【摘要】  评估中国河北省磁县申庄30岁及其以上年龄组中低视力和盲人的量方法 描述性横断面研究是此项调查的设计方案。所有的参加者都进行了统的问卷调查和检查。其中检查包括裸眼视力、电脑和主观验光，眼底数字照相，所有单眼矫正视力＜6/18者都进行了详细的眼科检查。结果 其样本总数是802人,665人参加了此项调查.应答率82.92%。男性的平均年龄为51.3岁,女性的平均年龄为50.9岁。低视力的发生率为2.1%（95%的可信区间是1.2%～3.6%）,其主要原因有白内障占42.9%,角膜病占14.3%,屈光不正占14.3%,眼后节疾病占14.3%，怀疑青光眼占7.1%和先天疾病占7.1%。盲人的发病率为0.5%（95%的可信区间是0.1%～1.4%）。主要原因有白内障占66.7%,先天性疾病占33.3%。结论 低视力和盲人的致病原因中,其50%以上的原因都是可预防和可治疗的疾病。高年龄、女性和低社会经济状况是导致低视力的高危险因素。在项调查中性别不是导致盲人的危险因素。

    【关键词】  低视力 失明

    Prevalence of low vision and blindness in shenzhuang village of Cixian county in Hebei province of China

    YANG Shun-ling.Handan Eye Hospital,Handan 056001,China

    ［Abstract］  Objective  To estimate the magnitude of low vision and blindness in people aged 30 years and above in Shenzhuang Village,Cixian County,Hebei Province,China.Methods  Descriptive cross-sectional study was implemented.All the participants underwent a standard interview and an examination including naked visual acuity,auto-refraction,subjective refraction and retinal digital photography.Those with corrected visual acuity less than 6/18 in any eye underwent detailed examination.Results  The target sample size was 802 and 665 persons who were examined.The response rate was 82.92%.The average age was 51.3 years in male and 50.9 years in female.The prevalence of low vision was 2.1% （95% confidence interval was 1.2%～3.6%）.The major causes of low vision were cataract （42.9%）,corneal opacity （14.3%）,refractive error （14.3%）,posterior segment disease （14.3%）,suspected glaucoma （7.1%） and congenital disease （7.1%）.The prevalence of blindness was 0.5% （95% confidence interval was 0.1%～1.4%） in this study.The major causes were cataract 66.7% and congenital disease 33.3%.Conclusion  More than half of the causes of low vision and blindness are preventable and curable diseases in this village.Old age,female gender and low socioeconomic status are associated with the high risk of low vision.But gender is not the high risk of blindness in this study.

    ［Key words］  low vision;blindness

    Introduction

    The People’s Republic of China is the largest country in East Asia.With over 1.31 billion people,it is the world's largest country in respect of population［1］.According to a WHO estimate,the annual incidence of blindness in China is 450,000,of whom 400,000 are due to cataract［2］.This means that in China one personbecomes blind every minute.From 2000 to 2020,the population aged 60 years and above in China will increase by 90%［3，4］.Therefore the burden of preventing blindness is very hard for China in 1999,the WHO Prevention of Blindness Program launched “VISION 2020:The Right to Sight Initiative” with the objective of assisting member states in eliminating avoidable blindness by the year 2020［5,6］.The global target is to ultimately reduce blindness prevalence to less than 0.5% in all countries,or less than 1.0% in any community［7,8］.China took part in this programme.During the past years,China had done a lot of work to eliminate avoidable blindness.As all known,the population of China is vast.Conduction of survey on prevalence of blindness and low vision for the whole country is not feasible due to lack of time and resources.So a small-administrative unit was selected to do this survey.The rationale of the study is to establish a baseline data on prevalence of blindness and low vision in Shenzhuang Village,Cixian County,China.This study is to estimate the prevalence of low vision and blindness in age group 30 and above in a rural village,China.The objectives are to estimate the prevalence of low vision and blindness by age,sex and literacy and find out the major causes of low vision and blindness in this village,to estimate the people who need cataract surgery and refer them to Handan Eye Hospital for treatment.Why was this survey done in this county? Cixian County is located in the south of Hebei Province of China.It is administrated by Handan City,Hebei Province.It is the origin of Cizhou kiln civilization.The population is 650,000.The area is 1,035 km2. It consists of 19 towns and 390 villages.The high prevalence of esophagus cancer happened there and the perfect tertiary health system for this disease has been set up.There is one county hospital,one cancer hospital and traditional Chinese medical hospital.

    Methods

    The study is based on cross-sectional study.The sample size is 802.They are all aged 30 and above in this village.The redesigned questionnaire according to China’s situation has been developed in Handan Eye Hospital and pilot study was conducted in Handan Eye Hospital for one day.In fieldwork,two local people were responsible to persuade the local people one by one to accept the eye examination.At the same time,in the examination centre one optometrist was willingly responsible for checking ID cards of participants,presenting visual acuity and completing the first part of the questionnaire.Secondly,one optometrist checked their auto-refraction.One ophthalmologist checked their subjective refractions and filled the second part of the questionnaire.Thirdly,all participants had been taken the retinal photography.If the patient's corrected visual acuity was less than 6/18 in any eye,one ophthalmologist would check their Glodmann IOP and the other ophthalmologist would examine their eyes in detail.After examination,the ophthalmologist gave the patients needed medicines and filled the questionnaire.If the patients’ disease was complex,the ophthalmologist would recommend him to the secondary hospital.Everyday 70 persons were examined.After a whole day’s work,the leader of the ophthalmologists checked all the questionnaires in detail and corrected them. At last,data was manually cleaned and the study number was written before it was typed into computer.Data was entered into two different computers.After compared and corrected,the data was analyzed with the help of Epi info software programme and the patients who needed cataract surgery were offered free surgery in Handan Eye Hospital within one week.

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