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M Al-Khudari, EM Robinson, AM Lora, AL Jamil, AJ Axelrod, RM Ahuja; Cause-Specific Etiology of Blindness in an Inner-City Hospital Setting . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3843.
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Purpose: To determine the etiology of blindness in an inner-city county hospital setting with a racially diverse population Methods: A retrospective chart review of patients presenting to the General Ophthalmology Clinic at Cook County Hospital Chicago, Illinois from January 1999 thru November 2001. Results: A total of 4016 patient charts were reviewed. Of these a total of 500 eyes of 442 patients were defined as legally blind (Va < 20/200). The average age was 55.8 years ranging from 6 to 94 years. There were a total of 223 (51%) males and 219 (49%) females. Patient ethnicity consisted of African American 57% (253), Hispanic 23% (101), White 6% (28), Southeast Asian (Indian and Pakistani) 5% (20), Asian 3% (13), Arabic 2% (7), unknown 4% (20). The leading cause of legal blindness was retinal disease 36% (182). Of retinal disease, 44% (80) was due to complications of diabetic retinopathy. Retinal diseases included conditions such as central retinal vein occlusion, retinal detachment, macular holes and others. Age-related macular degeneration accounted for only 1.4% (7) of the cases. Other causes included trauma 16% (80), glaucoma 15% (77), lens 11% (53), cornea 5% (27), amblyopia 5% (23), uveitis 4% (18), optic neuropathy 3% (16), tumor 0.6% (3), miscellaneous 0.4% (2), unknown 4% (18). Conclusion: The most common causes of blindness were equally distributed between diabetic retinopathy and trauma. Retinal diseases were the most common cause of blindness as a group, although, age-related macular degeneration accounted for only a small minority of cases. Previously, large population-based studies that included more homogenous populations and an older age group had a large percentage of blindness attributed to age-related macular degeneration. In our study with a more ethnically diverse population, diabetes and trauma predominated. An awareness of the differences in the etiology of blindness in such racially diverse populations may help to better focus health care expenditures to minimize vision loss.
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