Search

Objectives. We assessed global inequality in eye health by using data on the global burden of disease measured in disability-adjusted life years (DALYs). Methods. We estimated the burden of eye disease by calculating the sum of DALYs (from the Global Burden of Disease study, 2004 update) due to trachoma, vitamin A deficiency, glaucoma, cataract, refractive errors, and macular degeneration. We assessed the geographic distribution of eye disease in relation to economic status and etiology by calculating the Gini coefficient, the Theil index, and the Atkinson index. Results. The global burden of eye disease was estimated at 61.4 million DALYs worldwide (4.0% of total DALYs). Vitamin A deficiency and trachoma were distributed more unevenly than were noncommunicable eye diseases, regardless of economic status. For noncommunicable eye diseases, the major contributor was refractive errors, regardless of economic status. The most uneven distribution was observed for cataract (high-income countries) and refractive errors (middle- and low-income countries). Conclusions. Creating new eye health service for refractive errors and reducing the unacceptable eye health disparity in refractive errors should be the highest priorities for international public health services in eye care and eye health. [ABSTRACT FROM AUTHOR]

The author discusses the public health crisis of uncorrected vision and details her efforts to address it via the coalition EYElliance designed to increase access to eyeglasses.

Objectives. The validity {sensitivity and specificity) of a preschool vision screening program was measured over a 3-year period to determine how well strabismus and significant refractive errors could be detected. Methods, Public health nurses were trained to administer tests of visual acuity, stereoacuity, and ocular alignment. Failure on any test, visual acuity of 6/9 or less, stereoacuity of less than 100 seconds of arc, or an apparent misalignment of the eyes resulted in referral to an eye care practitioner. An age-matched control was also referred. Analysis of practitioner reports used predefined study-based criteria for ocular abnormalities. Results. More than 1100 children were screened each year. The annually calculated prevalence of vision problems ranged between 10.5% and 13.8%. The estimated sensitivity varied from 60.4% to 70.9% (specificity, 69.6% to 79.9%). The yield indicated that a very high percentage of children with vision problems were identified for the first time. Conclusions. The validity of this screening is comparable to that of other school screenings. The limitations are predictable. Consideration should be given to replacing visual acuity tests with a rapid, objective measure of refractive error and ocular alignment. [ABSTRACT FROM AUTHOR]

Survey questions are frequently used to collect data on the prevalence of vision difficulties. The 1971-1972 Health and Nutrition Examination Survey included both a question about ‘trouble with your vision even when wearing glasses or contact lenses,’ and clinical measurement of central distance visual acuity with usual corrective lenses. The question had low sensitivity for impairment of visual acuity, with variation by age and severity of impairment. Sensitivity analyses from other studies are reviewed. [ABSTRACT FROM AUTHOR]

Abstract: Thirty-two pairs of inexpensive sunglasses were examined for their effectiveness in preventing ultraviolet radiation (UVR) from reaching the eyes. The transmission of UVB (290-310 nm) by all of the sunglass lenses was < 2 per ¢. However, in measurements performed with mannikins wearing the sunglasses, up to 14.1 per ¢ of the incident UVR passed through to the eyes. When the sunglasses were moved 6 mm from the forehead, the per ¢ reaching the eyes ranged from 3.7 to 44.8 per ¢. Although sunglasses are somewhat more effective than untinted prescription eyewear in attenuating ocular exposure, the amount of attenuation is highly variable and depends mainly on their size, shape, and wearing position. [ABSTRACT FROM AUTHOR]

Early detection and treatment of diabetic eye disease can prevent blindness, yet many persons with diabetes lack regular eye care. This study followed 569 people with diabetes participating in blindness prevention programs during 1984 through 1987; it was found that 35% of subjects received dilated eye examination before entering the programs, in comparison with 60% afterward. About 85% of participants referred for proliferative retinopathy treatment began such treatment, and, of these, 85% completed treatment. A lack of knowledge about the disease and limited finances were primary reasons for non-adherence. To improve the effectiveness of prevention programs, eye care providers and program staff must strive to eliminate these educational and financial barriers. [ABSTRACT FROM AUTHOR]

We studied reasons for the improvement in the functional vision of enrollees receiving free care in the Rand Health Insurance Experiment. Among low income enrollees, 78 per cent on the free plan and 59 per cent on the cost-sharing plans had an eye examination; the proportions of those obtaining lenses were 30 per cent and 20 per cent, respectively. Visual acuity outcomes of low income vs non-poor enrollees were more adversely affected by enrollment in cost-sharing plans. Free care resulted in improved vision by increasing the frequency of eye examinations and lens purchases. (Am J Public Health 1989; 79:640-642.) [ABSTRACT FROM AUTHOR]

The article offers information on the Saint John Eye Hospital in east Jerusalem. It is stated to be a bridge for peace in a world at war. It serves as the main center for specialized eye care in the West Bank, Gaza, and east Jerusalem. The eye hospital started in 1882, and was then located in Ottoman Empire Jerusalem. It closed in 1914, during World War I, but reopened in 1919. It is said to be the only public hospital in the region specializing in ophthalmology. It is stated to place a high priority on training local doctors and nurses. Patients are predominantly Palestinians. The hospital operates a number of satellite clinics in areas where public services are not easily available. It works to eliminate the main causes of preventable blindness.

A letter to the editor is presented in response to the article "Diagnostic X-Ray Exposure and Lens Opacities: The Beaver Dam Eye Study," that was published in the April 1993 issue.

The article reports on the announcement of Vision Care Section of the American Public Health Association in the U.S. of its awards program for 1987. The association solicits nominations in the three categories of awards including distinguished achievement, outstanding student and outstanding paper or project. The distinguished achievement award is the highest honor bestowed by the Vision Care Section, designed to recognize the leaders in vision care and public health. The outstanding student award provides recognition to a student who has demonstrated the ability in the promotion of vision care in the public health field. The paper or project award is designed to recognize an individual, institution, or group that have significantly contributed to the advancement of vision care.

The article discusses the provisions on vision care in national health programs of the American Public Health Association in the U.S. The policies identify issues such as that vision health care problems are second most evident chronic health difficulty in the U.S. It also notes that there are only one-half of the population who receive eye or vision care from any source. It is recommended to support the preventive vision health services in any national health insurance of national health service program.

The article discusses optometry in the hospital. A wide variety of important eye care services are provided by optometrists, including vision screening and eye examination, contact lens fitting, glaucoma screening, orthoptics, and visual field testing. On the other hand, ophthalmologists are the bona fide medical specialists for the eye-diagnosing and treating eye diseases and performing eye surgery. There is interprofessional rivalry between optometrists and ophthalmologists. The problem arises from the fact that both professions share many of the same functions like vision testing, eye examination, and prescribing eyeglasses. Ophthalmologists take the position that optometry should be limited to refraction, prescribing and adjusting glasses, and providing optical devices, while optometrists feel that their role is considerably broader, including that of offering primary eye care services and ocular pathology screening, as well as detecting eye abnormalities that include ocular manifestations of systemic disease. It would appear that if adequate and comprehensive eye care is to be available to the entire population, the services of both professions will have to be effectively deployed and utilized.

The article presents policy statements adopted by the Governing Council of the American Public Health Association on November 1, 1995. Included in the policy statements are opposition to anti-immigrant statutes, improving access to vision and eye health services for long-term care facility residents, support for disabilities prevention activities, promotion of quality fitted mouthguards for oro-facial injury prevention, public health and community electronic networks, and full employment and public health.