Trends in registered blindness in eastern Bulgaria

Abstract

Purpose: The purpose of the study was to evaluate the incidence and causes of registered blindness and low vision in Eastern Bulgaria.Methods: Documentation per each included patient based on archives of the Expert Disability committee was evaluated and divided in two intervals. The cumulative incidence per 100 000 was calculated in 3 severity groups for bilateral and monocular blindness and by residence.Results: The incidence of binocular blindness decreased from 63.79 to 41.61 for males and from 64.21 to 41.14 for females during the second period. Meanwhile, monocular blindness increased from 41.14 to 65.14 for males and from 33.01 to 48.83 for females. It rapidly increases after 60 years of age and is the highest for those over 80. Patients with visual acuity (VA) below 0.05 comprise 40-35%, between 0.06 and 0.1 - 22- 35%, and 0.15 to 0.3 - 38-34%. The proportion and incidence of patients with VA below 0.05 have decreased two times during the second period among residents of cities and remained high - 42-48% in the rural population. Severe monocular blindness was significantly higher among males across the whole population. In the age group below 19 years, the leading causes of binocular blindness were retinopathy of prematurity (ROP), congenital glaucoma, microphthalmos and congenital cataract and for monocular impairment - trauma and amblyopia. For those above 20, the main causes were glaucoma, end-stage diabetic retinopathy, cataract - both with significant reduction in the incidence, AMD and trauma.Conclusions: Systematic evaluation of the deteriorated quality of life and estimation of the cost of vision loss and eye diseases to individuals and their families as well as extended family caregivers and thirdparty payers, the health care system and Bulgarian society is essential in the development of evidence-based interventions that translate research into enhanced clinical and community practice and prevention of unnecessary visual impairment