Prevalence of Cataract Blindness in Rural Ethiopia

Background: Over three-quarter of all blindness worldwide are preventable and usually caused by cataract and trachoma. Objective: To assess the prevalence of cataract blindness in rural Ethiopia in order to facilitate further health care planning. Methods: A Cross-sectional; community-based study of inhabitants over 40 years of age from villages in the Abeshge and Kebena Districts; south of Addis Ababa. A total of 1100 eligible participants were identified in the study. Visual acuity (VA) was measured using a Snellen's E chart at 6 metres and eye examinations were performed using torch light; 2.5 X magnifying glasses and an ophthalmoscope. Cataract was defined as lens opacity identified as the cause of blindness and low vision after ruling out other causes. Unfortunately; there was no access to a refraction set and slit lamp to conduct thorough examinations. Results: The adjusted prevalence of bilateral cataract blindness (VA3/60) was 2.4; 95confidence interval [CI]; 1.8-3.0. Cataract is the major cause of bilateral blindness (66.7) among the participants. The cataract surgical coverage was 28.9for men and 18.1for women. The adjusted prevalence of bilateral cataract and VA6/60 was 3.6(95CI; 1.4-5.8). In this last group; the surgical coverage was 41.2(persons) and 38.5(eyes). Of all operated eyes; 30could not see at 6/60. Inability to afford the procedure (64.5) and poor knowledge of cataract (29.8) were the reasons why surgery had not been performed. Conclusions: Cataract blindness is a major health problem in the study area with low surgical uptake. There is backlog of cataract blindness in the study area that will increase with ageing. This backlog was also reflected in other developing countries. Awareness campaigns; reducing cost; and expansion of surgical services may help to increase the cataract surgical rate; and women should be offered more cataract surgery. These results will enable health managers to plan effective interventions in line with Vision 2020

Gender differences in adult blindness and low vision, Central Ethiopia.

BACKGROUND: Blindness is a major global public health concern. Approximately 50 million people are blind, three times that number is visually impaired; 90% of whom live in poor countries. Women account for 65% of blind people in the world. OBJECTIVE: To assess gender differences in prevalence rates and causes of low vision and blindness. DESIGN: Population-based cross-sectional survey. PARTICIPANTS: Gurage Zone; Ethiopian adults 40 years old and above. (n = 1100). METHODS: Equal number of women and men 40 years-old and above in the Gurage Zone, Ethiopia, were selected using a multistage sampling method. MAIN OUTCOME MEASURES: Bilateral low vision was defined as presenting Visual Acuity (VA) worse than 6/18 and better than 3/60, and bilateral blindness as presenting VA worse than 3/60 in the better eye. RESULTS: The prevalence rates were 10.9% for bilateral low vision and 3.5% for bilateral blindness. Women comprised 59.0% of blindness, and 70.0% of low vision. The difference in gender distribution and low vision was statistically significant in all age groups. Women had 1.46 excess risk of bilateral blindness. The rates of bilateral low vision and blindness increased with age. Cataract is a leading cause of bilateral low vision (66.7%) and blindness (59.0%). Glaucoma is the second cause of blindness. Uncorrected refractive errors are the second cause of low vision (23.3%). Trachoma is the third cause of low vision and blindness. CONCLUSION: The age- and gender-adjusted rates of low vision and blindness is very high in general and in women in particular. Cataract is a leading cause of blindness and low vision in Ethiopian adults. It is recommended that gender sensitive prevention and intervention program of avoidable blindness needs to be an ongoing focus in the study area.

Liposarcoma presenting as a recurrent eyelid tumor.

Liposarcoma of the head and neck is rarely reported Orbital and eye lid involvement has been found to be extremely rare. A 25 year old male patient from Harar presented with left eyelid mass of two years duration and diagnosed to have liposarcoma by incisional biopsy. Despite the difficulty in obtaining wide surgical margins, the small tumor size at presentation and the apparent predominance of well-differentiated type means that the prognosis for orbital liposarcoma was generally good. The epidemiological, clinical feature and histological findings are discussed. It is recommended to consider liposarcoma as a differential diagnosis of orbital mass lesions.