我国防盲与眼科流行病学研究的现状及发展

Present status and development of prevention of blindness and ophthalmic epidemiologic studies in China

2005年以来的时期是我国防盲与眼科流行病学研究进展最显著的一个时期.全国眼病和视力残疾人抽样调查发现白内障（56.7%）、视网膜葡萄膜病（14.1%）和角膜病（10.3%）是目前我国盲和视力损伤的主要原因.＂视觉第一中国行动＂二期、＂百万贫困白内障患者复明工程＂等重大防盲项目已取得巨大成就.2005年至2009年我国共施行了387.1万白内障复明手术,2009年百万人口白内障手术率达到796.2.全国已建成白内障无障碍县673个、无障碍市70个、无障碍省（自治区）2个.近5年已为175 501例低视力患者验配了助视器,为47 009例盲人提供了定向行走训练.初级眼保健和沙眼、糖尿病视网膜病变的防治也取得了一定成果.5年来,虽然基本完成了国家防盲任务,但远未达到＂视觉2020＂行动的目标要求,特别是还存在白内障手术率仍然偏低、主要致盲性眼病并未根治;流行病学研究缺少创新性、深度和广度不够等问题.今后,应切实把握好眼科流行病学的良好发展趋势,开展原创造性和分子流行病学研究;还应整合包括初级眼保健在内的各级眼保健力量,＂高质量、低价格＂地开展白内障、视网膜病、角膜病、沙眼、屈光不正、低视力、青光眼等防盲工作,争取早日达到＂视觉2020＂根治我国可避免盲的宏伟目标.

Blindness prevention and ophthalmic epidemiology studies in China have obtained greatest progress in the past five years since 2005. For example, the secondary sampling epidemiologic study of disabled persons in China in 2006 showed that the major causes of blindness and vision impairment were cataract （56.7%）, retinal and uveal diseases （14. 1% ） and corneal diseases （10.3%）. Important blindness prevention projects, such as ＂Sight first, China action＂ stage Ⅱ project and ＂Free cataract surgeries for one million poor patients＂ project, have achieved their goals. From 2005 to 2009, 3. 871millions of cataract surgeries were performed in China, and the cataract surgical rate increased to 796. 2 per million population in 2009. Cataract surgery obstacle-free areas have been built in 673 counties, 70 cities and 2 provinces since 2007. The visual performance of 175 501 low-vision patients have been improved by low-vision aids, and 47 009 blind persons have been offered walk mobility training course. Furthermore,achievements and progress have been obtained in primary eye care, prevention and treatment for trachoma,childhood eye diseases and diabetic retinopathy. These results has met the requirements established by Chinese government, but has not reached the goal of ＂Vision 2020 ＂. Certain problems still exist in China,including low cataract surgical rate, major avoidable blinding diseases not eliminated, and lack of innovative and profound epidemiological studies. Future Chinese ophthalmic epidemiology studies may focus on original investigation and molecular research. In order to realize the goal of ＂Vision 2020＂ and eliminate avoidable cataract blindness, all kinds of eye care services should be integrated, and various prevention and treatment strategies with low cost and superior quality for cataract, retinal diseases, corneal diseases, trachoma,refractive error, low vision, and glaucoma should be used.