Blindness in the eastern Mediterranean countries.

Blinding eye diseases remain a highly prevalent and serious health problem in many developing countries. The exact number of blind individuals is not known. It is estimated that there are 38 million people who have visual impairment and are at risk of becoming blind. 2 The prevalence of blindness in developing countries is 10–40 times higher than in developed countries and close to three quarters of the world’s blindness is either curable or preventable. The majority of blind people on earth reside in the developing nations of Africa, Asia, and Latin America. The World Health Organization (WHO) definition of blindness is a visual acuity of less than 3/60 (20/200, 0.05), and low vision is less than 6/18 (20/50, 0.3) in the better eye with the best correction. In the eastern Mediterranean countries (Table 1), there are several studies on the prevalence of blindness. Certain studies were community based prevalence surveys while others included reports on blindness from registries of schools for the blind. The prevalence of blindness in Lebanon is 0.6% and 1.5% in Saudi Arabia. The leading causes of blindness have been determined by information retrieved from registries for the blind in a number of countries. In general, data obtained from hospitals, social security records, or institutions for the blind may give us an idea about the causes of blindness but these sources suVer from certain limitations. Often excluded from consideration are remote populations, those who do not seek medical advice, unilateral blindness, older individuals, and preschool children. In countries in the eastern Mediterranean eye diseases have long been recognised as a major health problem. Table 2 shows the leading causes of blindness in these countries. In Saudi Arabia, a community based blindness survey was conducted to determine the prevalence of blindness and visual impairment and to assess the prevalence of the major causes of blinding eye disease. 13 A nationwide random stratified, multistage cluster sample was included in the survey. This survey revealed that 1.5% of the population are blind and another 7.8% are visually impaired according to the WHO definition of blindness. The most common causes of blindness in Saudi Arabia were cataract, trachoma, non-trachomatous corneal scars, refractive errors, congenital anomalies, failed medical or surgical treatment, and glaucoma. On the other hand, refractive errors, amblyopia, and trauma were causes of unilateral loss of vision. About 7% of all Saudi Arabians and 42% of those older than 40 years developed cataract and over 3.5% of the population had corneal scars; about half were caused by trachoma. The data presented have demonstrated that eye disease and blindness are important health problems in Saudi Arabia. Over 1.5% of the total population and over 20% of the population older than 60 years of age were blind. The prevalence of blindness reflects the current and previous status of eye diseases. Recent socioeconomic development in Saudi Arabia and other Arab Gulf countries has greatly influenced the causation of blindness in these countries. For example, the prevalence of trachoma has decreased dramatically over the past two decades. Currently, in urban communities there are practically no cases of active trachoma. This socioeconomic development is less pronounced in other eastern Mediterranean countries.