a tertiary center. METHODS This prospective study evaluated a convenience sample from 10 municipalities in São Paulo State, Brazil. Patients were assessed in the municipality by a mobile ophthalmic unit and underwent a complete ophthalmic consultation. Patients were referred as warranted to a tertiary hospital. RESULTS The mobile ophthalmic unit screened 1,928 individuals and 714 (37%) were referred. The mean age of the referred patients was 57.12 (SD = 19.5) years with best corrected visual acuity of 0.37 (SD = 0.36) logMAR. Forty-seven (6.6%) patients were blind and 185 (26.5%) were visually impaired. Cataracts (44.7%) and pterygium (14.7%) accounted for most referrals. Of those referred, 67.1% presented to the tertiary center. The diagnosis by the mobile ophthalmic unit corresponded to the one by the tertiary center in 88.5% of the cases. There were a significantly higher number of blind and visually impaired persons among those who presented to the hospital. There was a significantly greater attendance among patients living in more distant municipalities from the reference center with a higher number of inhabitants and a greater number of ophthalmologists in the cities of origin (p < 0.05, all comparisons). Complete treatment was performed in 65.6% of patients, and loss to follow-up was the main cause of incomplete treatment in 50.7% of patients. A total of 313 cataract surgeries were performed, which reduced the number of blind patients from 20 to 2 and of visually impaired individuals from 87 to 2 (p < 0.001). CONCLUSIONS Only 37% of the patients assessed by a mobile ophthalmic unit required referral to a tertiary hospital. Among the referred patients, 67.1% presented to the hospital, and complete resolution after treatment was approximately 65.5%. There was a significant improvement in visual acuity and a reduction in the prevalence of blindness and visual impairment postoperatively.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vision Disorders/diagnosis , Mass Screening/methods , Tertiary Care Centers , Mobile Health Units , Vision Disorders/therapy , Vision Disorders/epidemiology , Cataract/diagnosis , Cataract/therapy , Cataract/epidemiology , Brazil/epidemiology , Pterygium/diagnosis , Pterygium/therapy , Pterygium/epidemiology , Visual Acuity , Prevalence , Prospective Studies , Cities/epidemiology , Treatment Outcome , Statistics, NonparametricABSTRACT
La catarata congénita es una las causas más frecuentes de baja visión en Cuba y en el mundo, y se manifiesta desde los primeros momentos de la vida. Se considera la responsable de 10 por ciento de la pérdida visual en el niño y la causa más frecuente de privación visual tratable. Puede ser parcial o completa y, a veces,acompaña a otras afecciones oftalmológicas como: estrabismo, microftalmías, microcórneas, colobomas de iris y coroides, nistagmos y, en ocasiones, se asocia a enfermedades generales y síndromes. Nuestro objetivo es evaluar la habilitación visual en pacientes con baja visión por catarata congénita atendidos en el Instituto Cubano de Oftalmología (ICO) "Ramón Pando Ferrer" en el período enero/2005-diciembre/2008. Se realizó un estudio descriptivo-retrospectivo en 23 pacientes (16 masculinos, 7 femeninos) con diagnóstico de catarata congénita. Las variables empleadas fueron: tipo de catarata según lateralidad, modalidad del tratamiento quirúrgico utilizado, afecciones asociadas a la catarata, resultados en agudeza visual y la ayuda óptica más empleada. La catarata bilateral se presentó en 96 por ciento de los pacientes; la cirugía sin lente intraocular fue el tratamiento más empleado (75 por ciento); la ambliopía profunda fue la afección más frecuente (86 por ciento), encontrándose una mejoría de la agudeza visual después de la habilitación en 34.7 por ciento; la ayuda óptica más empleada fueron los microscopios, para 95 por ciento. Con la adecuada y oportuna habilitación se logró alcanzar una mejoría visual en los pacientes.
Congenital cataract is one of the most common causes of low vision in Cuba and worldwide, and is manifest from the first moments of life. Is considered responsible for 10 percent of visual loss in children and the most common cause of treatable visual deprivation. It may be partial or comple te, and sometimes accompanies other eye problems such as strabismus, microphthalmia, microcórnea, iris and choroid colobomas, nystagmus and it is sometimes associated with systemic diseases and syndromes. To evaluate the visual clearance in patients with low vision congenital cataract treated at the Cuban Institute of Ophthalmology (ICO) "Ramón Pando Ferrer" in the period January/2005 - December/2008.We performed a retrospective descriptive study in 23 patients (16 male, 7 female) diagnosed with congenital cataracts. The variables used were: type of cataract by laterality, surgical treatment modality used, conditions associated with cataract, visual acuity results and the most widely used optical aids. Bilateral cataract was present in 96 percent of patients; surgery without intraocular lens was the most common treatment (75 percent); deep amblyopia was the most frequent disorder (86 percent), and found an improvement in visual acuity after empowerment in 34.7 percent, the most widely used optical aids were microscopes, 95 percent.