Expert consensus on stages of public health strategies for myopia prevention and control in children and adolescents / 中华预防医学杂志

Myopia has emerged as a public health issue with the increasing prevalence of myopia in children and adolescents in China. In the clinical diagnosis and treatment of myopia, there are clinical stages and classifications, but they are not suitable for the prevention and control of myopia at the public health level. At the public health level, because there is no staging standard for myopia, there is a lack of staging prevention and control guidance for different refractive errors. Therefore, the Public Health Ophthalmology Branch of the Chinese Preventive Medicine Association organized domestic experts in relevant fields to conduct literature searches and discuss based on the research data on myopia at home and abroad, put forward the stages of public health strategies for myopia prevention and control and corresponding group prevention and control measures for each stage to reached this experts consensus. This consensus first proposes a method for assessing myopia risk, in order to predict the occurrence and development of myopia in children and adolescents; From the perspective of public health, myopia prevention and control is further divided into four stages: myopia prodromal stage, myopia development stage, high myopia stage, and pathological myopia stage. According to this consensus, myopia prevention and control technology is targeted and implemented in different stages to provide guidance for myopia prevention and control from the perspective of public health.

Vision for the Future Project: Screening impact on the prevention and treatment of visual impairments in public school children in São Paulo City, Brazil

OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children's visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital's campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.

Avaliação da acuidade visual em escolares do ensino fundamental / Evaluation of visual acuity in municipal elementary school students

Resumo Objetivo: Descrever e analisar a prevalência de baixa acuidade visual nos estudantes da rede pública municipal de Cáceres, Mato Grosso. Métodos: Estudo transversal de 489 alunos do segundo e terceiro anos do ensino fundamental de 13 escolas municipais de Cáceres, atendidos entre dezembro de 2017 e janeiro de 2018. A acuidade visual foi avaliada através do uso da tabela de Snellen e considerada normal quando superior a 0,7 ou 20/30. Resultados: Dos 489 escolares triados, 85 (17,4%) apresentaram baixa acuidade visual, sendo encaminhados para exame oftalmológico com especialista. Dos escolares encaminhados, 63 (74,1%) compareceram à consulta e 28 (44,45%) tiveram indicação de correção visual, tendo ganhado os óculos. A prevalência de erros refrativos foi de 8,99%, constituindo-se a principal causa de baixa acuidade visual. A média de idade foi de 8,29 anos (DP= 0,809), sendo que a idade média das crianças com alterações oftalmológicas foi maior quando comparada àquelas sem alterações oftalmológicas (p = 0,027). Conclusão: O estudo mostrou que a prevalência de baixa acuidade visual, bem como suas causas, corrobora com a encontrada em outros programas de triagem em escolares. Demonstrou também a importância do diagnóstico precoce das alterações visuais para obtenção de melhores desfechos e ressaltou-se a necessidade de medidas preventivas para atenção à saúde ocular dos escolares.

Abstract Objective: To describe and analyze the prevalence of visual impairment in municipal public school students in Caceres, Mato Grosso. Methods: A transversal study of 489 school children from the second and third years of elementar school in 13 municipal schools in Caceres, attended between December 2017 and January 2018. Visual acuity was evaluated using Snellen optometric chart and considered normal when higher than 0.7 or 20/30. Results: Of the four hundred and eighty-nine children were evaluated, eighty-five (17.4%) had low visual acuity at the screening, being referred for ophthalmological examination with specialist. Of the students referred, sixty three (74.1%) presented at the ambulatory and twenty eight (44.45%) had indication of visual correction, having won the glasses. The prevalence of refractive error was 8.99%, constituting the main cause of low visual acuity. The mean age was 8.29 anos (SD = 0.809), being an average of children with ophthalmological alterations was higher when compared to those without ophthalmological alterations (p = 0.027). Conclusion: The study showed that the prevalence of low visual acuity, as well as its causes, corroborates with that found in other screening programs in school children. It also demonstrated the importance of early diagnosis of visual changes to get better outcomes and emphasized the need for preventive measures for attention to eyes health of school children.

Triagem oftalmológica em 510 alunos de escolas públicas: desenvolvimento de um projeto social de grande abrangência / Ophthalmologic screening in 510 students of public schools: development of a comprehensive social project

Resumo Objetivo: Avaliar a prevalência de crianças com dificuldade visual em triagens realizadas em 3 escolas públicas de Aracaju-SE, estimar a distribuição dos erros refrativos e usar os dados para planejamento de uma ação social mais extensa em todas as escolas públicas da cidade. Métodos: Estudo transversal, com medida da acuidade visual (AV), na forma de triagem. Foram analisados idade, gênero, AV, frequência dos principais erros refrativos, médias de equivalente esférico e cilindro das crianças com AV pior ou igual a 0,7 em qualquer olho, diferença superior a 0,2 entre os olhos, sinais de doenças oculares ou se já fizessem uso de óculos. Resultados: Foram avaliadas 510 crianças nas 3 escolas. A idade média foi 9,1 ± 1,6 anos. Gênero masculino correspondeu a 50,4%. Das 154 crianças (30%) que necessitaram de consulta mais detalhada, 97 se dirigiram à consulta. Destas, 51 tiveram indicação de uso de óculos. Míopes corresponderam a 44,1% dos olhos, hipermetropia a 15,6% e astigmatismo a 82,3%. A idade média das crianças com indicação de uso de óculos foi 9,5 ± 1,7 anos. Considerando-se que há em torno de 15 mil crianças entre o 1º e o 3º anos do ensino fundamental matriculadas nas escolas públicas de Aracaju, pode-se estimar que aproximadamente 30% delas necessitarão de consulta oftalmológica, correspondendo a 4500 atendimentos (2000 a 2500 destas deverão precisar de óculos). Conclusão: Conclui-se que aproximadamente um terço das crianças em idade escolar neste estudo apresentou dificuldade visual durante a triagem. Após avaliação oftalmológica, foram prescritos óculos para pouco mais da metade. Astigmatismo foi o erro de refração mais prevalente. Os dados obtidos foram utilizados para o planejamento de importante ação social a ser desenvolvida pela Sociedade Sergipana de Oftalmologia.

Abstract Purpose: To evaluate the prevalence of visually impaired children at screening in three public schools in Aracaju-SE, to estimate the distribution of refractive errors and to use the data to develop a more comprehensive social project in all public schools of town. Methods: Cross-sectional study with visual acuity (VA) measurement at screening. Age, gender, VA, frequency of the main refractive errors, spherical equivalent and cylinder of those children with VA lower than or equal to 0.7 in any eye, difference greater than 0.2 between the eyes, signs of eye diseases or if they already wore glasses. Results: A total of 510 children were evaluated in 3 schools. Mean age was 9.1 ± 1.6 years. Males were 50.4%. Of the 154 children (30%) who required a more detailed examination, 97 went to the office. Of these, 51 had a prescription of glasses. Myopes accounted for 44.1% of the eyes, hypermetropia to 15.6% and astigmatism to 82.3%. Mean age of children with glasses was 9.5 ± 1.7 years. Considering that there are 15 thousand children between the 1st and 3rd years of elementary school, it can be estimated that approximately 30% will require ophthalmological consultation, corresponding to 4500 consultations (2000 to 2500 of these should need glasses). Conclusion: We conclude that approximately one-third of school-age children in this study had visual impairment during screening. After ophthalmological evaluation, glasses were prescribed for just over half. Astigmatism was the most prevalent refractive error in the 3 schools of the study. The data obtained were used for the planning of important social project to be developed by Sergipe's Society of Ophthalmology.

Acuidade visual de crianças de 6 a 10 anos de idade: estudo em duas escolas públicas do sertão da Paraíba / Visual acuity of children 6 to 10 years of age: study in two public schools of sertão da Paraíba

Resumo Objetivo: Avaliar a acuidade visual de crianças de 6 a 10 anos de idade em duas escolas públicas do município de Patos, Paraíba. Métodos: Estudo transversal, quantitativo, nas escolas E.M.E.F. Dom Expedito Eduardo de Oliveira e CIEP II Anésio Leão/Miguel Mota, que envolveu um total de 195 alunos. A coleta dos dados foi realizada com o auxílio de um instrumento para a coleta das informações, realização de entrevista com os alunos e a acuidade visual foi aferida pela utilização do Teste de Snellen. O estudo foi realizado entre os meses de janeiro e maio de 2018. Os dados provenientes dos instrumentos de coleta utilizados, foram compilados no Programa Statistical Package for the Social Sciences (SPSS - versão 21.0), em que foi feita uma análise estatística do tipo descritiva. Resultados: Do total de 195 alunos das escolas selecionadas, 154 participaram dos testes de acuidade visual realizados por meio da Tabela de Snellen e 28 destes apresentaram baixa acuidade visual e foram encaminhados para a consulta com o oftalmologista. Conclusão: Os principais erros de refração foram encontrados: miopia, astigmatismo e hipermetropia. Além disso, foi observado que a prevalência de baixa acuidade e teve um decréscimo bastante relevante de acordo com os estudos publicados entre 2003 e 2017.

Abstract Objective: To evaluate the visual acuity of children from 6 to 10 years of age in two public schools in the city of Patos, Paraíba. Methods: Cross-sectional, quantitative study in schools E.M.E.F. Dom Eduardo Expedito de Oliveira and CIEP II Anésio Leão / Miguel Mota, which involved a total of 195 students. The data collection was performed with the aid of an instrument to collect information, conduct interviews with the students and visual acuity was measured using the Snellen Test. The study was carried out between January and May of 2018. Data from the collection instruments used were compiled in the Statistical Package for Social Sciences (SPSS - version 21.0), and a descriptive statistical analysis was done. Results: Of the total of 195 students from the selected schools, 154 participated in the visual acuity tests performed through the Snellen Table and 28 of them presented low visual acuity and were referred to the ophthalmologist. Conclusion: The main refractive errors found were myopia, astigmatism and hypermetropia. In addition, it was observed that the prevalence of low acuity had a significant decrease according to studies published since 2003 to 2017.

Refractive errors in children and adolescents in Bucaramanga (Colombia) / Erros refrativos em crianças e adolescents em Bucaramanga (Colombia)

ABSTRACT Purpose: The aim of this study was to establish the frequency of refractive errors in children and adolescents aged between 8 and 17 years old, living in the metropolitan area of Bucaramanga (Colombia). Methods: This study was a secondary analysis of two descriptive cross-sectional studies that applied sociodemographic surveys and assessed visual acuity and refraction. Ametropias were classified as myopic errors, hyperopic errors, and mixed astigmatism. Eyes were considered emmetropic if none of these classifications were made. The data were collated using free software and analyzed with STATA/IC 11.2. Results: One thousand two hundred twenty-eight individuals were included in this study. Girls showed a higher rate of ametropia than boys. Hyperopic refractive errors were present in 23.1% of the subjects, and myopic errors in 11.2%. Only 0.2% of the eyes had high myopia (≤-6.00 D). Mixed astigmatism and anisometropia were uncommon, and myopia frequency increased with age. There were statistically significant steeper keratometric readings in myopic compared to hyperopic eyes. Conclusions: The frequency of refractive errors that we found of 36.7% is moderate compared to the global data. The rates and parameters statistically differed by sex and age groups. Our findings are useful for establishing refractive error rate benchmarks in low-middle-income countries and as a baseline for following their variation by sociodemographic factors.

RESUMO Objetivo: O objetivo deste estudo foi estabelecer a frequência de erros refrativos em crianças e adolescentes com idade entre 8 e 17 anos, residentes na região metropolitana de Bucaramanga (Colômbia). Métodos: Este estudo foi uma análise secundária de dois estudos descritivos transversais que aplicaram levantamentos sociodemográficos e avaliaram a acuidade e a refração visuais. As ametropias foram classificadas como erros miopicos, erros hipermetrópicos e astigmatismo misto. Os olhos eram considerados emétropes se nenhuma dessas classificações fosse feita. Os dados foram coletados usando software livre e analisados com STATA/IC 11.2. Resultados: Mil e duzentos e vinte e oito indivíduos foram incluídos neste estudo. As meninas mostraram uma maior taxa de ametropia do que os meninos. Erros refrativos hipermetrópicos estavam presentes em 23,1% dos indivíduos e erros miópicos em 11,2%. Apenas 0,2% dos olhos apresentavam miopia alta (≤-6,00 D). O astigmatismo misto e a anisometropia eram incomuns e a frequência de miopia aumentava com a idade. Houve leituras queratométricas mais acentuadas estatisticamente significativas em míopes em comparação com os olhos hipermétropes. Conclusões: A frequência de erros de refração que encontramos em 36,7% é moderada em comparação com os dados globais. As taxas e os parâmetros diferiram estatisticamente por sexo e grupos etários. Nossas descobertas são úteis para estabelecer padrões de referência de erro de refração em países de baixa renda média e como base para seguir sua variação por fatores sociodemográficos.

Prevalência de ametropias e anisometropias em crianças no ensino fundamental nas escolas de 14 municípios do Estado de Alagoas / Prevalence of ametropias and anisometropias in elementary school children in schools from 14 cities in the State of Alagoas

RESUMO Objetivo: Avaliar a Prevalência de ametropias e anisometropias em crianças no ensino fundamental nas escolas de 14 municípios do estado de Alagoas. Métodos: Realizado um Estudo retrospectivo com dados de 40.873 alunos na faixa etária de 7 a 15 anos. Os pacientes com qualquer erro refrativo foram considerados ametropes e erros maiores que - 0,75D ou + 2,00D esféricos ou maiores que -0,75D cilíndricos com queixas visuais significativas tiveram óculos prescritos e anisometropia considerada com a diferença maior de duas dioptrias. Resultados: Encontrado prevalência, 5,2% de ametropias. Astigmatismo miópico composto (28,99%), seguido de astigmatismo hipermetrópico composto (20,39%). E anisometropia, de 10.38%. Conclusão: Conhecer a prevalência infanto-juvenil de ametropias e anisometropia na população é fundamental para a adoção de estratégias para diagnóstico e tratamento correto de causas evitáveis de baixa visão.

ABSTRACT Objective: Evaluate a prevalence of ametropias and anisometropias in elementar school children from 14 cities in the state of Alagoas. Methods: A retrospective study, total of 40.873 students, between 7 and 15 years of age, were examined. Patients presenting any refractive error were considered ametropic. Only patients claiming eye complaints with spherical errors greater than -0.75D or +2.00D and cylinder error greater than -0.75D were prescribed eyeglasses. Anisometropia was considered when the refractive difference between the two eyes was of 2 diopters or more. Results: 5.2% presented ametropia. Compound myopic astigmatism (28.99%) and compound hyperopic astigmatism (20.39%). And anisometropias was 10.38%. Conclusions: Understanding the prevalence of ametropias and anisometropias among children is essential to implement strategies for the correct diagnosis and treatment of avoidable visual impairment causes.

Aumento da prevalência de miopia em um serviço oftalmológico de referência em Goiânia - Goiás / Increased prevalence of myopia in a ophthalmologic hospital in Goiânia - Goiás

RESUMO Objetivo: Avaliar o aumento da prevalência de miopia entre pacientes atendidos em períodos diferentes em um serviço oftalmológico de Goiânia. Métodos: Foram comparados dados coletados em dois estudos científicos realizados em um serviço de oftalmologia, em diferentes períodos de tempo, que avaliaram dentre outros fatores, os erros refracionais dos participantes a partir destes dados comparou-se a porcentagem de pacientes portadores de miopia presentes nos estudos. Resultados: Observou-se um aumento na prevalência de Miopia dentre os participantes dos dois estudos. Na avaliação realizada entre 1995 e 2000 a porcentagem de pessoas com miopia representou 3,6% do total, já no estudo realizado no ano de 2014 a prevalência de pacientes com miopia foi de 9%. Dentre os pacientes com erros refracionais a prevalência de miopia no primeiro estudo foi de 9,97%, já no segundo a prevalência foi de 22%. Conclusão: Observou-se um aumento na prevalência de miopia entre os dois estudos, dados esses que corroboram com análises feitas que mostram um aumento da prevalência de miopia em todo mundo nos últimos 30 anos. Porém em uma proporção menor do que a observada em outros estudos populacionais.

ABSTRACT Objective: To evaluate the increased prevalence of myopia among patients in different periods in an ophthalmologic hospital in Goiânia. Methods: There were compared data collected in two scientific studies carried out in the same ophthalmologic hospital in different periods of time, they evaluated among other factors, the refractive errors of the participants, from this data there were compared the percentage of patients with myopia between the two studies. Results: There was an increase in the prevalence of myopia among the participants of the studies, in the evaluation carried out between 1995 and 2000 the percentage of people with myopia accounted for 3.6% of the total, in the study carried out in 2014 the prevalence of patients with myopia was 9%. Only among patients with refractive errors the prevalence of myopia in the first study was 9.97%, in the second study the prevalence was 22%. Conclusion: There was an increase in the prevalence of myopia between the two studies, these data corroborate with tests that shows an increasing prevalence of myopia in the world in the last 30 years. However, in a smaller proportion than in other population studies.

Refractive Errors in Koreans: The Korea National Health and Nutrition Examination Survey 2008-2012

PURPOSE: Our study provides epidemiologic data on the prevalence of refractive errors in all age group ≥5 years in Korea. METHODS: In 2008 to 2012, a total of 33,355 participants aged ≥5 years underwent ophthalmologic examinations. Using the right eye, myopia was defined as a spherical equivalent (SE) less than -0.5 or -1.0 diopters (D) in subjects aged 19 years and older or as an SE less than -0.75 or -1.25 D in subjects aged 5 to 18 years according to non-cycloplegic refraction. Other refractive errors were defined as follows: high myopia as an SE less than -6.0 D; hyperopia as an SE larger than +0.5 D; and astigmatism as a cylindrical error less than -1.0 D. The prevalence and risk factors of myopia were evaluated. RESULTS: Prevalence rates with a 95% confidence interval were determined for myopia (SE <-0.5 D, 51.9% [51.2 to 52.7]; SE <-1.0 D, 39.6% [38.8 to 40.3]), high myopia (5.0% [4.7 to 5.3]), hyperopia (13.4% [12.9 to 13.9]), and astigmatism (31.2% [30.5 to 32.0]). The prevalence of myopia demonstrated a nonlinear distribution with the highest peak between the ages of 19 and 29 years. The prevalence of hyperopia decreased with age in subjects aged 39 years or younger and then increased with age in subjects aged 40 years or older. The prevalence of astigmatism gradually increased with age. Education was associated with all refractive errors; myopia was more prevalent and hyperopia and astigmatism were less prevalent in the highly educated groups. CONCLUSIONS: In young generations, the prevalence of myopia in Korea was much higher compared to the white or black populations in Western countries and is consistent with the high prevalence found in most other Asian countries. The overall prevalence of hyperopia was much lower compared to that of the white Western population. Age and education level were significant predictive factors associated with all kinds of refractive errors.

Avaliação oftalmológica de crianças de escolas públicas de Belo Horizonte/MG: um panorama acerca da baixa acuidade visual / Ophthalmologic screening of children of public schools in Belo Horizonte/MG: an overview about the visual impairment in children

Objetivo:Descrever e analisar a prevalência de baixa acuidade visual e suas causas em estudantes do ensino público de Belo Horizonte/MG.Métodos:Estudo transversal de 1452 escolares de 5 a 19 anos, do ensino público de Belo Horizonte/MG, triados e atendidos entre 2011 e 2014.Resultados:Da amostra total, 150 pacientes (10,33%) apresentaram baixa acuidade visual à triagem, recebendo encaminhamento para atendimento oftalmológico. Quarenta (26,66%) foram encaminhados e compareceram à consulta, onde 29 (72,5%) apresentaram indicação de correção visual. O astigmatismo miópico simples e composto foram os diagnósticos mais relacionados à prescrição de óculos.Conclusão:O estudo mostrou que a prevalência de baixa acuidade visual na população estudada foi compatível com demais programas semelhantes. Em contrapartida, a taxa de abstenção foi maior do que o esperado, evidenciando a importância da criação de medidas preventivas e informativas quanto à importância do cuidado com a saúde ocular.

Objective:To describe and analyze the prevalence of visual impairment and its causes in public school students in Belo Horizonte/MG.Methods:Cross-sectional study of 1.452 public school children from 5 to 19 years old, in Belo Horizonte/MG, screened and evaluated between 2011 and 2014.Results:Of the total sample, 150 patients (10,33%) had low visual acuity at the screening, and were referred to an ophthalmologist to further examination. Forty (26%) of the referred patients presented at the ambulatory, where 29 (72,5%) of these showed indication of visual correction. Simple and compound myopic astigmatism were the most frequent diagnoses associated with prescription glasses.Conclusion:The study showed that the prevalence of visual impairment in this population were consistent with other similar programs. By contrast, the abstention rate was much higher than the expectation, showing the importance of preventive and informative actions about the eye health care.

Encuesta de ceguera y deficiencia visual evitable en Panamá / Survey on avoidable blindness and visual impairment in Panama

OBJETIVO: Determinar la prevalencia de ceguera y deficiencia visual en adultos de 50 años o más de Panamá, identificar sus principales causas y caracterizar la oferta de servicios de salud ocular. MÉTODOS: Estudio poblacional transversal mediante la metodología estándar de evaluación rápida de ceguera evitable. Se seleccionaron 50 personas de 50 años o más de cada uno de 84 conglomerados escogidos mediante muestreo aleatorio representativo de todo el país. Se evaluó la agudeza visual (AV) mediante una cartilla de Snellen y el estado del cristalino y del polo posterior por oftalmoscopía directa. Se calculó la cobertura de cirugía de catarata y se evaluó su calidad, así como las causas de tener AV < 20/60 y las barreras para acceder al tratamiento quirúrgico. RESULTADOS: Se examinaron 4 125 personas (98,2% de la muestra calculada). La prevalencia de ceguera ajustada por la edad y el sexo fue de 3,0% (intervalo de confianza de 95%: 2,3-3,6). La principal causa de ceguera fue la catarata (66,4%), seguida del glaucoma (10,2%). La catarata (69,2%) fue la principal causa de deficiencia visual (DV) severa y los errores de refracción no corregidos fueron la principal causa de DV moderada (60,7%). La cobertura quirúrgica de catarata en personas fue de 76,3%. De todos los ojos operados de catarata, 58,0% logró una AV < 20/60 con la corrección disponible. CONCLUSIONES: La prevalencia de ceguera en Panamá se ubica en un nivel medio con respecto a la encontrada en otros países de la Región. Es posible disminuir este problema, ya que 76,2% de los casos de ceguera y 85,0% de los casos de DV severa corresponden a causas evitables.

OBJECTIVE: Determine prevalence of blindness and visual impairment in adults aged > 50 years in Panama, identify their main causes, and characterize eye health services. METHODS: Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged > 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity < 20/60 and barriers to access to surgical treatment. RESULTS: A total of 4 125 people were examined (98.2% of the calculated sample). Age- and sex-adjusted prevalence of blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity < 20/60 with available correction. CONCLUSIONS: Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.

Prevalência de doenças oculares e causas de comprometimento visual em crianças atendidas em um Centro de Referência em Oftalmologia do centro-oeste do Brasil / Prevalence of eye diseases and refractive errors in children seen at a referral center for ophthalmology in the central-west region, Brazil

Objetivo: Identificar os níveis de comprometimento visual e a prevalência de oftalmopatias e ametropias em crianças atendidas em um centro de referência em oftalmologia do centro-oeste brasileiro. Comparar os achados com dados publicados referentes a outras regiões do Brasil. Métodos: Estudo transversal, descritivo e retrospectivo com análise de prontuários de crianças atendidas no Centro de Referência em Oftalmologia (CEROF) da Universidade Federal de Goiás, no período compreendido entre abril de 2009 e março de 2010. Resultados: Foram avaliados 2408 prontuários, sendo 2128 (88,4%) de atendimento eletivo e 280 (11,6%) de atendimento no setor de urgências do CEROF. Houve predomínio na faixa etária de 6 a 10 anos (44,2%), seguido pela de 11 a 14 anos (29,6%). O exame foi considerado normal em 12,9% (n=274) dos atendimentos eletivos e em 6,8 (n=19) dos atendimentos de urgência. As doenças mais encontradas nas crianças foram as conjuntivites infecciosas (248 casos, 26,4%) e alérgicas (204 casos, 21,7%), blefarite (69 casos, 7,3%), calázio (34 casos, 3,6%), estrabismo (133 casos, 12,06%), as doenças de retina e vítreo (24 casos, 2,6%), catarata e alterações de cristalino (20 casos, 2,1%). As ametropias mais frequentes, contadas por olho, foram a hipermetropia (46,9%) e o astigmatismo (42,2%) e as doenças sistêmicas mais informadas foramprematuridade (30 casos) e diabete melito (26 casos). Conclusão: Este estudo identificou as principais causas de doenças oculares em crianças atendidas em um centro universitário de referência. O grupo de doenças mais prevalente foi o das doenças de córnea e conjuntiva (conjuntivites alérgicas, olho seco e ceratites). As doenças de pálpebra ocuparam o segundo lugar (blefarite, calázio, e obstrução ...

Objective: To identify the levels of visual impairment and prevalence of eye diseases and refractive errors in children seen at a referral center for ophthalmology in the Central-West region compare findings with published data for other regions of Brazil. Methods: Crosssectional, descriptive and retrospective analysis of medical records of children enrolled in the Center of Reference in Ophthalmology Universidade Federal de Goiás, in the period between april 2009 and march 2010. Results: A total of 2408 patient charts, and 2128 (88.4%) of elective care and 280 (11.6%) of care in the emergency department CEROF. Predominated in the age group 6-10 years (44.2%), followed by 11-14 years (29.6%). The examination was normal in 12.9% (n=274) of elective care and 6.8 (n=19) of emergency visits. The disease most commonly found in children were infectious conjunctivitis (248 cases, 26.4%) and allergic (204 cases, 21.7%), blepharitis (69 cases, 7.3%), chalazion (34 cases, 3.6 %), strabismus (133 cases, 12.06%), diseases of retina and vitreous (24 cases, 2.6%), cataract and lens changes (20 cases, 2.1%). Ametropia frequently told by eye, were hyperopia (46.9%) and astigmatism (42.2%) and systemic diseases were more informed prematurity (30 cases) and diabetes mellitus (26 cases). Conclusion: This study identified the main causes of eye diseases in children seen in a university referral center. The group of diseases more prevalent was the disease of the cornea and conjunctiva (allergic conjunctivitis, dry eye and keratitis). Diseases were the second eyelid (blepharitis, chalazion, and lacrimal obstructions). The refractive errors were the most common hyperopia and astigmatism. The findings in the study population are shown similar to those observed in the national literature. .

Prevalência de ametropias e oftalmopatias no quilombo São José da Serra - Valença - RJ / Prevalence of refractive errors and eye diseases in quilombo São José da Serra - Valença - RJ

OBJETIVO: Determinar a prevalência das ametropias e oftalmopatias na população do Quilombo São José da Serra – Valença – RJ. MÉTODOS: Foram examinados 92 indivíduos de uma população de 102 pessoas da comunidade Quilombola em São José da Serra. Todos foram submetidos à avaliação oftalmológica completa, incluindo anamnese, ectoscopia ocular, medida da acuidade visual, teste de estereopsia, reflexo vermelho, cobertura monocular, Hirschberg, refração objetiva, subjetiva, biomicroscopia, tonometria de aplanação de GoldmannR, tonometria de sopro e fundoscopia direta ou binocular indireta usando lente de 20D. RESULTADOS: Foram examinados cerca de 90,19% da população quilombola, sendo 61,95% do sexo feminino e 38,04% do sexo masculino. A idade variou de 6 meses a 89 anos. Foram encontrados ametropias com necessidade de correção óptica em 23,91% dos indivíduos sendo mais frequente a presbiopia associada à hipermetropia, miopia e/ou astigmatismo com prevalência de 59,09% dos indivíduos examinados, seguido da presbiopia isolada em 22,72%, do astigmatismo hipermetrópico em 13,63% e do astigmatismo miópico em 4,54% dos examinados. Em relação às oftalmopatias encontraram-se catarata senil em 7,61%, ambliopia refracional em 6,52%, atrofia do epitélio pigmentar da retina e atrofia peripapilar em 2,17%, glaucoma em 1,09%, pterígio em 1,09%, retinocoroidite por toxoplasmose em 1,09% e hipopigmentação retiniana (albinismo ocular) em 1,09%. CONCLUSÃO: A prevalência das ametropias e doenças oculares no Quilombo São José da Serra foi de 23,9%(22/92) e 20,6%(19/92), respectivamente.

OBJECTIVE: To determine the prevalence of refractive errors and eye diseases in the population of the Quilombo São José da Serra – Valença – RJ. METHODS: We examined 92 individuals in a population of 102 people in the community Quilombo São José da Serra. All patients underwent complete ophthalmologic examination including anamnesis, ectoscopy, visual acuity, stereopsis test, red reflex, cover/uncover test, Hirschberg test, manifest and dynamic refraction, biomicroscopy, tonometry (Goldmann and air puff tonometry), direct monocular /or indirect binocular fundoscopy. RESULTS: We examined 90.19% of the population quilombola, and 61.95% were female and 38.04% male. Ages ranged from 6 months to 89 years. Refractive errors were found requiring optical correction in 23.91% of individuals, being more frequent presbyopia associated with hyperopia, myopia and / or astigmatism with a prevalence of 59.09%, followed by presbyopia isolated in 22.72%, hyperopic astigmatism in 13.63% and myopic astigmatism in 4.54%. The ophthalmopathies observed were senile cataracts in 7.61%, refractive amblyopia in 6.52%, atrophy of the retinal pigment epithelium and peripapillary atrophy in 2.17%, glaucoma 1.09%, pterygium in 1.09%, retinochoroiditis toxoplasmosis in 1.09% and hypopigmentation retinal (ocular albinism) in 1.09%. CONCLUSION: The prevalence of ametropia and eye diseases in the Quilombo São José da Serra were 23.9%(22/92) and 20.6%(19/92), respectively.

Prevalence of refractive errors in Möbius sequence / Prevalência de erros refrativos na sequência de Möbius

PURPOSE: To assess the prevalence of refractive errors in Möbius sequence. METHODS: This study was carried out during the Annual Meeting of the Brazilian Möbius Society in November 2008. Forty-four patients diagnosed with the Möbius sequence were submitted to a comprehensive assessment, on the following specialties: ophthalmology, neurology, genetics, psychiatry, psychology and dentistry. Forty-three patients were cooperative and able to undertake the ophthalmological examination. Twenty-two (51.2 %) were male and 21 (48.8%) were female. The average age was 8.3 years (from 2 to 17 years). The visual acuity was evaluated using a retro-illuminated logMAR chart in cooperative patients. All children were submitted to exams on ocular motility, cyclopegic refraction, and fundus examination. RESULTS: From the total of 85 eyes, using the spherical equivalent, the major of the eyes (57.6%) were emmetropics (>-0.50 D and <+2.00 D). The prevalence of astigmatism greater than or equal to 0.75 D was 40%. CONCLUSION: The prevalence of refractive errors, by the spherical equivalent, was 42.4% in this studied group.

OBJETIVO: Avaliar a prevalência de erros refrativos em crianças portadoras da sequência de Möbius. MÉTODOS: Trabalho realizado durante o encontro anual da Associação Möbius do Brasil (AMoB) em novembro de 2008. Quarenta e quatro pacientes com diagnóstico de sequência de Möbius foram submetidos a avaliação multidisciplinar: oftalmológica, neurológica, genética, psiquiátrica, psicológica e odontológica. Quarenta e três pacientes colaboraram com exame oftalmológico. Vinte e dois (51,2 %) eram do sexo masculino e 21 (48,8 %) do sexo feminino. A idade média foi de 8,3 anos (2 a 17 anos). A medida da acuidade visual foi realizada com tabela logMAR retro-iluminada, nos pacientes que colaboravam. Todas as crianças foram submetidas a exame da motilidade ocular, refração sob cicloplegia e fundo de olho. RESULTADOS: Do total de 85 olhos estudados, usando o equivalente esférico, a maioria dos olhos (57,6%) são emétropes (>-0,50 D e <+2,00 D). A prevalência de astigmatismo maior que 0,75D foi 40%. CONCLUSÃO: A prevalência de erros refrativos, pelo equivalente esférico, no grupo estudado foi de 42,4%.

Spectacle compliance amongst rural secondary school children in Pune district, India.

Background: Refractive errors (RE) are the most common cause of avoidable visual impairment in children. But benefits of visual aids, which are means for correcting RE, depend on the compliance of visual aids by end users. Aim: To study the compliance of spectacle wear among rural school children in Pune district as part of the sarva siksha abhiyan (education for all scheme) after 6 - 12 months of providing free spectacles. Settings and Design: Cross-sectional follow-up study of rural secondary school children in western India. Materials and Methods: The students were examined by a team of optometrists who collected the demographic details, observed if the child was wearing the spectacles, and performed an ocular examination. The students were asked to give reasons for non-wear in a closed-ended questionnaire. Statistical Analysis: Chi-square test and multiple logistic regression used for data analysis. Results: Of the 2312 students who were dispensed spectacles in 2009, 1018 were re-examined in 2010. 523 students (51.4%) were female, the mean age was 12.1 years 300 (29.5%) were wearing their spectacles, 492 (68.5%) students claimed to have them at home while 211 (29.4%) reported not having them at all. Compliance of spectacle wear was positively associated to the magnitude of refractive error (P < 0.001), father's education (P = 0.016), female sex (P = 0.029) and negatively associated to the visual acuity of the better eye (P < 0.001) and area of residence (P < 0.0001). Of those that were examined and found to be myopic (N = 499), 220 (44%) wore their spectacles to examination. Factors associated with compliance to spectacle usage in the myopic population included increasing refractive error (P < 0.001), worsening visual acuity (P < 0.001), and higher academic performance (P < 0.001). The causes for not wearing spectacles were ‘lost spectacles’ 67(9.3%), ‘broken spectacles’ 125 (17.4%), ‘forgot spectacles at home’ 117 (16.3%), ‘uses spectacles sometimes’ 109 (15.2%), ‘teased about spectacles’ 142 (19.8%) and ‘do not like the spectacles’ 86 (12%). Conclusion: Spectacle compliance was poor amongst school children in rural Pune; many having significant vision loss as a result.

Características clínicas y epidemiológicas de las ametropías en escolares de la Escuela Primaria Lidia Doce Sánchez / Clinical and epidemiological characteristics of ametropias in schoolchildren from

Objetivo: determinar las características clínicas y epidemiológicas de los trastornos refractivos en escolares. Métodos: se realizó un estudio descriptivo, observacional de corte transversal en la escuela primaria Lidia Doce Sánchez, en el municipio de Marianao, La Habana, desde septiembre a noviembre de 2011. El universo estuvo compuesto por 178 escolares y se realizó examen oftalmológico completo a 72 pacientes. Se distribuyeron según el defecto refractivo, grado de severidad, edad, género y la frecuencia de la ambliopía. Resultados: se encontró que 36 escolares presentaban trastornos refractivos y un predominio de la forma leve de estos. El astigmatismo representó el 55,5 por ciento de las ametropías, y el astigmatismo hipermetrópico compuesto fue el más frecuente. La ambliopía se halló en el 3 por ciento de los escolares. Conclusiones: el comportamiento de los defectos refractivos observado fue similar a lo obtenido por diversos autores del ámbito nacional e internacional

Objective: to describe the clinical and epidemiological behavior of ametropia in schoolchildren. Methods: an observational, descriptive and cross-sectional study was carried out from September to November 2011 in Lidia Doce Sanchez elementary school in Marianao municipality, Havana province. The universe of study was formed by 178 students. A complete ophthalmologic exam was performed on 72 eyes. They were distributed according to the refractive defect, degree of severity, age, gender and frequency of amblyopia. Results: thirty six children suffered from refractive defect, being the slight type predominant. Astigmatism represented 55,5 percent of all the ametropies, being the compound hypermetropic the most frequent. Amblyopia was found in 3 percent of children. Conclusions: the behavior of the refractive errors was similar to that observed by other authors in domestic and international reports

Perfil de distribuição de erros refracionais no sul do centro-oeste do estado de São Paulo e seu impacto na acuidade visual: estudo de base populacional / Distribution profile of refractive errors in the south of the center - west of the state of São Paulo and its impact on visual acuity: population-based study

Determinar o perfil de distribuição dos erros refracionais em uma amostra populacional do centro-oeste do Estado de São Paulo, suas possíveis associações com características individuais e a influência sobre a acuidade visual. foi desenvolvido estudo de secção transversal com amostragem residencial probabilística e sistemática em nove municípios no sul do centro-oeste paulista, como parte do Projeto de Prevenção à Cegueira na Comunidade. Os indivíduos acima de um ano de idade foram submetidos a entrevista e exame oftalmológico completo. A acuidade visual em sistema Snellen e posterior conversão para logMAR foi obtida antes e após exame de refração e categorizada em quatro segmentos. Os erros refracionais foram classificados em miopia (EE ≤ - 0,50D), hipermetropia (EE ≥ 0,50D), astigmatismo (DC ≤ -0,50D) e anisometropia (diferença de EE ≥ 1,00D entre os olhos). Foi realizada a análise descritiva dos dados de prevalência na amostra, análise univariada e multivariada com modelos de regressão logística múltipla para determinar possíveis associações de prevalências. 3012 residências foram entrevistadas e 7654 indivíduos foram incluídos no estudo, sendo 62,7% mulheres, 92,1% considerados com pele branca e média para a idade de 36,89 anos (extremos de 1 a 96 anos). A miopia foi mais prevalente na terceira e quarta décadas de vida, atingindo 43,31% sem diferenças significativas entre sexos, enquanto a hipermetropia foi mais prevalente entre mulheres acima de 60 anos de idade, com uma frequência de 65,6% nesta faixa etária. O astigmatismo apresentou uma frequência progressivamente maior com a idade e semelhante entre os sexos. O eixo do astigmatismo também apresentou variação conforme a idade, com o eixo horizontal mais frequente em jovens e o vertical nos idosos...

Establish the refractive errors distribution in a population sample of the Central São Paulo State, correlations with personal features and its influence in visual acuity. A cross sectional survey was developed with randomized and systematic residential sampling in nine cities of middle region of São Paulo St/Brazil as part of Blindness Prevention Project at Community. Inhabitants above one year old were submitted to an interview and full ophthalmic exam. Visual acuity in logMAR system was determined before and after refraction exam and classified in four categories. Refractive errors were classified in myopia (SE ≤ -0,50D), hyperopia (SE ≥ 0,50D), astigmatism (CD ≤ -0,50D) and anisometrophy (SE difference between eyes ≥ 1,00D). Prevalence data sample were submitted to descriptive analysis, univariate and multivariate logistic regression models to find eventual prevalence associations. 7654 participants were included in this survey, in which 62,7% were women, 92,1% with white skin and middle age of 36,89 years old (1 to 96 years). Myopia was more prevalent at 3rd and 4th decades, achieving 43,31% without significant differences between genders, while hyperopia was more prevalent in women above 60 years old, with 65,5%. Astigmatism prevalence increased by age with no differences between genders. Astigmatism axis changed by age too, when horizontal axis were more frequently observed in youngers and vertical in olders. Anisometrophy prevalence changed by age, more frequent at extremes, achieving 32,66% after 70 years old. No significant differences were found in ethnic categories...

Prevalencia de patología oftalmológica en prematuros menores de un año de edad / Prevalence of ocular pathology in premature children under one year of age

Objetivo: Reportar hallazgos oftalmológicos en niños prematuros examinados antes del año de edad gestacional corregida (EGC). Pacientes y Método: Revisión retrospectiva de fichas clínicas de una serie de prematuros ([peso nacimiento (PN) < 1 500 g y/o < 32 sem edad gestacional (EG)] nacidos en CAS entre 2006-2009, examinados antes del año de EGC. Se consignó EG, PN, antecedente de retinopatía del prematuro (ROP), EGC al examen, refracción, anisometropia y estrabismo. Resultados: De 149 prematuros nacidos en el período, 100 tuvieron examen oftalmológico antes del año de edad (67,14 por ciento); el promedio de EG y PN fue 29,3 (rango 2336) semanas y 1217 (343-2190) g, respectivamente. El 29 por ciento presentó ROP, requiriendo tratamiento el 4 por ciento. La EGC promedio al examen oftalmológico fue 6,4 (3-11,5) meses. El equivalente esférico fue +1,34D (-1,75 a +5,75), presentando anisometropia >1D el 2,2 por ciento(95 por ciento IC, -0,82-5,26). El 3,3 por ciento (95 por ciento IC, -0,38-7,04) presentaba indicación de lentes según recomendaciones internacionales y el 4 por ciento (95 por ciento IC, 0,16-7,84) presentó estrabismo. Conclusiones: La baja prevalencia de factores de riesgo para ambliopia detectada en esta cohorte comparada con la reportada para prematuros con ROP severa podria explicarse por la baja prevalencia de ésta última en la presente serie.

Objective: To report ocular abnormalities in premature infants examined before one year of Corrected Gestational Age (CGA). Patients and Methods: Retrospective review of medical records of a number of premature infants ([birth weight (BW) < 1 500 g and/or < 32 week gestational age (GA)] born between 2006 and 2009 and examined before one year of CGA. GA, BW, retinopathy of prematurity (RQP), CGA examination, refraction, anisometropia and strabismus information were recorded. results: Out of the 149 premature infants born during the period, 100 had eye exam before one year of age (67.14 percent), the mean GA and BW was 29.3 (range 23-36) weeks and 1217 (343-2190) g, respectively. 29 percent had ROP, 4 percent required treatment. The mean CGA at the time of ophthalmologic examination was 6.4 (3 to 11.5) months. The spherical equivalent was +1.34 D (-1.75 to +5.75), 2.2 percent presented anisometropia > 1D (95 percent CI, -0.82 to 5.26). 3.3 percent (95 percent CI, -0.38 to 7.04) were in need of glasses according to international recommendations and 4 percent (95 percent CI, 0.16 to 7.84) had strabismus. Conclusions: The low prevalence of risk factors for amblyopia detected in this population compared with that reported for premature infants with severe RQP could be explained by the low prevalence of the latter in this study.