Rehabilitation of vision disorder and improved quality of life in patients with primary open angle glaucoma

Background Primary open angle glaucoma （POAG） is a common cause of irreversible blindness. The variable etiology of POAG poses significant challenges for treatment and rehabilitation. We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder, assess vision-related quality of life （VRQL）, and to evaluate the efficacy of rehabilitative treatments. Methods We analyzed the visional disturbances in 500 POAG patients （890 eyes） by regular ophthalmic examination and visual field examination using Humphrey 30-o perimetry. Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia, health education, counseling, and the fitting of typoscopes. VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire. Results Scores on the VRQL self-assessment were significantly lower compared to healthy controls. The primary cause of the vision disturbances was ametropia （97.99%）, and 51.61% of the ametropia eyes had not received appropriate correction. The secondary causes of visual impairment were glaucomatous neurodegeneration （26.29%）, complicated cataract, or other accompanying eye diseases. The causes of the clinical low vision （44 patients） were glaucomatous neurodegeneration （32 eyes）, fundus diseases （23 eyes）, keratopathy （11 eyes）, and other eye diseases （10 eyes）. The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia （P 〈0.01）. Twenty-five patients with low vision were provided with typoscopes, and 21 （84%） experienced significant functional recovery, while the remaining low vision patients could see letter lines two or more levels lower （smaller） on visual charts in a near vision test. Conclusions Vision disorders in POAG patients are common and severe. Appropriate rehabilitation, especially the correction of ametropia, can significantly improve VRQL as revealed by the self-assessment of POAG patients.

A survey of blindness and poor vision in leprosy patients

Objective To determine the prevalence, cause and distributions of blindness and poor vision in patients with leprosy.Methods An epidemiological survey of blindness and poor vision among 1045 cases of leprosy was carried out in Taixing City of Jiangsu Province, China.Results The prevalence of bilateral blindness was 7.67%, unilateral blindness 4.4%, bilateral poor vision of various degrees 9.28% and unilateral poor vision 5.84%. The prevalence of eye complications varied significantly among different groups of patients; females had a higher prevalence than males, multibacillary patients higher than paucibacillary patients, and in-patients higher than out-patients. Corneal disease was the most common cause of blindness in study groups, followed by iritic disease and cataract; while the main cause of poor vision was cataract, then corneal and iritic diseases. Treatable blindness accounted for 62.7% of the cases and treatable poor vision for 88.6% of the patients studied. 56.62% of cases with eye complications expressed their willingness to be treated.Conclusions Although prevention and treatment of low vision and blindness in leprosy patients is very hard, it is necessary for doctors and medical workers to make clear of the factors to cause low vision and blindness, especially those in leprosy patients so that some measures for prevention and treatment of the disease could be taken accordingly.