Visual impairment and blindness: an overview of prevalence and causes in Brazil.

Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from two cross-sectional population-based studies - the São Paulo Eye Study and the Refractive Error in School Children Study is presented. 3678 older adults and 2441 school children were examined between July 2004 and December 2005. Prevalence of blindness in older adults using presenting visual acuity was 1.51% decreasing to 1. 07% with refractive correction. The most common causes of blindness in older adults were retinal disorders, followed by cataract and glaucoma. In school children, the prevalence of uncorrected visual impairment was 4.82% decreasing to 0.41% with refractive correction. The most common cause of visual impairment in school children was uncorrected refractive error. Visual impairment and blindness in Brazil is an important public health problem. It is a significant problem in older Brazilians, reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling. In school-children cost-effective strategies are needed to address a readily treatable cause of vision impairment - prescription and provision of glasses.

[1]  S. West Epidemiology of Cataract: Accomplishments over 25 years and Future Directions , 2007, Ophthalmic epidemiology.

[2]  S. Gupta,et al.  A population-based eye survey of older adults in a rural district of Rajasthan: II. Outcomes of cataract surgery. , 2001, Ophthalmology.

[3]  L. Ellwein,et al.  Prevalence of blindness and cataract surgery in Shunyi County, China. , 1998, American journal of ophthalmology.

[4]  R. Klein,et al.  Ten-year incidence and progression of age-related maculopathy: The Beaver Dam eye study. , 2002, Ophthalmology.

[5]  L B Ellwein,et al.  Refractive Error Study in Children: results from La Florida, Chile. , 2000, American journal of ophthalmology.

[6]  Serge Resnikoff,et al.  Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. , 2008, Bulletin of the World Health Organization.

[7]  G. Murthy,et al.  Refractive error in children in an urban population in New Delhi. , 2002, Investigative ophthalmology & visual science.

[8]  L. Ellwein,et al.  The Prevalence of Visual Impairment in School Children of Upper-Middle Socioeconomic Status in Kathmandu , 2008, Ophthalmic epidemiology.

[9]  J. Evans,et al.  Antioxidant supplements to prevent or slow down the progression of AMD: a systematic review and meta-analysis , 2008, Eye.

[10]  L. Ellwein,et al.  Prevalence of blindness and cataract surgery in Nepal , 1998, The British journal of ophthalmology.

[11]  S. Resnikoff,et al.  Global data on visual impairment in the year 2002. , 2004, Bulletin of the World Health Organization.

[12]  A. Hofman,et al.  Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study. , 2000, Investigative ophthalmology & visual science.

[13]  P. Mitchell,et al.  Bilateral involvement by age related maculopathy lesions in a population , 1998, The British journal of ophthalmology.

[14]  R. Klein,et al.  Risk Factors Associated with Age-Related Macular Degeneration: A Case-control Study in the Age-Related Eye Disease Study: Age-Related Eye Disease Study , 2000 .

[15]  Yingfeng Zheng,et al.  Refractive error and visual impairment in school children in rural southern China. , 2007, Ophthalmology.

[16]  Rakhi Dandona,et al.  Refractive error in children in a rural population in India. , 2002, Investigative ophthalmology & visual science.

[17]  L B Ellwein,et al.  Refractive Error Study in Children: results from Shunyi District, China. , 2000, American journal of ophthalmology.

[18]  H. Taylor,et al.  The prevalence of glaucoma in the Melbourne Visual Impairment Project. , 1998, Ophthalmology.

[19]  S. West Looking forward to 20/20: a focus on the epidemiology of eye diseases. , 2000, Epidemiologic reviews.

[20]  A. Berezovsky,et al.  Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo--Brazil. , 2008, Arquivos brasileiros de oftalmologia.

[21]  Giel Nijpels,et al.  Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study. , 2003, Archives of ophthalmology.

[22]  L. Dandona,et al.  Revision of visual impairment definitions in the International Statistical Classification of Diseases , 2006, BMC medicine.

[23]  M. C. Leske,et al.  Open-Angle Glaucoma—An Epidemiologic Overview , 2007, Ophthalmic epidemiology.

[24]  Avesh Raghunandan,et al.  Refractive error and visual impairment in African children in South Africa. , 2003, Investigative ophthalmology & visual science.

[25]  A D Negrel,et al.  Refractive Error Study in Children: sampling and measurement methods for a multi-country survey. , 2000, American journal of ophthalmology.

[26]  L. Ellwein,et al.  Refractive Error Study in Children: results from Mechi Zone, Nepal. , 2000, American journal of ophthalmology.

[27]  T. Wong,et al.  Management of Diabetic Retinopathy , 2007 .

[28]  M. He,et al.  A survey of blindness and cataract surgery in Doumen County, China. , 1999, Ophthalmology.

[29]  Allen Foster,et al.  Vision 2020 – the Right to Sight , 2003, Tropical doctor.

[30]  S. Azen,et al.  Prevalence of open-angle glaucoma and ocular hypertension in Latinos: the Los Angeles Latino Eye Study. , 2003, Ophthalmology.

[31]  L. Ellwein,et al.  Refractive error and visual impairment in school-age children in Gombak District, Malaysia. , 2005, Ophthalmology.

[32]  J C Javitt,et al.  Preventing blindness in Americans: the need for eye health education. , 1995, Survey of ophthalmology.

[33]  Jingjing Xu,et al.  Refractive error and visual impairment in urban children in southern china. , 2004, Investigative ophthalmology & visual science.

[34]  A D Négrel,et al.  2002 Global update of available data on visual impairment: a compilation of population-based prevalence studies , 2004, Ophthalmic epidemiology.

[35]  N. Congdon,et al.  Important causes of visual impairment in the world today. , 2003, JAMA.

[36]  J. J. Wang,et al.  The prevalence of age-related maculopathy: the visual impairment project. , 2000, Ophthalmology.

[37]  A. Reunanen,et al.  A nationwide population-based survey on visual acuity, near vision, and self-reported visual function in the adult population in Finland. , 2005, Ophthalmology.

[38]  H. Taylor,et al.  Cataract blindness--challenges for the 21st century. , 2001, Bulletin of the World Health Organization.

[39]  R. Klein,et al.  Causes and prevalence of visual impairment among adults in the United States. , 2004, Archives of ophthalmology.

[40]  L. Ellwein,et al.  Prevalence and Causes of Vision Impairment and Blindness in Older Adults in Brazil: The São Paulo Eye Study , 2008, Ophthalmic epidemiology.

[41]  Rao Gn,et al.  VISION 2020. The right to sight. , 2000 .

[42]  L. Ellwein,et al.  Prevalence of visual impairment, blindness, and cataract surgery in the Hong Kong elderly , 2002, The British journal of ophthalmology.

[43]  L Dandona,et al.  Refractive error blindness. , 2001, Bulletin of the World Health Organization.

[44]  T. Wong,et al.  Management of diabetic retinopathy: a systematic review. , 2007, JAMA.

[45]  Melissa M. Brown PREVALENCE OF OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION IN LATINOS: THE LOS ANGELES LATINO EYE STUDY , 2005 .

[46]  P. Foster,et al.  The definition and classification of glaucoma in prevalence surveys , 2002, The British journal of ophthalmology.

[47]  U. Schmidt-Erfurth,et al.  Management of neovascular age-related macular degeneration , 2007, Progress in Retinal and Eye Research.

[48]  S. Gupta,et al.  A population-based eye survey of older adults in a rural district of Rajasthan: I. Central vision impairment, blindness, and cataract surgery. , 2001, Ophthalmology (Rochester, Minn.).

[49]  J E AYOUB,et al.  Eye diseases. , 1879, The Medical annual.

[50]  Serge Resnikoff,et al.  VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. , 2004, Archives of ophthalmology.

[51]  Umberto Boffa,et al.  Vision loss in Australia , 2005, The Medical journal of Australia.

[52]  D. Apple,et al.  Elimination of cataract blindness: a global perspective entering the new millenium. , 2000, Survey of ophthalmology.

[53]  Hamilton Am,et al.  Management of Diabetic Retinopathy , 1996 .

[54]  R. Pararajasegaram VISION 2020-the right to sight: from strategies to action. , 1999, American journal of ophthalmology.

[55]  H. Limburg,et al.  Review of recent surveys on blindness and visual impairment in Latin America , 2008, British Journal of Ophthalmology.

[56]  J. Hubley,et al.  Eye health promotion and the prevention of blindness in developing countries: critical issues , 2006, British Journal of Ophthalmology.

[57]  L. Ellwein,et al.  Prevalence and causes of visual impairment in low-middle income school children in Sao Paulo, Brazil. , 2008, Investigative ophthalmology & visual science.

[58]  L. Ellwein,et al.  Prevalence and causes of functional low vision in school-age children: results from standardized population surveys in Asia, Africa, and Latin America. , 2008, Investigative ophthalmology & visual science.

[59]  M. C. Leske,et al.  Patterns of open-angle glaucoma in the Barbados Family Study. , 2001, Ophthalmology.

[60]  H. Taylor,et al.  Vision loss in Australia , 2005, The Medical journal of Australia.

[61]  A Sommer,et al.  Prevention of blindness and priorities for the future. , 2001, Bulletin of the World Health Organization.

[62]  A Hofman,et al.  Risk factors for age-related macular degeneration: Pooled findings from three continents. , 2001, Ophthalmology.

[63]  R. Klein,et al.  The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. , 1998, Ophthalmology.

[64]  L. Ellwein,et al.  A population based eye survey of older adults in Tirunelveli district of south India: blindness, cataract surgery, and visual outcomes , 2002, The British journal of ophthalmology.