Introduction Blindness continues to be one of the major public health problems in developing countries. Materials and Methods As corneal blindness is a major public health problem and the status is expected to change over time, there is a need to periodically review the published literature on the subject. An extensive Medline and Google search was performed, including websites of the National Programme for Control of Blindness, World Health Organization, Eye Bank Association of India, etc. The literature database was searched till October 2011. The terms, “corneal blindness and population-based surveys in India”; “visual impairment and corneal diseases”; “prevalence of corneal blindness”; “causes of unilateral and bilateral corneal blindness and morbidity in India” were used to locate papers on the subject in any language published 1991 onwards, covering about two decades up to the present. The abstract of each of these publications was reviewed; full papers that were actually related to corneal blindness and its causes in India were obtained from the journals. Magnitude of corneal blindness illustrates various community-based studies conducted in India and the burden of corneal blindness from 1987 through 2010.(,,,,,,,,,,,,) A metaanalysis of seven relevant population-based studies published from 2001 to 2010 was performed [].

These studies were selected as comparable data on corneal blindness (similar methodology, age group, definition of blindness, type of population) could be retrieved from all seven studies. Full papers and reports of these population-based surveys were extensively studied to include a uniform definition of blindness (defined as “presenting visual acuity less than 6/60 in the better eye” in all seven studies included) and population aged 50 years and above only. This was done to obtain homogenous studies for analysis with similar inclusion criteria for metaanalysis. In the first stage of metaanalysis, the prevalence of corneal blindness with its 95% confidence intervals (CIs) was calculated for each individual study.

In the second stage of metaanalysis, an overall prevalence of corneal blindness was calculated as a weighted average of individual summary statistics. The metaanalysis was conducted on Stata 12.0 (Stata Corporation, College Station, TX, USA). The forest plot [] thus generated demonstrates that the true prevalence of corneal blindness in the Indian population is 0.45% (95% CI: 0.27-0.64%). The prevalence of unilateral corneal blindness and corneal opacities as estimated by population-based surveys is depicted in Tables and, respectively.(,,) The pattern of corneal blindness reported from hospital-based data is depicted in.(,). Avoidable corneal blindness The term avoidable encompasses preventable and treatable causes. The Andhra Pradesh Eye Disease Study reported that a significant burden of corneal blindness in the rural population of Andhra Pradesh was avoidable.() Of the 0.66% prevalence of corneal blindness in at least one eye in this population, nearly 95% was avoidable. The avoidable causes of corneal blindness reported in this study were keratitis in childhood, trauma, aphakic bullous keratopathy, severe astigmatism post cataract surgery, keratitis in adulthood and traditional eye medicines.

Corneal conditions amenable to primary prevention include measles infection, Vitamin A deficiency, ophthalmia neonatorum, trachoma, ocular trauma, the use of harmful traditional eye medication remedies and congenital rubella syndrome. Corneal blindness resulting due to these diseases can be completely prevented by institution of effective preventive or prophylactic measures at the community level.

Treatable or curable blindness can be tackled by an effective and accessible health care service delivery network. In cases such as corneal ulceration and selected cases of corneal scarring, sight can be restored with timely and prompt management. The prompt diagnosis and appropriate treatment of corneal ulceration and the easy availability of antibiotics and anti-fungals, even in rural areas, should be the aim of community health programs.

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Many of those currently blind from corneal diseases can be visually rehabilitated by corneal transplantation. Penetrating keratoplasty is the most effective and most often performed solid organ transplantation.

It is estimated that 50% of corneal blindness is treatable.() The economic burden due to corneal blindness has not been extensively studied. It has been estimated that if strategies are implemented successfully to prevent 90% of the preventable blindness due to corneal disease by 2020, blindness in an additional 3.6 million persons in 2020 and 29 million blind-years would be prevented.() As most of the corneal blindness is preventable, and because surgical intervention for treating corneal blindness is a difficult option in a developing country setting, the need for effective health promotion strategies takes paramount importance. Prevention and early treatment will prove to be more viable and cost-effective in the long term in reducing the burden of corneal blindness in our country. Causes of corneal blindness in India Corneal blindness encompasses a range of eye conditions that alter the transparency of the cornea, leading to corneal scarring and, eventually, blindness.

Causes of corneal blindness include a wide variety of infections and inflammatory eye diseases, ranging from keratitis, xerophthalmia, eye trauma, trachoma, congenital disease and traditional eye medicine or home remedies, which often harm the eye rather than relieve pain or improve eyesight.() The causal factors responsible for corneal blindness vary with age. Corneal dystrophy Corneal dystrophies are a heterogenous group of inherited corneal diseases that are more commonly reported as cause of corneal blindness in the developed world. A hospital-based study in South India reported that corneal dystrophy was responsible for 8.1% (144 patients) of all keratoplasty performed. The main types of corneal dystrophy encountered in this population were macular corneal dystrophy, congenital hereditary endothelial dystrophy, Fuchs dystrophy and lattice dystrophy.(). Trauma Trauma is often the most significant cause of unilateral loss of vision in developing countries,() and up to 5% of all bilateral blindness has been attributed to direct ocular trauma.() Corneal and corneoscleral perforation and subsequent scarring due to ocular trauma may result in a variable amount of blindness.

Chemical injuries with acids and alkali contribute significantly to corneal blindness in the younger age group. In a study from North India, 43 of 102 patients suffered bilateral injuries and nearly 45% of the eyes had severe-grade burns. Occupational exposure contributed to a majority of the injuries in this study. Hp Usb Disk Format Tool Device Media Is Write-protected. () Penetrating injuries remain an important cause of acquired corneal scarring in the pediatric age group.

In a study involving 204 children below 14 years of age, the most common cause of injury was bow and arrow (15.2%), followed by household appliances (14.3%).() Most ocular injuries in children are preventable and occur from unsupervised activities, which can lead to significant visual loss. Epidemiological community-based studies on ocular trauma have been conducted in various distinct populations of the country. In the urban slums of Delhi, the prevalence of ocular trauma in 6704 participants was 2.4%.

Blunt trauma was the most common mode of injury (41.7%), and contributed to blindness in 11.4% of the eyes.() In the rural population of Andhra Pradesh, 824 of 7771 (10.6%) subjects reported having sustained ocular trauma. The most common mode of injury (45.3%) in this population was trauma with vegetative matter.() Likewise, nearly 5% people above 40 years of age were affected with ocular trauma in a rural population of Tamil Nadu. Blunt trauma in an agricultural setting was the most frequent cause of trauma in this population.() In the urban population of South India, the prevalence of ocular trauma was 3.97%, with majority of trauma resulting in blindness occurring during childhood and young adulthood.() Eye care programs and strategies targeting high-risk ocular trauma groups need to be developed in our country in order to reduce blindness due to trauma. Pseudophakic/Aphakic bullous keratopathy The etiology of pseudophakic bullous keratopathy is varied and depends largely on the surgical technique used for cataract extraction. The incidence of pseudophakic bullous keratopathy is on the increase as we strive to eliminate avoidable blindness due to cataract.

With the increasing cataract surgical rate in India and because more intraocular lenses being implanted, a large number of eyes are at risk of going blind due to corneal decompensation. In a study involving 2022 penetrating keratoplasties performed in a tertiary eye care center in North India, bullous keratopathy accounted for 13.5% of all operated cases.() In cataract-related corneal edema, aphakic bullous keratopathy (7.27%) was almost as frequent as pseudophakic bullous keratopathy (6.18%). Visual rehabilitation after keratoplasty is compromised in these cases due to a high incidence of graft failure contributed by increased intraocular pressure.(). Conclusion In aiming to eliminate corneal blindness, a multi-pronged strategy needs to be developed. In a country with limited resources and a vast population, optimization of available facilities and prioritization of healthcare commitments need to be proportioned rationally. Control of preventable causes requires extensive public support and community participation.

It falls in the realm of public health. Curable or treatable blindness requires a spectrum of care, including medication, optical rehabilitation and corneal transplantation. Overall, continued assessment of the burden of corneal blindness with periodic review of trends is required to effectively plan preventive, promotive and rehabilitative blindness control strategies.

Abstract Purpose.: We developed and validated an instrument to measure the quality of life (QoL) of caregivers of children with primary congenital glaucoma (PCG): the Caregiver's Congenital Glaucoma Quality of Life (CarCGQoL) questionnaire. Methods.: A total of 70 caregivers of children with PCG under follow-up at a tertiary eye care center in India participated in a series of focus groups, and pre- and pilot testing phases in the development of the 45-item CarCGQoL questionnaire.

Java Games Free Download Mobile Waptrick. Subsequently, this instrument was administered to 111 caregivers of children with PCG awaiting glaucoma surgery. Response to each item was rated on a four-category scale. Rasch analysis was used to validate the instrument's psychometric properties, such as unidimensionality (by principal components analysis [PCA] of residuals), item fit to model, measurement precision (by person separation [PS]), response category performance, differential item functioning (DIF), and targeting of items to participant's QoL.

Results.: Categories required reorganization resulting in a shortened rating scale of 3 categories. The instrument showed misfit to the Rasch model and lacked unidimensionality. Deleting 15 items (obtained through PCA of residuals) restored unidimensionality, but additional items misfit, necessitating item reduction. In addition, 2 items showed DIF and were deleted.

Finally, a 20-item CarCGQoL instrument showed good fit and unidimensionality. Targeting was good (0.69 logits) and PS was 2.51, indicating good measurement precision. Conclusions.: We have developed a psychometrically robust 20-item caregiver derived questionnaire, the CarCGQoL, that is a valid and reliable measure of QoL of caregivers of children with PCG. Given its brevity, it is quick and easy to administer in the clinic, and has potential for use as an outcome measure in clinical trials of treatment of PCG. Primary congenital glaucoma (PCG) results from developmental abnormality of the trabecular meshwork as well as of the anterior chamber angle of the eye. It is found commonly between birth to 3 years, with the majority being diagnosed during the first year of life.

Congenital glaucoma is responsible for 4% of childhood blindness and the prevalence of PCG has been estimated to be 1 per 3300 births in the Indian state of Andhra Pradesh, as opposed to 1 per 10,000 births in the Caucasian populations. It more often is familial in nature in Indian than it is in Caucasian populations.