Vision related quality-of-life among patients with traumatic or non-traumatic ocular disease and its association with the Rights of Persons with Disabilities Act: Unveiling-the-hidden

Purpose: To assess vision?related quality of life (VrQoL) in cases with visual loss after ocular trauma (OT) or non?traumatic ocular disease (NTOD) using the National Eye Institute’s 25?Item Visual Function Questionnaire 25 (VFQ?25) and its association with visual disability % (VD%) based on the Rights of Persons with Disabilities (RPwD) Act, 2016. Methods: This was a prospective observational study conducted among cases with ocular morbidity in either or both eyes with a visual acuity of ?6/24. VFQ?25 questionnaire was administered to measure QoL scores. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 23. P < 0.05 was taken as significant. Results: Eighty-eight respondents completed the questionnaire. Mean age of participants was 40.272 ± 9.35 years (range: 23–55 years). Forty?three (48.9%) and 45 (51.1%) participants had OT and NTOD, respectively. The most common cause was traumatic optic neuropathy (21.6%) followed by corneal causes (19.4%). Low visual QoL scores were reported in all the cases (57.52 ± 16.08). Between OT and NTOD, a significant difference in terms of age (P = 0.001) and general vision (P = 0.03) was seen. Lowest scores were for driving. Based on VD%, 77 cases had ?40 and the rest had >40% VD with a significant difference in overall mean scores (P = 0.03), specifically in domains of general vision (P = 0.00), near activities (P = 0.00), and driving (P = 0.007). QoL was decreased in each subscale of ?40%VD group, who faced the same predicament everywhere as by the cases with more disability. Conclusion: Ocular morbidity is associated with low QoL, predominantly in domains like general vision, near activities and driving. The RPwD Act leaves out a huge population with VD without any government benefits. One might need to consider other vision?related factors also to provide them with social, psychological, and employment benefits.

Motor learning in visual impaired individuals during a coincident timing task in a non-immersive virtual reality / Aprendizagem motora em indivíduos com deficiência visual em uma tarefa de timing coincident em realidade virtual não imersiva

Introduction: virtual reality (VR) is used nowadays as an assessment and intervention tool in rehabilitation. One of the skills that can be assessed through VR is coincident timing (perceptual-motor ability to execute a motor response in synchrony with an external stimulus). Visually impaired (VI) people require this synchronization of movements with external objects in their daily and leisure activities. Objective: to investigate the performance of VI individuals in a VR coincident timing task. Methods: sixty individuals over 18 years of age participated in this study: 20 with VI, 20 without VI but blindfolded and 20 individuals without VI that used visual feedback (without blindfold). A semi-structured interview and a virtual coincident timing task were used. Results: although VI individuals started the task with the worst performance (Absolute error = VI group 945ms x blindfolded group 591ms x without blindfold group, 557ms), they improved performance throughout the task, as did the other groups, reducing the number of errors (mean absolute error= 698ms to 408ms). Furthermore, all groups presented increased task speed (mean variable error= last acquisition block 408ms x immediate transfer 227ms x late transfer 247ms). Conclusion: individuals with VI had difficulties at the beginning of the proposed task, but with practice they were able to adapt to the task with an improved of performance (observed by the decrease in error time). The auditory feedback was sufficient to allow adaptation to the task which improved participant performance with VI.

Introdução: A realidade virtual (RV) é usada atualmente como ferramenta de avaliação e intervenção na reabilitação. Uma das tarefas motoras possíveis de verificar desempenho por meio da RV é o timing coincidente (habilidade perceptivo-motora de executar uma resposta motora em sincronia com um estímulo externo). Essa sincronização de movimentos com estímulos externos é importante para pessoas com deficiência visual (DV) nas tarefas diárias e de lazer.Objetivo: Investigar o desempenho de indivíduos com DV em uma tarefa de timing coincident em RV não imersiva.Método: Participaram deste estudo 60 indivíduos maiores de 18 anos: 20 com DV, 20 sem DV mas vendados e 20 indivíduos sem DV que utilizaram feedback visual (não vendado). Foi utilizada entrevista semiestruturada e uma tarefa de timing coincident no computador. Resultados: O grupo DV iniciou a tarefa com o pior desempenho (erro absoluto = grupo DV 945ms x grupo vendado 591ms x grupo não vendado 557ms), mas melhoraram ao longo da tarefa. Apesar da dificuldade inicial do grupo com DV, todos os grupos reduziram o número de erros (erro absoluto médio = 698ms para 408ms). Além disso, todos os grupos aumentaram a precisão da tarefa (erro variável médio = último bloco de aquisição 408 ms x transferência imediata 227 ms x transferência tardia 247 ms).Conclusão: Indivíduos com DV apresentaram dificuldades no início da tarefa proposta mas com a prática conseguiram se adaptar a tarefa com melhora no desempenho (observado pela diminuição no tempo de erro). Ou seja, o feedback auditivo foi suficiente para possibilitar adaptação à tarefa e melhora de desempenho dos participantes com DV.

Analysis of visual disability in Buenos Aires, Argentina. Pathologic myopia is the leading cause in working age / Análisis de discapacidad visual en Buenos Aires, Argentina. La miopía patológica es la principal causa en edad laboral

Abstract This study assessed the causes of visual impairment over a decade in Buenos Aires City. This is a retrospective case series where we reviewed the database of visual disability certificates issued by the Buenos Aires City Ministry of Health between 2009 and 2017. In Argentina, visual disability is defined as a visual acuity ≤ 20/200 in the better eye, or a corresponding visual field of less than 20 degrees in the less impaired eye. The database included the following variables: year of issue, age, gender, and cause of visual disability. Between 2009 and 2017 a total of 7656 subjects were certified as legally blind. The mean age of the sample was 57 ± 21 years and 52.1% were females. The emission was near 700 certificates per year. The age distribution showed that 62.8% of certificates were from patients older than 50 years and that only 6.6% were given to subjects under 20. The leading causes of visual disability in Buenos Aires City were age-related macular degeneration (ARMD) with a rate of 15.5%, degenerative myopia (14.4%), primary open-angle glaucoma (11.3%) and diabetic retinopathy (6.6%). In subjects younger than 50, degenerative myopia was the first cause of visual disability. Interestingly in Argentina, where the prevalence of myopia is low, degenerative myopia is found to be the major cause of visual disability in middle-aged adult subjects. Population and clinical methods to avoid this preventable disease should need to be implemented as a matter of urgency.

Resumen Este trabajo estudia las causas de la discapacidad visual durante una década en la Ciudad de Buenos Aires. Se presenta una serie de casos retrospectiva donde se revisó la base de datos de certificados de discapacidad visual emitidos por el Ministerio de Salud de la Ciudad de Buenos Aires entre 2009 y 2017. En Argentina, la discapacidad visual se define como una agudeza visual ≤ 20/200 en el mejor ojo, o un campo visual correspondiente de menos de 20 grados en el ojo menos deteriorado. La base de datos incluyó las siguientes variables: año de emisión, edad, sexo y causa de la discapacidad visual. Entre 2009 y 2017 se certificaron un total de 7656 sujetos con ceguera legal. La edad media de la muestra fue de 57 ± 21 años y el 52.1% fueron mujeres. La distribución por edades mostró que el 62.8% de los certificados fueron dados a pacientes mayores de 50 años y que solo el 6.6% se otorgó a menores de 20 años. Las principales causas de discapacidad visual fueron la degeneración macular asociada a la edad (DMAE) (15.5%), la miopía degenerativa (14.4%), el glaucoma primario de ángulo abierto (11.3%) y la retinopatía diabética (6.6%). En los menores de 50 años, la miopía degenerativa fue la primera causa de discapacidad visual. Resulta interesante que, en Argentina, donde la prevalencia de miopía es baja, la miopía degenerativa sea la principal causa de discapacidad visual en adultos de mediana edad.

Pertinencia de una estrategia de profesionalización para oftalmólogos sobre la prevención de la discapacidad visual / Relevancy of a professionalization strategy for ophthalmologists on the prevention of visual disability

En la especialidad de oftalmología, la profesionalización constituye una exigencia, atendiendo al principio humanista de la atención al paciente, sustentada en el perfeccionamiento continuo de saberes y habilidades que garanticen su calidad de vida y bienestar social, así como en el análisis del proceso de capacitación profesional en promoción de salud y prevención de las enfermedades que causan discapacidad visual. En tal sentido, en este artículo se argumenta la pertinencia de la implementación de una estrategia de profesionalización sobre discapacidad visual para los especialistas en oftalmología, la cual resulta coherente con la educación permanente y continuada, pues contribuye al mejoramiento del desempeño profesional en la atención integral a los pacientes aquejados por este problema de salud.

In the ophthalmology specialty, professionalization constitutes a demand, taking into account the humanist principle of the patient care, sustained in the continuous improvement of knowledge and abilities that guarantee his life quality and social well-being, as well as in the analysis of the process of professional training in health promotion and prevention of the diseases that cause visual disability. In such a sense, the relevancy of a professionalization strategy implementation on visual disability for the specialists in ophthalmology is argued in this work, which is coherent with the permanent and continuous education, because it contributes to the improvement of the professional performance in the comprehensive care to the patients that are suffering due to this health problem.

Determinantes sociales de la salud y la enfermedad visual en caficultores de Caldas, Colombia / Social Determinants of Health and Visual Disease in Coffee Harvesters from Colombia

Introducción: Aunque existen iniciativas globales que buscan mejorar la salud visual en las poblaciones y alcanzar una mayor inclusión social de las personas afectadas con pérdida de la visión, coexisten barreras importantes como la poca accesibilidad y equidad de los servicios de salud y las diferencias económicas y de género que impiden obtener mejores indicadores. Objetivo: Establecer la asociación entre los determinantes sociales de la salud y la enfermedad visual en una comunidad de caficultores en el Departamento de Caldas, Colombia. Métodos: Estudio descriptivo correlacional en el que participaron 1387 caficultores. La información se recolectó en el momento de la valoración por optometría. Se aplicó un cuestionario para explorar los determinantes sociales de la salud estructurales e intermedios y datos relacionados con salud visual. La asociación entre las variables fue establecida a través de la prueba de chi cuadrado. Resultados: La edad promedio fue de 57 años ± 10,7 años, 77,3 por ciento hombres, el 97,2 por ciento pertenecía al estrato socioeconómico bajo y un 73 por ciento habían realizado estudios primarios. Las enfermedades visuales más frecuentes fueron los trastornos de refracción en un 85,7 por ciento, el principal diagnóstico fue la presbicia con una prevalencia de 75,8 por ciento (IC 95 por ciento: 73,5 por ciento; 78,03 por ciento). En el análisis bivariado se encontró asociación estadísticamente significativa (p < 0,05) entre el diagnóstico de optometría y los determinantes sociales de la salud estructurales e intermedios: sexo, estado civil, grupo de edad, nivel educativo, estrato socioeconómico y ocupación. Conclusiones: La enfermedad visual en caficultores se encuentra influenciada por determinantes sociales de la salud estructurales e intermedios, modificables con acciones intersectoriales y transectoriales como el nivel educativo, estrato socioeconómico y la ocupación, los que deben ser incorporados a las políticas públicas para mejorar su calidad de vida y reducir la ceguera prevenible(AU)

Introduction: Although there are global initiatives aimed at improving visual health in populations and at achieving greater social inclusion of people affected with vision loss, important barriers coexist such as poor accessibility and equity of healthcare services and economic and gender-related differences that prevent obtaining better indicators. Objective: To establish the association between the social determinants of health and visual disease in a community of coffee harvesters in the department of Caldas, Colombia. Methods: Descriptive and correlational study with the participation of 1,387 coffee harvesters. The information was collected at the time of optometric assessment. A questionnaire was applied to explore the structural and intermediate social determinants of health and data related to visual health. The association between the variables was established through the chi-square test. Results: The average age was 57 years ± 10.7 years, 77.3 percent were men, 97.2 percent belonged to the low socioeconomic stratum and 73 percent had completed elementary school. The most frequent visual diseases were refractive disorders, account ting for 85.7 percent; and the main diagnosis was presbyopia, with a prevalence of 75.8 percent (95 percent CI: 73.5 percent; 78.03 percent). The bivariate analysis showed a statistically significant association (p<0.05) between the diagnosis of optometry and the structural and intermediate social determinants of health: sex, marital status, age group, educational level, socioeconomic status, and occupation. Conclusions: Visual disease in coffee harvesters is influenced by structural and intermediate social determinants of health, modifiable with intersector and cross-sector actions such as educational level, socioeconomic stratum, and occupation, which must be incorporated into public policies to improve their quality of life and to reduce preventable blindness(AU)

Determinantes sociales de la salud y la enfermedad visual en caficultores de Caldas, Colombia / Social Determinants of Health and Visual Disease in Coffee Harvesters from Colombia

RESUMEN Introducción: Aunque existen iniciativas globales que buscan mejorar la salud visual en las poblaciones y alcanzar una mayor inclusión social de las personas afectadas con pérdida de la visión, coexisten barreras importantes como la poca accesibilidad y equidad de los servicios de salud y las diferencias económicas y de género que impiden obtener mejores indicadores. Objetivo: Establecer la asociación entre los determinantes sociales de la salud y la enfermedad visual en una comunidad de caficultores en el Departamento de Caldas, Colombia. Métodos: Estudio descriptivo correlacional en el que participaron 1387 caficultores. La información se recolectó en el momento de la valoración por optometría. Se aplicó un cuestionario para explorar los determinantes sociales de la salud estructurales e intermedios y datos relacionados con salud visual. La asociación entre las variables fue establecida a través de la prueba de chi cuadrado. Resultados: La edad promedio fue de 57 años ± 10,7 años, 77,3 % hombres, el 97,2 % pertenecía al estrato socioeconómico bajo y un 73 % habían realizado estudios primarios. Las enfermedades visuales más frecuentes fueron los trastornos de refracción en un 85,7 %, el principal diagnóstico fue la presbicia con una prevalencia de 75,8 % (IC 95 %: 73,5 %; 78,03 %). En el análisis bivariado se encontró asociación estadísticamente significativa (p < 0,05) entre el diagnóstico de optometría y los determinantes sociales de la salud estructurales e intermedios: sexo, estado civil, grupo de edad, nivel educativo, estrato socioeconómico y ocupación. Conclusiones: La enfermedad visual en caficultores se encuentra influenciada por determinantes sociales de la salud estructurales e intermedios, modificables con acciones intersectoriales y transectoriales como el nivel educativo, estrato socioeconómico y la ocupación, los que deben ser incorporados a las políticas públicas para mejorar su calidad de vida y reducir la ceguera prevenible.

ABSTRACT Introduction: Although there are global initiatives aimed at improving visual health in populations and at achieving greater social inclusion of people affected with vision loss, important barriers coexist such as poor accessibility and equity of healthcare services and economic and gender-related differences that prevent obtaining better indicators. Objective: To establish the association between the social determinants of health and visual disease in a community of coffee harvesters in the department of Caldas, Colombia. Methods: Descriptive and correlational study with the participation of 1,387 coffee harvesters. The information was collected at the time of optometric assessment. A questionnaire was applied to explore the structural and intermediate social determinants of health and data related to visual health. The association between the variables was established through the chi-square test. Results: The average age was 57 years ± 10.7 years, 77.3% were men, 97.2% belonged to the low socioeconomic stratum and 73% had completed elementary school. The most frequent visual diseases were refractive disorders, account ting for 85.7%; and the main diagnosis was presbyopia, with a prevalence of 75.8% (95% CI: 73.5%; 78.03%). The bivariate analysis showed a statistically significant association (p<0.05) between the diagnosis of optometry and the structural and intermediate social determinants of health: sex, marital status, age group, educational level, socioeconomic status, and occupation. Conclusions: Visual disease in coffee harvesters is influenced by structural and intermediate social determinants of health, modifiable with intersector and cross-sector actions such as educational level, socioeconomic stratum, and occupation, which must be incorporated into public policies to improve their quality of life and to reduce preventable blindness.

Unmet Needs and Services of Rehabilitation for People with Visual Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To analyze the characteristics of needs and development of rehabilitation services for people with visual disability (PVD). Methods:A total of 241 865 PVDs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:There were 50 882 (21.0%) PVDs reported their needs of rehabilitation, from high to low were assistive devices (56.5%), medicine (29.0%), nursing care (24.6%), functional training (15.5%), and surgery (4.2%). There were 43 492 (18.0%) PVDs reported their received services of rehabilitation, from high to low were assistive devices (55.0%), medicine (21.6 %), nursing care (20.8%), functional training (20.7%) and surgery (2.3%). The logistic regression model showed that severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PVDs reported unmet needs mainly in the fields of assistive devices, medicine, and nursing care. There is match structure of unmet needs and received services. It is important to provide accessible information environment. Information and communication technology (ICT) are proposed to assistive technology services for PVDs to enhance their capacity of information acquisition and to promote their participations.

An Analytical Study on Visual Handicap in Patients Attending Ophthalmology OPD: A Hospital Based Study in Mathura

Background: India requires 40,000 optometrists, it has only 8,000. Besides this, we needs 2.5 lakh donated eyes every year, the country’s 109 eye banks manage to collect a maximum of just 25,000 eyes, out of which 30% can’t be used. It is reported that India has 12,000 ophthalmologists who have no time to conduct blindness-preventing surgeries as they are flooded with general eye check-up of patients. Methods: This study conducted in the Department of Ophthalmology in the K M Medical College & Hospital, Mathura. The duration of study was over a period of one year Result: In this study we revealed that the visually disabled retinitis pigmentosa accounted for (16%), congenital anomalies which included microcornea, microphthalmos, anophthalmos, and coloboma of eye (15.3%), refractive errors (11.6%),age related macular degeneration(10%), corneal opacity(9.6%), uveitis(8.6%), glaucoma(6.6%), optic atrophy(6%), lens(congenital cataract and complicated cataract) (5.3%), diabetic retinopathy(5%). Conclusion: This study was revealed that there is no proper treatment available for the most common causes of blindness, only preventive measures can be undertaken.

How to Make the Body Speak? Visual Disability, Verbalism and Embodied Speech / Como Fazer Falar o Corpo? Deficiência Visual, Verbalismo e Fala Encarnada / ¿Cómo Hacer que el Cuerpo Hable? Discapacidad Visual, Verbalismo y Discurso Incorporado

Verbalism represents a controversial issue in the field of visual disability. It is frequently stated that blind people use statements with words and expressions which are not based on direct sensory experience. Sometimes it is considered a pathology or something specific to blind people. In taking the work of three blind researchers ­ Pierre Villey, Joana Belarmino and Bertrand Verine ­ as a guideline, this paper emphasizes two main points: 1) The usage of words with visual references constitutes a strategy of inclusion in a social environment dominated by vision; 2) The importance to develop new affirmative actions to stimulate embodied and multisensory discourse, favoring experiences of belonging and sharing between the blind and the sighted beyond the hegemony of vision....(AU)

O verbalismo constitui um problema controverso no campo da Psicologia da deficiência visual. É frequente a afirmação de que pessoas cegas utilizam enunciados que portam palavras concretas, mas que não estão baseadas na experiência sensorial direta. Por vezes é considerado algo patológico e específico de pessoas que não dispõem da visão. Tomando como fio condutor o trabalho de três pesquisadores cegos ­ Pierre Villey, Joana Belarmino e Bertrand Verine ­, o estudo destaca dois pontos principais: 1) O uso de palavras com referências visuais é uma estratégia desenvolvida pelas pessoas cegas visando sua inclusão num ambiente social dominado pela visão; 2) É importante desenvolver ações afirmativas de estímulo à produção discursiva encarnada e multissensorial, favorecendo experiências de pertencimento e partilha entre cegos e videntes, para além da hegemonia da visão....(AU)

El verbalismo representa un tema controvertido en el campo de la discapacidad visual. Con frecuencia se afirma que las personas ciegas usan afirmaciones con palabras y expresiones que no se basan en la experiencia sensorial directa. A veces se considera una patología o algo específico de las personas ciegas. Al tomar el trabajo de tres investigadores ciegos ­ Pierre Villey, Joana Belarmino y Bertrand Verine ­ como una guía, este documento enfatiza dos puntos principales: 1) El uso de palabras con referencias visuales constituye una estrategia de inclusión en un entorno social dominado por la visión; 2) La importancia de desarrollar nuevas acciones afirmativas para estimular el discurso incorporado y multisensorial, favoreciendo las experiencias de pertenencia e intercambio entre los ciegos y los videntes más allá de la hegemonía de la visión....(AU)

Estudio sobre la prevención de la discapacidad visual en pacientes diabéticos del municipio Playa / Study on the prevention of visual disability in diabetic patients from Playa municipality

Objetivo: determinar el comportamiento de la discapacidad visual por retinopatía diabética en dos áreas de salud del municipio Playa. Métodos: se realizó una investigación exploratoria, observacional y descriptiva, en la que se practicó un examen oftalmológico a los diabéticos, donde se evaluó por especialistas de retina la presencia de lesiones en el fondo de ojo y su asociación con otras afecciones oftalmológicas. Resultados: las dos áreas de salud presentaron características demográficas y de la enfermedad diabética similares. Las formas no proliferativas de los dos grupos se presentaron en el 8,5 y 4,8 por ciento, no así la forma proliferativa, que fue de 2 y 2,7 por ciento. La maculopatía leve fue más frecuente que la severa en los dos grupos. La prevalencia de algún grado de retinopatía y de maculopatía fue de 13,1 y 10,6 por ciento, respectivamente. El mayor porcentaje de pacientes en los dos grupos de estudio no había sido examinado o había transcurrido más de un año de haberse realizado un fondo de ojo. Se encontró un número elevado de ojos de pacientes con catarata evidente (31,2 y 26,5 por ciento. La prevalencia de baja visión (10,9 y 11 por ciento) y de ceguera (2,9 y 2,7 por ciento) fue similar en los dos grupos, pero sus causas pueden ser reversibles, prevenibles y tratables. Conclusiones: a pesar de que la muestra fue pequeña y la prevalencia de retinopatía y/o maculopatía fue baja, se presentaron pacientes con discapacidad visual prevenible y tratable(AU)

Objective: to determine the situation of visual disability caused by diabetic retinopathy in two health areas of Playa municipality. Methods: a descriptive, observational and exploratory research study was conducted where eye exam was performed in diabetic patients to evaluate the presence of fundus oculi lesions and their association with other ophthalmological diseases. Results: it was found that the two health areas showed similar demographic characteristics and diabetic disease features. Non-proliferative forms of the two groups occurred in 8.5 and 4.8 percent whereas the proliferative form was seen in 2 percent and 2.7 percent. Mild maculopathy was more common than the severe one in the two groups of patients. The prevalence of retinopathy and maculopathy was 13.1 and 10.6 percent, respectively. The highest percentage of patients in the two study groups had not been examined or their fundus oculi test had been performed over a year ago. There was a high number of patients with evident cataract (31.2 and 26.5 percent). The prevalence rates of low vision (10.9 and 11 percent) and of blindness (2.9 and 2.7 percent) were almost the same in the two groups; however it should be borne in mind that their causes can be reversible, preventable and treatable. Conclusions: despite the small sample size and the low prevalence of retinopathy and/or maculopathy, there were patients with preventable and treatable vision(AU)

Causes of visual impairment and blindness in children at Instituto Benjamin Constant Blind School, Rio de Janeiro / Causas de baixa visão e cegueira infantil na Escola para cegos do Instituto Benjamin Constant, Rio de Janeiro

Abstract Objective: To determine the main causes of visual impairment and blindness in children enrolled at Instituto Benjamin Constant blind school (IBC) in 2013, to aid in planning for the prevention and management of avoidable causes of blindness. Methods: Study design: cross-sectional observational study. Data was collected from medical records of students attending IBC in 2013. Causes of blindness were classified according to WHO/PBL examination record. Data were analyzed for those children aged less than 16 years using Stata 9 program. Results: Among 355 students attending IBC in 2013, 253 (73%) were included in this study. Of these children, 190 (75%) were blind and 63 (25%) visually impaired. The major anatomical site of visual loss was retina (42%), followed by lesions of the globe (22%), optic nerve lesions (13.8%), central nervous system (8.8%) and cataract/pseudophakia/aphakia (8.8%). The etiology was unknown in 41.9% and neonatal factors accounted for 30,9% of cases. Forty-eight percent of cases were potentially avoidable. Retinopathy of prematurity (ROP) was the main cause of blindness and with microphthalmia, optic nerve atrophy, cataract and glaucoma accounted for more than 50% of cases. Conclusion: Provision and improvement of ROP, cataract and glaucoma screening and treatment and programs could prevent avoidable visual impairment and blindness.

Resumo Objetivo: Determinar as causas de cegueira e deficiência visual nas crianças matriculadas na Escola do Instituto Benjamin Constant (IBC) em 2013, para contribuir na elaboração de estratégias de controle e prevenção de causas evitáveis de cegueira. Métodos: Desenho de estudo: observacional do tipo transversal. Os dados foram coletados através dos prontuários dos alunos matriculados na Escola em 2013. As causas de cegueira foram classificadas de acordo com os registros de exames elaborados pela OMS/IAPB. Os dados foram analisados, em crianças com idade abaixo de 16 anos, usando o Programa Stata9. Resultados: Entre 355 alunos matriculados no IBC em 2013, 253 (73%) foram incluídos nesse estudo. Dessas crianças, 190 (75%) eram cegas e 63 (25%), deficientes visuais. O principal sítio anatômico, responsável pela perda visual, encontrado foi a retina (42%), seguido de lesões do globo ocular (22%), lesões no nervo óptico (13,8%), cegueira de origem no sistema nervoso central (8,8%) e catarata/pseudofácico/afácico (8.8%). A etiologia foi desconhecida em 41,9% e fatores neonatais corresponderam a 30,9% dos casos. Quarenta e oito porcento dos casos foram potencialmente evitáveis. Retinopatia da prematuridade (ROP) foi a principal causa de cegueira e microftalmia, atrofia do nervo óptico, catarata e glaucoma contaram com mais de 50% dos casos. Conclusão: A oferta e melhoria de programas de triagem e tratamento do ROP, catarata e glaucoma podem prevenir os casos de deficiência visual e cegueira evitáveis.

EscreverCOM: com quem? com o quê? para quê? / WritingWITH: with whom? with what? For what? / EscribirCON: ¿con quién? ¿con qué? ¿para qué?

Este artigo problematiza a escrita do trabalho acadêmico. Toma por base o argumento de que a escrita é parte inerente à investigação e, a partir das considerações de Haraway (2008, 1995), afirma a escrita como prática situada e marcada. O trabalho aposta no fazerCOM como direção ética e epistemológica da pesquisa e apresenta discussão acerca da partilha da escrita de diários de campo, entre pesquisadores e pesquisados. O texto conclui indicando que a escrita partilhada dos diários de campo abre possibilidades inéditas na construção das narrativas acerca da deficiência, menos como déficit e mais como reinvenção da vida.

This paper problematizes academic writing by arguing that writing is an inherent part of research. Based on considerations of Haraway (2008, 1995) it affirms that writing is a situated and marked practice. The work bets on doingWITH as the ethical and epistemological direction of the research and presents a discussion about the sharing of written field diaries, between researchers and researched. The text concludes by pointing out that the shared writing of the field diaries opens up new possibilities in the construction of narratives about disability, less as deficits and more as a reinvention of life.

En este artículo se analiza la escritura del trabajo académico. Se basa en el argumento de la escritura como parte inherente de la investigación y desde las consideraciones de Haraway (2008, 1995) plantea la escritura como práctica situada y marcada. El trabajo apuesta en el hacerCON como dirección ética y epistemológica de la investigación y presenta la discusión acerca de compartir los diarios de campo entre investigadores e investigados. El texto concluye indicando que la escritura compartida de los diarios de campo abre nuevas posibilidades en la construcción de narrativas sobre la discapacidad, sin tomarla como déficit sino como reinvención de la vida.

Personas en situación de discapacidad visual en relación a las barreras y estrategias que afectan las actividades de la vida diaria instrumentales / Persons with visual impairment in relation with barriers and strategies affecting their performance in instrumentals daily living activities

El objetivo del estudio de metodología cuantitativa fue conocer la información disponible sobre el desempeño en las actividades de la vida diaria instrumentales (AVDI) de las personas en situación de discapacidad visual en relación a las barreras que presentan para su ejecución. Para ello se llevó a cabo una revisión bibliográfica en distintas bases de datos y sitios web y documentos e información disponible en todo tipo de prensa. Las variables utilizadas fueron: actividades de la vida diaria instrumental, discapacidad visual, barreras, edad, año, idioma y país. Del total de la información recopilada, el 32,60 por ciento de las investigaciones tenían relación con la temática a investigar. En su mayoría correspondía a publicaciones del año 2008 con un 17,4 por ciento, siendo con mayor frecuencia documentos en idioma español (78,3 por ciento). En la literatura de Chile se encontró aproximadamente un 21,7% de información. La mayoría de la literatura incluía a todas las personas en situación de discapacidad con un porcentaje de 58,7 por ciento, todas éstas relacionadas con las barreras y AVDI, sin embargo, los documentos abarcaban mayor información sobre las barreras de comunicación (32,6 por ciento) y las AVDI relacionadas con la gestión de comunicación (37 por ciento). En conclusión la información para aquellas actividades como el cuidado de mascotas y crianza de niños y las investigaciones sobre el tema abordado, es insuficiente para así poder implementar estrategias que faciliten la independencia de estas personas.

The aim of this research with quantitative methodology was to know the available information about the performance at instrumental daily life activities of people with visual impairment in relation to the barriers that present to their performance. For this, a bibliographic review was carried out in different databases and websites, documents and information available in all types of press. The variables used were instrumental activities of daily life, visual impairment, barriers, age, year, language and country. The total of the information gathered, 32.60 percent of investigations had related to theme to investigate. The greatest amount of information found corresponded to publications of year 2008 with 17.4 per cent, being more frequently documents of Spanish language (78.3 percent). In the Chilean literature, approximately 21.7 percent of information was found. Most of information included all persons in situations of disability with a percentage of 58.7 percent, all these related to barriers and IADL however, documents included more information on the communication barriers (32.6 percent) and IADL related to the management of communication (37 percent). In conclusion, the information for activities such as pet care, child care and researching on the main theme is insufficient to implement strategies that facilitate the independence of these persons.

PesquisarCOM: efeitos de uma oficina de experimentação corporal com pessoas cegas e com baixa visão / ResearchCom: effects of a body experimentation workshop with visually disabled and blind people / InverstigarCON: efectos de un taller de experimentación corporal con personas ciegas y con baja visión

A pesquisa Perceber sem Ver realiza-se no Instituto Benjamin Constant (IBC) e conta com um dispositivo-intervenção, as Oficinas de Experimentação Corporal, oferecidas às pessoas cegas e com baixa visão. Nas oficinas, exploramos o encontro entre corpos-músicas-bexigas-sons e investigamos aquilo que o corpo pode vir a criar. Definimos corpo como corporeidade, existência que se realiza na prática de experimentar-se. A perda da visão exige uma (re)elaboração da relação entre cada corpo singular e o mundo. Perguntamos: quais os efeitos de uma oficina de experimentação corporal com pessoas cegas e com baixa visão? Lançando mão do método pesquisarCOM, afirmamos que o trabalho corporal coloca em cena um eu-corpo sabido de si mesmo, que no caminho de experimentar-se, apreende de si e partilha essas descobertas em conjunto. O corporeisar-se, dado nas oficinas, passa corporeisar a cegueira, passa também pelo corporeisar nossos próprios corpos de pesquisadoras, nossos próprios referenciais visuocêntricos.

The research Perceive without Seeing is conducted at the Benjamin Constant Institute (IBC) and offers intervention-devices, Body Experimentation Workshops, offered to visually disabled and blind people. During the workshops we explore the meeting of bodies-music-balloons-sounds and we investigate what the body can be able to create. We define body as corporeity, an existence that takes place in the practice of trying oneself out. The loss of vision demands a (re)elaboration of the relation between each singular body and the world. We ask: what are the effects of a body experimentation workshop with visually disabled and blind people? Making use of the research With method, we affirm that the corporal work sets into scene an I-body known by oneself, which in the path of self-experiencing, learns about oneself and shares these discoveries in group. The self-embodying, experiencied at the workshops, begins to embody blindness, and also embodies our own researcher bodies, our own visually centred benchmarks.

El grupo de investigación Percibir sin Ver se realiza en el Instituto Benjamim Constant (IBC) y cuenta con un dispositivo-intervención, les talleres de Experimentación, ofrecidas a las personas ciegas y con baja visión. En les talleres, exploramos el encuentro entre cuerpo-musicas-globos-sonidos y investigamos aquello que se podría el cuerpo llegar a crear. Definimos cuerpo como corporeidad, existencia que se realiza en la práctica de experimentarse. La perda de la visión exige uma (re)elaboración de la relación entre cada cuerpo singular y el mundo. Preguntamos:¿cuales los efectos de una oficina de experimentación corporal con personas ciegas y con baja visión? Lanzando mano del método investigarCON, afirmamos que el trabajo corporal pone en escena un yo-cuerpo sabido de sí mismo, que en el camino de experimentarse, aprehende de sí y comparte esos descubrimientos en conjunto. El corporeisar dado en los talleres pasa pelo corporeisar la ceguera, pasa también pelo corporeisar nuestro propio cuerpo de investigadoras, nuestros propios puntos de referencia visuocêntricos.

Contar histórias, povoar o mundo: a escrita acadêmica e o feminino na ciência / Storytelling, populate the world: academic writing and the feminine in science / Contar historias, poblar el mundo: la escrita académica y lo femenino en la ciência

Este artigo problematiza a escrita do trabalho acadêmico. Toma por base o argumento de que a escrita é parte inerente à investigação e, a partir das considerações de Haraway (2008, 1995), Mol (2008) e outras autoras, afirma a escrita como prática situada e marcada. Com a diretriz de método pesquisarCOM, argumenta que contar histórias é uma das formas de relatar a pesquisa. No campo da deficiência visual narrar histórias encarnadas de ver e não ver permite colocar em xeque versões únicas e desencarnadas da deficiência como falta ou deficit. O artigo propõe outras gramáticas para o trabalho acadêmico e afirma o feminino na ciência como um modo de marcar o conhecimento, isto é, de tornar explícitas as mediações que fazem possível o conhecer.

This paper problematizes academic writing by arguing that writing is an inherent part of research. Based on considerations of Haraway (2008, 1995), Mol (2008) and others, we posit that writing is a sited and marked practice. In agreement with embodied perspective researchWITH methodology guidelines, we postulate that storytelling is one way of relating research. In the field of visual disability, to narrate embodied stories of seeing and non-seeing allows the researcher to question disembodied versions of disability as lack or deficiency. We propose other grammars for academic work and affirm that the ‘female’ take on science is a way of marking knowledge, of rendering explicit the mediations that make knowledge possible.

Este artículo problematiza la escrita del trabajo académico. Tomando por base el argumento de que la escrita es parte inherente de la investigación. Con base en las consideraciones de Haraway (2008, 1995), Mol (2008) y otras se afirma la escrita como práctica marcada y situada. A partir de la directriz del método pesquisarCON se argumenta que contar historias es una de las tantas formas de relatar una investigación. En el campo de la deficiencia visual narrar historias de ver y no ver permite colocar en cuestión versiones únicas de la deficiencia como falta. Dicho artículo finaliza proponiendo otras gramáticas para el trabajo académico, afirmando lo femenino en las ciencia como un modo de dejar huellas en el campo del conocimiento, esto es, tornar explicitas las mediaciones que hacen posible el conocer.

Status analysis on visual disability population in Yuzhong district of Chongqing / 国际眼科杂志(Guoji Yanke Zazhi)

To investigate the status of visual disability population in Yuzhong district of Chongqing, in order to provide a counter measure for improving their quality of life.METHODS:The data of visual disability population was analyzed, which was registered in federation of the disabled of Yuzhong district of Chongqing from January 21, 2009 to July 17, 2013, collected the information of their gender and age constituent ratio, visual disability level differences, and the differences of their disability pathogeny.RESULTS: There was no significant difference between the total numbers of male and female visual disability, and before the age of 60, the number of male was more than female, but after 60, it was opposite. The grade four of visual disability accounted for the largest proportion, followed by a level of grade one, two, and three. The main causes of visual disability in proper order were:ametropia ( high myopia) , retina and pigment membrane disease, ocular trauma, optic nerve disease, glaucoma, corneal disease, congenital anomaly or eccyliosis, cataract, amblyopia, agnogenic, methysis, trachoma, and the others ( hyperpyrexia) .CONCLUSlON: The diagnosis and treatment of juvenile in Yuzhong district must be strengthened, also include retina and pigment membrane disease, to reduce the visual disability caused by these diseases.

History of dental caries and need for dental treatment among children with visual disabilities, Chile, 2014 / Historia de caries y necesidad de tratamiento odontológico en niños con discapacidad visual, Chile, 2014

Objective: To determine the history of dental caries and the need for dental treatment among visually disabled children between 6 and 12 years old attending special Schools in Chile during 2014. Material and method: Descriptive and observational cross-sectional study. The target population was children with visual disabilities from special schools in Chile. A clinical examination was performed to obtain a dmft/DMFT index and know the need for treatment. Two calibrated examiners performed the visual clinical examination, according to the WHO criteria. Additionally, clinically detectable enamel lesions on cavitated and non cavitated surfaces were recorded. The recorded data were analyzed using descriptive statistics. Results: Ninety-four children attending to seven special schools were examined. The average dmft index was 2.05 (SD+/-2.6) and DMFT index was 0.96 (SD+/-1.3). For 6 year olds, the dmft/DMFT index was 3/0, respectively. For 12 year olds, the dmft index was 0.17 and the DMFT index was 1.42. Caries prevalence was 56.3 percent From the total, 95 percent of children needed sealants, 50 percent needed at least one restoration of one face, and 29 percent restoration of 2 or more surfaces. As for enamel lesions, 34 percent of children had at least one non cavitated lesion and 48 percent of them had a cavitated lesion. Conclusion: History of dental caries is similar to that reported in the general population; however, there is a high need for preventive treatment. Therefore, it is necessary to conduct more research to clarify whether these patients have a higher cariogenic risk due to their visual impairment in order to establish effective promotional/ preventive strategies.

Objetivo: Determinar la historia de caries y la necesidad de tratamiento odontológico de niños con discapacidad visual entre 6-12 años, pertenecientes a Escuelas Especiales de Chile, el año 2014. Material y método: Estudio observacional descriptivo de corte transversal. Se examina-ron niños con discapacidad visual de escuelas especiales en Chile, según los criterios de la OMS, para obtener el ceod, COPD y la necesidad de tratamiento. Se registraron las lesiones de esmalte clínicamente detectables en superficies cavitadas y no cavitadas. Los resultados se analizaron mediante estadística descriptiva. Resultados: 94 niños fueron examinados, pertenecientes a 7 escuelas especiales. El ceod promedio fue 2,05 (SD +/- 2,6) y el COPD fue de 0,96 (SD +/- 1,3). A los 6 años el ceod/COPD fue de 3/0 respectivamente. A los 12 años el ceod fue 0,17 y COPD fue 1,42. La prevalencia de caries fue de 56,3 por ciento. El 95 por ciento necesita sellantes, el 50 por ciento necesita a lo menos una restauración de una cara, y el 29 por ciento una restauración de 2 o más superficies. En cuanto a las lesiones de esmalte, el 34 por ciento de los niños presentaban al menos una lesión no cavitada y un 48 por ciento de ellos tenían una lesión cavitada. Conclusión: La historia de caries es similar a lo descrito en la población general, sin embargo, existe una alta necesidad de tratamiento preventivo. Es necesario realizar más investigaciones que permitan esclarecer si poseen un mayor riesgo cariogénico debido a su alteración visual, para así establecer estrategias promocionales/preventivas efectivas.

Capacidad funcional y calidad de vida en los ancianos con degeneración macular y baja visión / Functional capacity and quality of life in elderly patients with macular degeneration and low vision

OBJETIVO: caracterizar la capacidad funcional y la calidad de vida en los ancianos con degeneración macular y baja visión, atendidos en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en el período comprendido de enero a junio de 2013. MÉTODOS: se realizó un estudio descriptivo, de corte transversal. Fueron estudiadas las siguientes variables: edad, sexo, color de la piel, agudeza visual mejor corregida de cerca con cartilla Zeiss, antes y después de la rehabilitación visual, discapacidad visual, capacidad funcional para las actividades de la vida diaria, tipo clínico de degeneración macular, factores de riesgo de la enfermedad, motivación para la rehabilitación visual y ayudas ópticas y no ópticas prescritas. RESULTADOS: existió un predominio de la enfermedad en las mujeres (55,2 %), entre los 75-79 años de edad y en el color de la piel blanca. La discapacidad visual que prevaleció fue la baja visión ligera a moderada; la capacidad funcional mayormente encontrada fue la independencia con alguna limitación. La degeneración macular seca se presentó en el 82,7 % de los casos; el factor de riesgo más frecuente fue el tabaquismo (82,7 %); la lectoescritura fue la motivación principal y el mayor número de pacientes mejoró la agudeza visual después de la rehabilitación visual. Las ayudas ópticas y no ópticas que más se prescribieron fueron los microscopios y la iluminación. CONCLUSIONES: el grupo de edades entre 75 y 79 años, el sexo femenino y la piel blanca o caucasiana son los factores que aportan un mayor número de casos de degeneración macular y baja visión. La discapacidad visual que prevalece es la de los clasificados como baja visión ligera a moderada. La degeneración macular seca se presenta en casi la totalidad de los casos. Los factores de riesgo más frecuentes son el tabaquismo, la herencia y las enfermedades cardiovasculares. El mayor número de pacientes mejora después de la rehabilitación visual.

OBJECTIVE: to characterize the functional capacity and the quality of life of the elderly people with macular degeneration and low vision who were seen at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to June 2013. METHODS: cross-sectional and descriptive study that included the following variables: age, sex, race, best corrected near visual acuity using Zeiss chart before and after visual rehabilitation, visual disability, functional capacity for daily life activities, clinical type of macular degeneration, risk factors for the disease, reason for visual rehabilitation and prescribed optical and non-optical aids. RESULTS: the disease prevailed in females (55,2 %), 75-79 years-old age group and Caucasians. Predominant visual disability was mild to moderate low vision; the mostly found functional capacity was independence with some limitations. Dry macular degeneration was present in 82,7 % of cases; the most frequent risk factor was smoking (82,7 %); reading and writing was the main motivation and a large number of patients improved their visual acuity after rehabilitation. The optical and non-optical aids that were mostly prescribed included microscopes and lighting. CONCLUSIONS: females, 75-79 years-old age group and Caucasians are the risk factors that cause the highest number of cases with macular degeneration and low vision. Visual disability prevailed among those classified as mild to moderate low vision patients. Dry macular degeneration was present in almost all the cases. The most frequent risk factors were smoking, heredity and cardiovascular diseases. Most of the patients improved their condition after visual rehabilitation.

Efectividad de la biometría de inmersión para el cálculo del poder dióptrico de la lente intraocular / Effectiveness of immersion biometry for the calculation of intraocular lens dioptric power

OBJETIVO: determinar la efectividad de la biometría de inmersión para el cálculo del lente intraocular. MÉTODOS: se realizó un estudio observacional descriptivo, prospectivo. El universo estuvo constituido por los pacientes operados de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre enero y septiembre de 2011. La muestra estuvo conformada por 39 ojos de 34 pacientes que cumplieron con los criterios de inclusión establecidos para la investigación y fueron operados por la técnica de facoemulsificación con previo cálculo del lente intraocular por biometría de inmersión e interferometría de coherencia óptica. RESULTADOS: el promedio de edad fue de 72,33 años, con un predominio del sexo femenino. La diferencia de longitud axial promedio entre los pacientes calculados por inmersión y los de IOL Máster fue de 0,09 mm, mientras que la diferencia de profundidad de la cámara anterior fue de 0,19 mm. Se obtuvo una diferencia de 0,13 D y no existió diferencia significativa en cuanto al cálculo del poder del lente intraocular entre ambos métodos. CONCLUSIONES: los valores de longitud axial y de profundidad de cámara anterior obtenidos mediante biometría de inmersión pueden ser utilizados para calcular con efectividad el poder del lente intraocular de los pacientes que serán sometidos a cirugía de cataratas, lo que demuestra ser una alternativa en ausencia del IOL Máster.

OBJECTIVE: to characterize the functional capacity and the quality of life of the elderly people with macular degeneration and low vision who were seen at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to June 2013. METHODS: Cross-sectional and descriptive study that included the following variables: age, sex, race, best corrected near visual acuity using Zeiss chart before and after visual rehabilitation, visual disability, functional capacity for daily life activities, clinical type of macular degeneration, risk factors for the disease, reason for visual rehabilitation and prescribed optical and non-optical aids. RESULTS: the disease prevailed in females (55,2 %), 75-79 years-old age group and Caucasians. Predominant visual disability was mild to moderate low vision; the mostly found functional capacity was independence with some limitations. Dry macular degeneration was present in 82,7 % of cases; the most frequent risk factor was smoking (82,7 %); reading and writing was the main motivation and a large number of patients improved their visual acuity after rehabilitation. The optical and non-optical aids that were mostly prescribed included microscopes and lighting. CONCLUSIONS: females, 75-79 years-old age group and Caucasians are the risk factors that cause the highest number of cases with macular degeneration and low vision. Visual disability prevailed among those classified as mild to moderate low vision patients. Dry macular degeneration .

Representación social de los prestadores de servicios de salud en la discapacidad visual / Social representation of the health service providers in visual disability

Introducción: el conocimiento de la representación social de los prestadores de servicios de salud resulta de suma importancia para la salud pública, debido a su influencia en la calidad de su relación con los pacientes. Objetivo: caracterizar la representación social de los prestadores de servicios de salud acerca de la discapacidad visual. Métodos: estudio de caso realizado en el policlínico Hermanos Ruíz Aboy en San Miguel del Padrón en el período de enero a junio de 2012. Participaron 33 informantes clave escogidos por muestreo intencional. Las técnicas de indagación empleadas fueron la asociación libre de palabras y las entrevistas en profundidad. Resultados: el estudio reveló la existencia en los prestadores de una representación angustiosa-conmiserativa-dependiente que configura elementos provenientes de referentes experienciales, componentes afectivos e insumos informacionales relacionados con las personas en situación de discapacidad visual. Conclusiones: los prestadores de servicios de salud investigados tiene en el núcleo de sus representaciones experiencias y conocimientos relacionados con el daño anatómico que condiciona limitación e incapacidad para la participación en la vida social de las personas con discapacidad visual, pero las asociaciones relativas a las necesidades de atención, definen un deficiente reconocimiento de elementos que garantizarían la compensación e integración psicosocial en estas personas...

Introduction: knowing the social representation of the health service providers is very important for the public health, due to their influence on the quality of relationship with the patients. Objective: to characterize the social representation of the health service providers on visual disability. Methods: case study performed in Hermanos Ruiz Aboy in San Miguel del Padron municipality in the period of January through June, 2012. Thirty three key informants selected by intentional sampling participated. The research techniques were free association of words and in-depth interviews. Results: this study disclosed the existence in health providers of an anguishing-commisserative-dependent representation that shapes elements from experience referents, affective components and informational inputs related to the persons facing visual disability. Conclusions: the health service providers under research have, in the core of their representation, experiences and knowledge linked to the anatomical damage that causes limitation and disability to be involved in the people with visual disability; however, the relative associations with the care requirements define a poor recognition of those elements that would assure compensation and psychosocial integration of these people...