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Bethlehem Mekonnen, Lijuan Huang, Ying Han, Ogonna Nnamani, Jianmin Hu; The shift in the causes of vision loss at China’s largest blind school during a period of significant economic growth. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4095.
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This cross-sectional study was performed to evaluate vision loss tends and school-based treatment regimens at Quanzhou Blind School, China’s largest blind school in 2008 and 2016.
One hundred forty-four students in 2008 and 125 students in 2016 received comprehensive eye exams along with a complete family and ophthalmic history. Vision loss was categorized into visual impairment (VI) and blindness classifications based on WHO guidelines. The etiologies of VI and blindness in 2008 were compared to those in 2016 using a Fisher Exact Test, and the use of visual aids was also analyzed during this period.
The leading cause of VI significantly shifted from corneal scarring in 2008 to retinopathy of prematurity in 2016 (p=0.020) while congenital cataracts remained the leading cause of blindness in 2008 and 2016. In 2016, there was a significant increase in the use of visual aids with 63.2% (79/125) of students using them in 2016 compared to 8.3% (12/144) of students in 2008 (p=0.0001).
The changes in the etiological attribution of VI and the increased usage of visual aids are associated with China’s robust economic growth during this time. Corneal scarring, a condition that is more associated with poor nutrition and infectious diseases significantly decreased in 2016 when compared to 2008 while improvements in neonatal care and premature infant survival rates led to a higher prevalence of ROP. The persistence of congenital cataracts as the leading cause of blindness highlights the difficulty of successfully managing congenital cataracts because the coordination of medical and rehabilitative services is arduous and treating secondary ophthalmic diseases that are associated with congenital cataracts, such as amblyopia and glaucoma, can be challenging. This study highlights the importance of revising screening protocols to account for this change.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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