Evaluation of the etiologies and rehabilitation status of patients with blindness: A prospective observational study

Objective:Preventive measures and appropriate rehabilitation are important in reducing the social burden of blindness.This study was to evaluate the etiologies,proportions,and level of rehabilitation for patients with blindness.Materials and Methods:A prospective observational study with 1000 visually impaired patients was conducted.The data regarding age,gender,socioeconomic status(SES),etiologies,curable or incurable blindness(IB),treatments,awareness,and state of rehabilitation were collected and reviewed.Results:The ratio of curable to IB was 0.82:1.The proportion of blindness rises after 40,even while the proportion of curable blindness(CB)increases after 60.The male–female ratios were 1.25:1 and 1:1.66 in the cases of CB and IB,respectively.On the other hand,the male–female ratio for childhood blindness was 1.66:1.Cataracts(78.22%)were the most common cause of CB,whereas diabetic retinopathy(24%),corneal opacity(17.5%),and trauma(12.4%)were causes of IB.Patients with illiteracy,low SES,and female gender were more likely to develop IB.There were low enrollment rates at the blind school and poor rehabilitation,mainly because of a lack of knowledge.Conclusion:Diabetic retinopathy,corneal opacity,and trauma are the major causes of IB.IB and poor rehabilitation were more profound in women and were associated with illiteracy,low SES,and a lack of awareness.

The Cultural Paradigm of Visuality in Times of Blindness

Visuality can be generically described as the quality of the visual,that is,as the given visual field in which a subject’s attention is concentrated.In fact,the visual is intrinsically linked to human vision,and this presupposes the existence of a visible horizon from which(visual)images are given.However,this formulation presents something uncanny paradoxical because it forgets,on one hand,the broader status of the image(such as auditory and olfactory images)-seeing is not just a visual process(at least since Diderot we know it)and there are mental mechanisms in the visual constitution process that help to fabricate reality and that gestalt theory has explained-and on the other hand,the possibility of seeing beyond what is visible,after all,everything(or almost everything)that presents itself in a digital and virtual environment it can be quite ontologically suspect.Based on some of these premises,we will trace a path of analysis that leads us to the current blindness:unconditional faith in digital technology and the fragile hope of happiness in a way that rejects the reality of the visible.

Countermeasure against blinding attack for single-photon detectors in quantum key distribution

Quantum key distribution(QKD),rooted in quantum mechanics,offers information-theoretic security.However,practi-cal systems open security threats due to imperfections,notably bright-light blinding attacks targeting single-photon detectors.Here,we propose a concise,robust defense strategy for protecting single-photon detectors in QKD systems against blinding attacks.Our strategy uses a dual approach:detecting the bias current of the avalanche photodiode(APD)to defend against con-tinuous-wave blinding attacks,and monitoring the avalanche amplitude to protect against pulsed blinding attacks.By integrat-ing these two branches,the proposed solution effectively identifies and mitigates a wide range of bright light injection attempts,significantly enhancing the resilience of QKD systems against various bright-light blinding attacks.This method forti-fies the safeguards of quantum communications and offers a crucial contribution to the field of quantum information security.

A quantum blind signature scheme based on dense coding for non-entangled states

In some schemes, quantum blind signatures require the use of difficult-to-prepare multiparticle entangled states. By considering the communication overhead, quantum operation complexity, verification efficiency and other relevant factors in practical situations, this article proposes a non-entangled quantum blind signature scheme based on dense encoding. The information owner utilizes dense encoding and hash functions to blind the information while reducing the use of quantum resources. After receiving particles, the signer encrypts the message using a one-way function and performs a Hadamard gate operation on the selected single photon to generate the signature. Then the verifier performs a Hadamard gate inverse operation on the signature and combines it with the encoding rules to restore the message and complete the verification.Compared with some typical quantum blind signature protocols, this protocol has strong blindness in privacy protection,and higher flexibility in scalability and application. The signer can adjust the signature operation according to the actual situation, which greatly simplifies the complexity of the signature. By simultaneously utilizing the secondary distribution and rearrangement of non-entangled quantum states, a non-entangled quantum state representation of three bits of classical information is achieved, reducing the use of a large amount of quantum resources and lowering implementation costs. This improves both signature verification efficiency and communication efficiency while, at the same time, this scheme meets the requirements of unforgeability, non-repudiation, and prevention of information leakage.

Quantum circuit-based proxy blind signatures:A novel approach and experimental evaluation on the IBM quantum cloud platform

This paper presents a novel approach to proxy blind signatures in the realm of quantum circuits,aiming to enhance security while safeguarding sensitive information.The main objective of this research is to introduce a quantum proxy blind signature(QPBS)protocol that utilizes quantum logical gates and quantum measurement techniques.The QPBS protocol is constructed by the initial phase,proximal blinding message phase,remote authorization and signature phase,remote validation,and de-blinding phase.This innovative design ensures a secure mechanism for signing documents without revealing the content to the proxy signer,providing practical security authentication in a quantum environment under the assumption that the CNOT gates are securely implemented.Unlike existing approaches,our proposed QPBS protocol eliminates the need for quantum entanglement preparation,thus simplifying the implementation process.To assess the effectiveness and robustness of the QPBS protocol,we conduct comprehensive simulation studies in both ideal and noisy quantum environments on the IBM quantum cloud platform.The results demonstrate the superior performance of the QPBS algorithm,highlighting its resilience against repudiation and forgeability,which are key security concerns in the realm of proxy blind signatures.Furthermore,we have established authentic security thresholds(82.102%)in the presence of real noise,thereby emphasizing the practicality of our proposed solution.

A Blind Batch Encryption and Public Ledger-Based Protocol for Sharing Sensitive Data

For the goals of security and privacy preservation,we propose a blind batch encryption-and public ledger-based data sharing protocol that allows the integrity of sensitive data to be audited by a public ledger and allows privacy information to be preserved.Data owners can tightly manage their data with efficient revocation and only grant one-time adaptive access for the fulfillment of the requester.We prove that our protocol is semanticallly secure,blind,and secure against oblivious requesters and malicious file keepers.We also provide security analysis in the context of four typical attacks.

For LEO Satellite Networks: Intelligent Interference Sensing and Signal Reconstruction Based on Blind Separation Technology

In LEO satellite communication networks,the number of satellites has increased sharply, the relative velocity of satellites is very fast, then electronic signal aliasing occurs from time to time. Those aliasing signals make the receiving ability of the signal receiver worse, the signal processing ability weaker,and the anti-interference ability of the communication system lower. Aiming at the above problems, to save communication resources and improve communication efficiency, and considering the irregularity of interference signals, the underdetermined blind separation technology can effectively deal with the problem of interference sensing and signal reconstruction in this scenario. In order to improve the stability of source signal separation and the security of information transmission, a greedy optimization algorithm can be executed. At the same time, to improve network information transmission efficiency and prevent algorithms from getting trapped in local optima, delete low-energy points during each iteration process. Ultimately, simulation experiments validate that the algorithm presented in this paper enhances both the transmission efficiency of the network transmission system and the security of the communication system, achieving the process of interference sensing and signal reconstruction in the LEO satellite communication system.

Population-based survey of prevalence,causes,and risk factors for blindness and visual impairment in an aging Chinese metropolitan population

AIM： To assess the prevalence, causes, and risk factors for blindness and visual impairment among elderly （〉60 years of age） Chinese people in a metropolitan area of Shanghai, China. METHODS： Random cluster sampling was conducted to identify participants among residents ≥60 years of age living in the Xietu Block, Xuhui District, Shanghai, China. Presenting visual acuity （PVA） and best-corrected visual acuity （BCVA） were checked by the Early Treatment Diabetic Retinopathy Study （ETDRS） visual chart. All eligible participants underwent a comprehensive eye examination. Blindness and visual impairment were defined according to World Health Organization （WHO） criteria. RESULTS： A total of 4190 persons （1688 men and 2502 women） participated in the study, and the response rate was 91.1%. Based on PVA, the prevalence of blindness was 1.1% and that of visual impairment was 7.6%. Based on BCVA, the prevalence of blindness and visual impairment decreased to 0.9% and 3.9%, respectively. Older （〉80 years of age） women, with low educational levels and smoking habits, exhibited a significantly greater chance for blindness and visual impairment than did those with high educational levels and no smoking habits （P〈0.05）. Based on PVA and BCVA, the main causes of blindness were cataract, myopic maculopathy, and age-related macular degeneration （AMD）. CONCLUSION： Our findings help to identify the population in need of intervention, to highlight the need for additional eye healthcare services in urban China.

Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet

AIM: To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes.METHODS: We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questio-nnaire, and underwent presenting and pinhole visual acuity tests,and a comprehensive ophthalmic examination.RESULTS: There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41% ). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet.CONCLUSION: The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.

Unrecognized and unregistered blindness in people 70 or older in Jing'an district, Shanghai, China

AIM: To evaluate the efficacy of a registration system for the blind people and to monitor the blindness due to uncorrected refractive error and cataract in Jing’an district, Shanghai, China. ·METHODS: Five hundred and ten blind people, based on visual acuity screening in a population aged 70 or older were enrolled into the study. Four hundred and forty subjects were interviewed. The following data were collected on each patient: demographic data, number of hospital visits for eye related problems, distance visual acuity, visual fields, ophthalmic diagnoses, education and registration status. If the eligible subject was not registered as blind, the reason for non -registration was recorded. ·RESULTS: Ten point nine one percent blindness was due to cataract, 27.5% due to uncorrected refractive error, and only 61.59% met the eligible blindness criteria (uncorrected refractive error and cataract are not considered as eligible blindness). The first four leading causes of eligible blindness were age related macular degeneration (25.09% ), myopic macular degeneration (21.40%), glaucoma (18.82%) and corneal disease (8.12%). Only 68.27% eligible blind people were registered. The patients with macular degeneration and glaucoma tendednot to register. Blind people with an above primary school education were 2.59 times more likely to be registered than those who were illiterate or had only a primary school education (OR=2.59, 95%CI: 1.49-4.48, P 【0.01). Patients who had 4 or more visits to the hospital requesting eye care services in a year were 2.2 times more likely to be registered than those with less than 4 visits to the hospital (OR =2.54, 95% CI: 1.47 -4.38, P 【 0.001). The first two leading reasons of misregistration were unknowing the registration system (48% ) and unwilling to register (21%). ·CONCLUSION: Under-registration of the eligible blind people exists in the registry system. Education and the number of hospital visits for eye care services were factors associated with registration levels. Uncorrected refractive error and cataract are important causes of blindness.

Mayombian ethnic,vegetables low intake,insulin treatment,diabetic nephropathy and severe diabetic retinopathy are determinants of blindness in diabetic Africans

· AIM: to determine the frequency and causes of blindness in diabetic Africans. ·METHODS: The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching Hospital, University of Kinshasa, between 2005 and 2007. Examination methods included interviewer -administered structured question - naire, eye examinations (visual acuity, tonometry, funduscopy), and fasting plasma glycaemia test. ·RESULTS: Of the 227 patients examined, 15.9% had blindness. Univariate analyses showed significant association between female, severity of diabetic retinopathy, Mayombian ethnic group, use of insulin treatment, low intake of vegetables, diabetic nephropathy, open angle glaucoma and blindness in all diabetics. After logistic regression, only diabetic nephropathy, use of insulin treatment, macular oedema, Mayombian ethnic group and vegetables low intake were the independent risk factors of blindness in all diabetics. However, after logistic regression in the sub -group with diabetic retinopathy, only open angle glaucoma and proliferative diabetic retinopathy were the independent determinants of blindness.·CONCLUSION: The majority of the causes of blindness in these diabetic Africans are avoidable. It is recommended that appropriate diabetes care, nutrition education, periodic eye examination and laser photocoagulation facilities should be provided for treating diabetics in sub-Saharan Africa. ·

Novel TRPM1 mutations in two Chinese families with early-onset high myopia, with or without complete congenital stationary night blindness

AIM：To investigate the relationship between high myopia [with or without complete congenital stationary night blindness（CSNB1）] and TRPM1 and NYX.METHODS： Two unrelated families with early-onset high myopia（eo HM） and 96 normal controls were recruited.Sanger sequencing or clone sequencing were used for mutation screening.Further analyses of the available family members and the 96 normal controls were subsequently conducted to obtain additional evidence of the pathogenicity of these variants.The initial diagnosis of the probands was eo HM.We performed a further comprehensive examination of the available family members after mutations were detected in TRPM1 or NYX. RESULTS： Two novel compound heterozygous mutations in TRPM1 were detected in the recruited families.The proband in family A with eo HM carried a c.2594 C 〉T missense mutation in exon 19 and a c.669 ＋3_669 ＋6del AAGT splicing mutation,which was co-segregated with CSNB1 in this family.A patient in family B with a compound heterozygous missense mutation（c.3262 G〉A and c.3250 T〉C） was detected.No mutations were found in NYX.These two identified compound heterozygous mutations were not found in the 96 normal controls.After further examination of the family members,the patients in family A could be diagnosed as eo HM with CSNB1.However due to the limited clinic data,the patient in family B cloud not clearly diagnosed as CSNB1.CONCLUSION： This study has expanded the mutation spectrum of TRPM1 for CSNB1 and additional studiesare needed to elucidate the association between isolated high myopia and TRPM1 and NYX.

The Association of Socioeconomic Status with the Burden of Cataract-related Blindness and the Effect of Ultraviolet Radiation Exposure: An Ecological Study

Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.

The Prevalence of Blindness, Visual Impairment and Cataract Surgery in Tuoketuo and Shangdu Counties, Inner Mongolia, China

Aim: A population-based survey was conducted in Tuoketuo and Shangdu Counties in Inner Mongolia Autonomous Region, China, in the Autumn of 2010, to assess the prevalence and causes of blindness and visual impairment of people aged 50 years and over. Methods: Random cluster sampling was used to select 82 clusters of 50 residents in the 2 counties. Each survey team included an ophthalmologist, a nurse and a coordinator, who went to door to door in each cluster to identify eligible people. A torch, direct ophthalmoscope and portable slit lamp were used for eye examination. Visual acuity (VA) was tested for each eye of every subject. Those with VA below 6/18 in either eye were examined and causes identified. Results: The survey identified a prevalence of blindness in people aged 50+ in Tuoketuo of 1.2% (95% Confidence Interval: 0.7% - 1.7%) and in Shangdu of 1.4% (95% CI: 1.0% - 1.9%). Cataract was identified as the leading cause of blindness (BL) and severe visual impairment (SVI), and uncorrected refractive errors were the major causes of moderate visual impairment (MVI) in both counties. Over two thirds of blindness, SVI and MVI were identified as avoidable. Conclusions: The prevalence of blindness in people aged 50+ in Tuoketuo and Shangdu was low compared to other studies conducted in China [1] [2]. The prevalence of blindness of people aged 50 years and over could be reduced by up to two thirds through better eye services in the two study areas.

Prevalence and associated factors of corneal blindness in Ningxia in northwest China

AIM:To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia,located in the northwest part of China.METHODS:A stratified,randomized sampling procedure was employed in the study,including urban and rural area of all age group.Visual acuity,anterior segment and ocular fundus were checked.Related factor of corneal disease,including age,gender,education status,ethnic group,location and occupation,were identified according to uniform customized protocol.An eye was defined to be corneal blindness if the visual acuity was【20/400 due to a corneal disease.RESULTS:Three thousand individuals(1290 from urban area and 1710 from rural area)participated in the investigation,with a response rate of 80.380%.The prevalence of corneal blindness was 0.023%in both eyes and 0.733%in at least one eye.The blindness in at least one eye with varied causes was present in 106participants(3.533%)and in bilateral eyes in 34participants(1.133%).The corneal diseases accounted for 20.754%of blindness in at least one eye and 20.588%of bilateral blindness.The prevalence of corneal disease was higher in older and Han ethnic group,especially those who occupied in agriculture and outdoor work.People with corneal blindness were more likely to be older and lower education.Rural population were more likely to suffer from bilateral corneal blindness than the urban population in≥59-year group(χ2=6.716,P=0.019).Infectious,trauma and immune corneal disease were the three leading causes of corneal disease.Trauma cornealdisease was more likely leading to blindness in one eye.However,infectious and immune corneal diseases make more contribution to the bilateral corneal blindness.CONCLUSION:Corneal blindness is a significant burden of in Ningxia population,encompassing a variety of corneal infections and trauma;the majority of those were avoidable.Health promotion strategies and good hygienic conditions have to be developed.

Eye health is everyone's responsibility: China's first Western-style eye hospital improves in the prevention of blindness

AIM: To investigate the relationship between China's first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today. METHODS: Data about eye health, blindness and cataract surgery rate of China from public website of World Health Organization (WHO), ORBIS International, Ministry of Health (MOH) of China, Pubmed center and Historical Archives of Zhongshan Ophthalmic Center (ZOC) were reviewed and analyzed. RESULTS: ZOC is China's first Western-style eye hospital. In 2012, the ORBIS Flying Eye Hospital has chosen ZOC once again as one of its destinations, 30 years after ORBIS expanded internationally to train eye care professionals and treat underserved patients in developing countries in 1982. During the past 30 years, cataract surgery rate and public awareness of blindness prevention were improved greatly in China, in which ZOC plays a very important role. CONCLUSION: ZOC, as China's first Western-style eye hospital,has improved in the prevention of blindness. Eye health has become everyone’s responsibility.

Cataract blindness in Hungary

AIM:To estimate the prevalence of blindness and visual impairment resulting from cataract in the population aged≥50 y in Hungary,and to assess the cataract surgical services.METHODS:A rapid assessment of avoidable blindness(RAAB)was conducted.A total of 3523 eligible people were randomly selected and examined.Each participant underwent surgery for cataract was interviewed with regard to the year,place,and costs of the surgery.Participants with obvious cataract were asked why they had not yet undergone surgery(barriers to surgery).RESULTS:An estimated 12514 people were bilaterally blind;the visual acuity(VA)in 19293 people was<6/60,and the VA in 73962 people was<6/18 in the better eye due to cataract.An estimated 77933 eyes are blind;98067 eyes had a VA of<6/60,and an estimated 277493 eyes had a VA of<6/18 due to cataract.Almost all cataract surgeries were conducted in government hospitals.The age-and sexadjusted cataract surgical coverage with VA<3/60 in eyes was 90.0%.The rate of good visual outcome after surgery was 79.5%.Ocular comorbidity was the main cause of poor outcome(78.1%),followed by late complications(such as posterior capsule opacification)(17.2%),inadequate optical correction(3.1%),and surgical complications(1.6%).The main barrier to surgery in people with bilateral cataract and VA of<6/60 was‘need not felt’.CONCLUSION:The prevalence of visual impairment resulting from cataract is slightly higher than expected.The quality of the cataract surgical service seems adequate in Hungary.However,the number of cataract operations per year should continue to increase due to the increasing patient demands and the aging population.

Corneal blindness and current major treatment concerngraft scarcity

According to World Health Organization, the global prevalence of blindness in 2010 was 39 million people, among which 4% were due to corneal opacities. Often, the sole resort for visual restoration of patients with damaged corneas is corneal transplantation. However, despite rapid developments of surgical techniques, instrumentations and immunosuppressive agents, corneal blindness remains a prevalent global health issue. This is largely due to the scarcity of good quality corneal grafts. In this review, the causes of corneal blindness, its major treatment options, and the major contributory factors of corneal graft scarcity with potential solutions are discussed.

Blindness as A Challenging Medical and Social Problem in China

China, a country with about one fifth of the world' s population, has been gaining a rapideconomic growth since 1980s. This country has around 5 million blind people, accountingfor 18% of the blind in the world. The major causes of blindness include cataract,corneal diseases, trachoma, glaucoma, vitreoretinopathy and a number of factorscontributing to blindness in children. The principal cause of blindness in China was nolonger trachoma but cataracts. Vitamin A deficiency remains a public health problem inthe under-developed areas.Age-related conditions in China, such as vision loss due tocataract and retinal disorders, will increase accordingly if no preventive meaunes aretaken. Glaucoma and diabetic retinopathy appear to be predominant induction of thedevastating blind. In this fast developing country blindness is not only a medical orhealth, but also a social problem. Developed strategies have been adopted simultaneouslyby national efforts under the leadership of the government, international agencies,nongovernmental organizations, as well as private sectors in their every-day work toprevent and treat blindness.

Prevalence of refraction errors and color blindness in heavy vehicle drivers

AIM: To investigate the frequency of eye disorders in heavy vehicle drivers.METHODS: A cross-sectional type study was conducted between November 2004 and September 2006 in 200 driver and 200 non-driver persons.A complete ophthalmologic examination was performed,including visual acuity,and dilated examination of the posterior segment.We used the auto refractometer for determining refractive errors.RESULTS: According to eye examination results,the prevalence of the refractive error was 21.5% and 31.3% in study and control groups respectively (P <0.05).The most common type of refraction error in the study group was myopic astigmatism (8.3%) while in the control group simple myopia (12.8%).Prevalence of dyschromatopsia in the rivers,control group and total group was 2.2%,2.8% and 2.6% respectively.CONCLUSION: A considerably high number of drivers are in lack of optimal visual acuity.Refraction errors in drivers may impair the traffic security.