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1.
Artigo em Inglês | MEDLINE | ID: mdl-32482781
2.
Curr Opin Ophthalmol ; 31(4): 261-267, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32487813

RESUMO

PURPOSE OF REVIEW: As keratoconus is a chronic disease affecting young people, vision-related quality of life is often significantly impaired in patients with this disease. However, successful management of keratoconus, including visual rehabilitation strategies, can improve quality of life in these patients. This review will describe clinical approaches that improve vision-related quality of life in patients with stable keratoconus. RECENT FINDINGS: Several types of contact lenses including scleral lenses have been used successfully to manage keratoconus. Eyes with severe keratoconus, even those in which fitting with other types of lenses is challenging, can be successfully fitted with scleral lenses. Although laser ablative procedures, such as photorefractive keratectomy (PRK) have been traditionally contraindicated in patients diagnosed with or suspected of having keratoconus, PRK has been attempted to partially correct refractive errors in keratoconus. Although phototherapeutic keratectomy and radial keratotomy have been reported to be used in eyes with keratoconus, effectiveness and safety results have varied. Implantation of phakic intraocular lenses and intraocular lenses, including toric intraocular lenses, which primarily correct regular astigmatism, with cataract extraction or refractive lens exchange can improve vision-related quality of life in patients with keratoconus by significantly reducing cylinder while improving uncorrected visual acuity. SUMMARY: Appropriate selection and application of treatment options based on consideration of multiple factors will help patients with keratoconus, improving their vision-related quality of life and delaying or avoiding keratoplasty.


Assuntos
Ceratocone/terapia , Qualidade de Vida/psicologia , Transtornos da Visão/reabilitação , Extração de Catarata , Lentes de Contato , Cirurgia da Córnea a Laser , Humanos , Ceratocone/psicologia , Implante de Lente Intraocular , Lentes Intraoculares Fácicas , Transtornos da Visão/psicologia , Acuidade Visual/fisiologia
3.
Br J Hosp Med (Lond) ; 81(6): 1-10, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32589541

RESUMO

Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Oftalmopatias/terapia , Unidades de Terapia Intensiva , Oftalmologia , Pneumonia Viral/terapia , Encaminhamento e Consulta , Doença Aguda , Betacoronavirus , Doenças da Túnica Conjuntiva/prevenção & controle , Doenças da Túnica Conjuntiva/terapia , Conjuntivite/prevenção & controle , Conjuntivite/terapia , Doenças da Córnea/prevenção & controle , Doenças da Córnea/terapia , Lesões da Córnea/prevenção & controle , Lesões da Córnea/terapia , Cuidados Críticos , Estado Terminal , Edema/prevenção & controle , Edema/terapia , Endoftalmite/prevenção & controle , Endoftalmite/terapia , Oftalmopatias/prevenção & controle , Glaucoma/diagnóstico , Glaucoma/terapia , Humanos , Ceratite/prevenção & controle , Ceratite/terapia , Lubrificantes/uso terapêutico , Pomadas/uso terapêutico , Pandemias , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
5.
Medicine (Baltimore) ; 99(20): e20109, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443320

RESUMO

To assess the prevalence and causes of visual impairment (VI) in the elderly Chinese rural population in Shaanxi Province.A population-based, cross-sectional study design was used to determine the extent of VI in Chinese people over the age of 50 years in Shaanxi Province. Visual acuity and best-corrected visual acuity were measured using the logarithm of minimum angle of resolution chart. Blindness and low vision were defined according to WHO criteria. The major cause of VI was identified for all participants who were visually impaired.A total of 1912 residents completed a standard questionnaire and underwent a detailed eye examination, and the response rate was 90%. The overall prevalence of blindness and low vision were 1.5% and 8.2%. There was no statistically significant differences between genders in the prevalence of blindness and low vision (P > .05). The prevalence of blindness and low vision was higher among older individuals (P < .05) and lower (P < .05) among those with the highest education level. Cataract, corneal opacity, and glaucoma were considered as the main causes of blindness, which accounted for 67.9%, 10.7%, and 7.1%, respectively. Cataract, refractive error, and age-related macular degeneration were always considered as the leading causes of low vision, which accounted for 66%, 14.7%, and 5.8%, respectively.Cataract, corneal opacity, and glaucoma were the main causes of blindness and low vision in the population aged 50 years or more. The prevalence of these diseases that causes blindness and low vision was higher than that reported in other studies.


Assuntos
Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Acuidade Visual
7.
Invest Ophthalmol Vis Sci ; 61(3): 52, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32232347

RESUMO

Purpose: To evaluate fear of falling using the Fall Efficacy Scale-International (FES-I) in glaucoma patients and investigate its association with glaucomatous visual field loss. Methods: This study included 273 patients (160 men and 113 women, average age 64.2 years) with primary open-angle glaucoma. Participants were requested to answer the FES-I questionnaire, translated into Japanese, in a face-to-face interview. The relationship between total FES-I score and the following variables was analyzed using multivariable linear regression: age, sex, better and worse best corrected visual acuity, total deviation (TD) in four visual field areas, body mass index (BMI), minutes walked per day, history of diabetes mellitus, history of systemic hypertension, number of previous falls. Results: Univariate analysis suggested that total FES-I score increased with age and in woman, whereas other variables were not significantly associated with total FES-I score. However, age (coefficient, 0.23; standard error [SE], 0.04; P < 0.001), sex (coefficient, 1.79 for women; SE, 0.84; P = 0.034), mean TD in the inferior central area (coefficient, 0.92; SE, 0.22; P <0.001), and mean TD in the inferior peripheral area (coefficient, -0.86; SE, 0.21; P < 0.001) were included in the optimal model for total FES-I score. Conclusions: Inferior peripheral visual field damage and preserved inferior central visual field sensitivity were associated with increased fear of falling assessed with FES-I in glaucoma.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Medo/psicologia , Glaucoma de Ângulo Aberto/psicologia , Transtornos da Visão/psicologia , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Inquéritos e Questionários , Tonometria Ocular , Transtornos da Visão/fisiopatologia , Acuidade Visual/fisiologia , Testes de Campo Visual
8.
PLoS Negl Trop Dis ; 14(4): e0008198, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32294081

RESUMO

INTRODUCTION: Praziquantel has been in use by helminthiasis and schistosomiasis control programs for about 30 years. Although deemed to be safe with regard to its adverse drug reaction profile in reference to the product information of Biltricide, the Eritrean Pharmacovigilance Center received reports of visual abnormalities related to the drug. This is a case series assessment of unusual cases of visual abnormalities associated with praziquantel. METHODS: Search was made in VigiBase by setting praziquantel as a drug substance, Eritrea as the reporting country and all eye disorders, high level term (HLT) to capture all visual disorders associated with Praziquantel. The retrieved dataset was exported into an Excel spreadsheet for descriptive analysis and causality was assessed using Austin Bradford-Hill criteria. RESULTS: There are a total of 2579 Individual Case Safety Reports (ICSRs) of various Adverse Drug Reactions (ADRs) of praziquantel reported from Eritrea in VigiBase. The 61 reports of visual abnormalities that arose within the first 24 hours of praziquantel administration are of note. With a strong association as evidenced by the positive IC025 value, the association of praziquantel and blurred vision was consistently reported from different health facilities over a period of three years. It is a specific association in terms of both the exposure (only praziquantel) and the outcome (blurred vision) as reported in majority of the cases. However, experimental evidences for the association are lacking, the underweight profile of the Eritrean population suggests overdosing as a possible risk factor for the occurrence of these reactions. CONCLUSION: The strength, temporal plausibility, consistency and specificity of the association are suggestive of a causal association between praziquantel and visual disorders.


Assuntos
Anti-Helmínticos/efeitos adversos , Praziquantel/efeitos adversos , Transtornos da Visão/induzido quimicamente , Transtornos da Visão/epidemiologia , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Criança , Bases de Dados Factuais , Eritreia/epidemiologia , Feminino , Helmintíase/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Farmacovigilância , Fatores de Risco , Adulto Jovem
9.
Adv Clin Exp Med ; 29(4): 469-473, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32343889

RESUMO

BACKGROUND: The effect multiple sclerosis (MS) has on the social functioning and integration of patients has been recently considered as an important factor of the disease. OBJECTIVES: To assess social participation of MS patients with regard to demographic and disease-related variables. MATERIAL AND METHODS: The study comprised 201 MS patients: 140 women, 61 men, aged 24-69 years. The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was applied to assess the aspects of social functioning and the Beck Depression Inventory (BDI) was applied to evaluate the level of depression. Disease duration, degree of disability in Expanded Disability Status Scale (EDSS), most disabling symptoms and type of treatment were determined. WHODAS 2.0 scores (total and within particular domains) and their relationships with age, gender, disease-related variables and level of depression were analyzed. RESULTS: The results of WHODAS 2.0 for 27.4% of patients exceeded the 90th percentile compared to the population norms (with the highest scores for "getting around" and "participation in society" domains). The results of BDI and WHODAS 2.0 were strongly correlated (p < 0.001; ß = 0.73) and mobility impairment was related to both of them (p < 0.001; ß = -0.12 and 0.25, respectively). Other disabling symptoms were associated with scores in domains "understanding and communicating", "getting around" and "participation in society". CONCLUSIONS: Social participation of the MS patients is affected by the impact of disease and associated with depression. Particular symptoms of neurological deficit (motor and visual impairment, fatigue) influence social functioning more than general disease-related variables.


Assuntos
Depressão/diagnóstico , Depressão/psicologia , Fadiga/diagnóstico , Esclerose Múltipla/psicologia , Qualidade de Vida , Participação Social , Adulto , Idoso , Depressão/etiologia , Avaliação da Deficiência , Pessoas com Deficiência , Fadiga/etiologia , Fadiga/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Escalas de Graduação Psiquiátrica , Perfil de Impacto da Doença , Transtornos da Visão , Adulto Jovem
12.
Medicine (Baltimore) ; 99(16): e19623, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311932

RESUMO

To report on the characteristics and outcome of management of Coats' disease, and to describe a novel surgical technique for management of stage 3B with total retinal detachment (RD) by scleral external drainage with anterior chamber (AC-maintainer) placement before the drainage without pars plana vitrectomy.A retrospective study of 26 eyes from 25 Coats' patients. Outcome measures included: demographics, presentation, laterality, stage, treatment, and outcome.The median age at diagnosis was 3.5 years. Twenty patients (80%) were males, and all except 1 girl had unilateral disease. The presenting complaint was impaired vision in 13 (50%) eyes, leukocoria in 6 (23%) eyes, and strabismus in 7 (27%) eyes. Based on the Shields classification; 3(12%) eyes were stage 1, 9 (35%) eyes were stage 2, 10 (38%) eyes were stage 3, 2 (8%) eyes were stag e4, and 2 (8%) eyes were stage 5. Primary management included cryotherapy (54%), laser photocoagulation (27%), intravitreal anti-vascular endothelial growth factor (23%), intravitreal steroids (23%), and surgical drainage (12%). The 3 eyes in stage 3B (with total exudative RD) underwent subretinal fluid drainage with AC maintainer, and all had the retina reattached completely for 6 months follow up after the surgery. At mean follow up 21 months, 4 (15%) eyes were enucleated, 19 (73%) eyes had improvement or stabilization in visual acuity.Coats' disease usually presents at advanced stage with poor visual prognosis, individualized management with close follow up are mandatory to save the eye. Subretinal fluid drainage with AC maintainer is a safe and useful technique for repairing total RD in eyes with stage 3B Coats' disease.


Assuntos
Crioterapia , Drenagem/instrumentação , Fotocoagulação a Laser , Descolamento Retiniano/terapia , Telangiectasia Retiniana/terapia , Adolescente , Câmara Anterior/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Injeções Intravítreas , Masculino , Descolamento Retiniano/etiologia , Telangiectasia Retiniana/complicações , Estudos Retrospectivos , Esclera/cirurgia , Índice de Gravidade de Doença , Esteroides/administração & dosagem , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Transtornos da Visão/etiologia , Acuidade Visual
13.
Medicine (Baltimore) ; 99(16): e19875, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32312013

RESUMO

INTRODUCTION: Systemic lupus erythematosus (SLE) is a multisystem, chronic, autoimmune disease which can affect any organ system including the eye. About one-third of the patients can be diagnosed with SLE-related eye involvement which is usually indicative of disease activity. Retinopathy is one of the most vision-threatening complications that can be associated with the disease. PATIENT CONCERNS: An 11-year-old girl was hospitalized with complains of repeated swelling and pain in her extremities for 1 month, chest pain for 24 days, rash for 5 days and proteinuria for 1 day. On the morning of her fourth day in hospital, she suddenly complained of sudden, painless vision loss in the left eye. The ophthalmologist found that she had obstruction of central retinal vein and artery with diffuse retinal hemorrhages and macular edema. DIAGNOSIS: The patient was diagnosed with systemic lupus erythematosus, lupus nephritis, and lupus retinopathy through her clinical manifestations and laboratory tests. INTERVENTIONS: After diagnosis, she received steroid therapy, retinal laser photocoagulation, and intravitreal injection of dexamethasone (OZURDEX, Allergan Pharmaceuticals, Dublin, Ireland) early in her course. OUTCOMES: At the latest follow-up, her vision improved partially. However, she still has the possibility of subsequent neovascular glaucoma and bleeding in the future. CONCLUSIONS: An early diagnosis and the prompt therapeutic measures are necessary to prevent sight-threatening consequences, especially in pediatric patients with SLE.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Doenças Retinianas/etiologia , Doenças Retinianas/terapia , Transtornos da Visão/etiologia , Criança , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Feminino , Glaucoma Neovascular/epidemiologia , Glaucoma Neovascular/etiologia , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Hemorragia , Humanos , Injeções Intravítreas , Fotocoagulação a Laser/métodos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/patologia , Nefrite Lúpica/complicações , Nefrite Lúpica/diagnóstico , Edema Macular , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/etiologia , Doenças Retinianas/patologia , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/etiologia , Resultado do Tratamento
14.
Strabismus ; 28(1): 7-12, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32301677

RESUMO

Objective: Acute acquired concomitant esotropia (AACE) is a distinct subtype of esotropia. The purpose of this retrospective study was to describe the clinical characteristics and discuss the diagnostic and therapeutic management, and evaluate the effect of prism treatment.Methods: The records of 30 patients who presented with acute-onset diplopia at the General Hospital of Central Theater Command from August 2015 to November 2018 were reviewed. All patients underwent a complete medical history, ophthalmological and orthoptic examinations, and brain and orbital imaging. The patients were followed up between 2 and 8 months (mean 3.9 ± 1.2). Angle of strabismus, refractive error, stereopsis, and results of treatment with prisms were analyzed. Level of stereopsis was assessed before and after prismatic correction. Patient satisfaction was assessed with a telephone follow-up survey.Results: The mean age of the 30 patients was 29.7 ± 10.3 years (range 14-52). All patients complained about uncrossed diplopia, only at distance. The esophoria was concomitant in all cases ranging from 12 to 60 prism diopters (PD) at distance (mean 35.80 ± 14.17) and from 10 to 46 PD at near (mean 26.23 ± 11.46) (t = 6.51, P <.001). Cycloplegic spherical-equivalent refraction averaged -5.25 ± 1.67 D (range -0.50 to -8.13), 28 patients were myopic and 2 were emmetropic, all did not wear glasses for near work. All patients received brain and orbital computed tomography scans and magnetic resonance imaging and, in some cases, neurological examinations were performed. All of these examinations were normal. In 27 out of 30 patients treated with prisms, the diplopia resolved, whereas three patients were not satisfied with prismatic correction and underwent surgery. With prisms the esophoria was concomitant, ranging from 6 to 23 PD at distance fixation and from 4 to 18 PD at near fixation. Out of 30 patients, 23 patients were satisfied, 3 patients were not satisfied because their vision remained uncomfortable and 4 patients had an intermediate score.Conclusion: AACE was characterized by a sudden onset of concomitant non-accommodative esotropia with diplopia or visual confusion. In most cases, prismatic correction had a favorable effect with a resolution of diplopia. It offers a good treatment alternative in the early stage, when the angle of strabismus is unstable and surgery is not without risk.


Assuntos
Diplopia/terapia , Esotropia/terapia , Óculos , Transtornos da Visão/terapia , Doença Aguda , Adolescente , Adulto , Percepção de Profundidade/fisiologia , Diplopia/fisiopatologia , Esotropia/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Transtornos da Visão/fisiopatologia , Testes Visuais , Acuidade Visual/fisiologia , Adulto Jovem
16.
Pan Afr Med J ; 35: 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32117517

RESUMO

We report a case of sight threatening vitreous haemorrhage and retinal detachment as complication of sickle cell disease (SCD). A 35 years old female Nigerian patient had presented to ophthalmology clinic of Princess Marina Hospital, Botswana, with two weeks history of poor vision in the left eye. The loss of vision was due to vitreous haemorrhage and retinal detachment which was confirmed by direct and indirect ophthalmoscopy and B-Scan ultrasound. Prior to presentation, patient didn't have any follow up by an ophthalmologist as part of regular medical care for patients with SCD. We emphasize the importance of regular follow up for early detection, treatment and prevention of complication associated with sickle cell disease.


Assuntos
Anemia Falciforme/complicações , Descolamento Retiniano/diagnóstico , Hemorragia Vítrea/diagnóstico , Adulto , Feminino , Humanos , Oftalmoscopia , Descolamento Retiniano/etiologia , Ultrassonografia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Hemorragia Vítrea/etiologia
18.
Invest Ophthalmol Vis Sci ; 61(3): 30, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32186671

RESUMO

Purpose: To investigate the association between balance and gait measures with fall rates in glaucoma patients. Methods: Balance and gait were measured for 239 participants with glaucoma or suspected glaucoma. Daily falls were evaluated over 24 months. Annual accelerometer trials captured average daily steps. Multivariable negative binomial models evaluated balance and gait associations with average daily steps and rates of falls per time or step, as well as whether balance and gait parameters mediated the association between integrated visual field (IVF) sensitivity and falls. Results: Average age was 70.5 years (SD = 7.6), and 22% of the participants had moderate to severe visual field damage. Over the first 12 months of the follow-up, the cumulative probability of falling one or more times was 44.8%, and the cumulative probability of falling two or more times was 17.7%. Gait deficits were associated with fewer daily steps (P < 0.03), but no balance parameters were (P > 0.19). Worse balance was associated with a higher rate of falls per year and step (P < 0.03). No gait measures were associated with the rate of falls per year (P > 0.17). More time in double support and greater swing time variability were associated with higher falls per step, and higher velocity and faster cadence were associated with fewer falls per step (P < 0.05 for all). Neither gait nor balance measures mediated the relationship between visual field damage and fall rates. IVF remained an independent predictor of falls per step (rate ratio = 1.36 to 1.48; P < 0.001 to P < 0.005) in multivariable models including individual balance/gait parameters. Conclusions: Although balance and gait measures are associated with fall rates, they do not explain why persons with greater visual field damage fall more frequently, suggesting the importance of other potential factors such as hazard perception.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Marcha/fisiologia , Glaucoma/fisiopatologia , Equilíbrio Postural/fisiologia , Idoso , Feminino , Glaucoma/epidemiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/epidemiologia , Hipertensão Ocular/fisiopatologia , Estudos Prospectivos , Medição de Risco , Inquéritos e Questionários , Transtornos da Visão/epidemiologia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia
19.
Arq Bras Oftalmol ; 83(1): 48-54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130306

RESUMO

PURPOSE: To study the cost-effectiveness of ranibizumab and bevacizumab for the treatment of age-related macular degeneration. METHODS: We used a decision tree model to analyze the cost-effectiveness of ranibizumab and bevacizumab for the treatment of age-related macular degeneration, from the Brazilian Public Health System (SUS) perspective. Ranibizumab and bevacizumab were administered to patients with the same treatment procedure, and the difference in treatment costs was calculated based on the cost of the drugs. Direct costs were estimated using the information provided by the Brazilian SUS. Effectiveness in terms of quality-adjusted life years (QALYs) was calculated based on the utility values for visual impairment. Incremental cost-effectiveness ratio was calculated by comparing both treatments. The analytical horizon was one year. RESULTS: The decision tree analysis showed that the difference in treatment effectiveness was 0.01 QALY. Incremental cost-effectiveness ratio showed that ranibizumab treatment required an incremental annual cost of more than R$ 2 million to generate 1 additional QALY, as compared to bevacizumab. CONCLUSIONS: From the Brazilian SUS perspective, bevacizumab is more cost-effective than ranibizumab for the treatment of neovascular age-related macular degeneration. Its use could allow potential annual savings in health budget.


Assuntos
Inibidores da Angiogênese/economia , Bevacizumab/economia , Ranibizumab/economia , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/economia , Inibidores da Angiogênese/administração & dosagem , Bevacizumab/administração & dosagem , Brasil , Análise Custo-Benefício , Custos de Medicamentos/estatística & dados numéricos , Custos de Cuidados de Saúde , Humanos , Programas Nacionais de Saúde , Anos de Vida Ajustados por Qualidade de Vida , Ranibizumab/administração & dosagem , Acuidade Visual
20.
PLoS One ; 15(3): e0229108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32126114

RESUMO

BACKGROUND: Uncorrected refractive error (URE) is a major cause of vision impairment among children that impacts negatively on their lives including distresses. We aim to understand the disability-related distress among vision-impaired children due to URE in rural and semi-rural South Africa using qualitative techniques. METHODS: Structured focus groups of children (aged 5-12 years old) with normal vision and vision impairment due to URE from four schools in Pinetown, KwaZulu Natal, South Africa, were performed (four mixed-gender group discussions and eight single gender group discussions). We recruited the study participants after the children underwent standardised vision screening. Criterion sampling was used when selecting study participants. The interviews were transcribed to identify meaning units and broken down to condensed meaning units, which were then grouped into megathemes. Themes were then generated. RESULTS: Thirteen children with normal vision and 63 children with vision impairment due to URE participated in the twelve focus group discussions with 36 boys (47%) and 40 girls (53%). Twelve themes were generated. The megathemes were Loss of Self Confidence (number of themes (n) = 3), Loss of self-worth (n = 3), Loss of interconnection/ interaction with community (n = 2), Humiliation (n = 2) and Discrimination (n = 2). CONCLUSIONS: We found that vision impairment due to URE can cause distress in different domains in children's life and further grouped them into different themes. The themes will be used for the development of a tool to assess disability-related distress among children with vision impairment due to URE. We also recommend that distresses caused by URE should be taken into consideration when designing eye care programmes for children.


Assuntos
Pessoas com Deficiência/psicologia , Angústia Psicológica , Erros de Refração/epidemiologia , Estresse Psicológico/epidemiologia , Estudantes , Transtornos da Visão/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Erros de Refração/complicações , Erros de Refração/psicologia , População Rural/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , África do Sul/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Transtornos da Visão/etiologia , Transtornos da Visão/psicologia
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