Diabetic retinopathy (DR), one of the chronic complications of diabetes, is a serious and irreversible blinding disease. It is difficult to detect in the early stage, to control in the progressive stage, to operate in the advanced stage of DR. Recently, the "14th Five-year plan" for National Eye Health proposed to "improve the management mode of chronic eye disease, and build a chronic disease management system". The project team used artificial intelligence technology based on cloud platform, joint outpatient service, virtual ward to explore the comprehensive management of DR from the aspects of early screening, multidisciplinary collaborative diagnosis and treatment, and refined blood glucose management during perioperative period. In the future, it is urgent to integrate DR chronic disease management with other systemic chronic diseases to reduce the blindness caused by DR.
Humans ; Diabetic Retinopathy/diagnosis* ; Artificial Intelligence ; Mass Screening ; Blindness/prevention & control* ; Diabetes Mellitus

INTRODUCTIONWith the increased use of filler and fat injections for aesthetic purposes, there has been a corresponding increase in the incidence of complications. Vision loss as an uncommon but devastating vascular side effect of filler injections was the focus of this paper.

METHODSA review committee, consisting of plastic surgeons, aesthetic medical practitioners, ophthalmologists and dermatologists from Singapore, was convened by the Society of Aesthetic Medicine (Singapore) to review and recommend methods for the prevention and management of vision loss secondary to filler injections.

RESULTSThe committee agreed that prevention through proper understanding of facial anatomy and good injection techniques was of foremost importance. The committee acknowledged that there is currently no standard management for these cases. Based on existing knowledge, injectors may follow a proposed course of action, which can be divided into immediate, definitive and supportive. The goals were to reduce intraocular pressure, dislodge the embolus to a more peripheral location, remove or reverse central ischaemia, preserve residual retinal function, and prevent the deterioration of vision. Dissolving a hyaluronic acid embolus remains a controversial option. It is proposed that injectors must be trained to recognise symptoms, institute immediate actions and refer patients without delay to dedicated specialists for definitive and supportive management.

CONCLUSIONSSteps to prevent and manage vision loss based on current evidence and best clinical practices are outlined in this paper. Empirical referral to any emergency department or untrained doctors may lead to inordinate delays and poor outcomes for the affected eye.

Blindness ; etiology ; prevention & control ; Dermal Fillers ; adverse effects ; Embolism ; Esthetics ; Humans ; Hyaluronic Acid ; adverse effects ; Iatrogenic Disease ; Incidence ; Injections ; adverse effects ; Ophthalmology ; Singapore ; Societies, Medical

Biomedical Research ; Blindness ; etiology ; prevention & control ; surgery ; Corneal Diseases ; complications ; prevention & control ; surgery ; Corneal Transplantation ; education ; methods ; Education, Medical, Graduate ; Health Promotion ; Humans ; Ophthalmology ; education ; Singapore

Blindness ; epidemiology ; etiology ; prevention & control ; China ; epidemiology ; Humans ; Vision, Low ; epidemiology ; etiology ; prevention & control

Blindness ; etiology ; prevention & control ; Humans ; Smoking ; adverse effects ; Smoking Cessation

OBJECTIVE: To explore the causes and the management of serious eye complications occurring in the endoscopic sinus surgery. METHOD: Three patients of chronic sinusitis and nasal polyps suffered with blindness in endoscopic sinus surgery and in nasal packing with iodoform and petrolatum gauze were treated. RESULT: Orbital wall and structure were injured in 2 cases during endoscopic sinus surgery, among which, 1 case blinded with deformation of the eyeball during operation underwent optic nerve exploration and orbital muscle reparation immediately. One case developed periocular swelling, eyelid hematoma, conjunctiva edema and blinded 2 days later, and was treated with hematoma clearance and optic nerve decompression. Another 1 case blinded immediately after ethmoid packing, and vision recovered after nasal pack removed. Antibiotics, corticosteroid and nerve growth factor were administered for 4 weeks in all patients. After 6-month follow-up, 1 case was blinded with eyeball atrophy, 1 case was only photonasty, another regained normal vision. CONCLUSION The causes of blindness in endoscopic sinus surgery are directly related to orbital structure trauma and orbital hematoma. The optic nerve during operation should be protected carefully, if ethmoid sinus over development is demonstrated by CT scan. The application of gauze should be avoided when the medial orbital wall is injured. Decompression of optic nerve should be performed as early as possible, if vision damaged.
Adult ; Blindness ; etiology ; prevention & control ; Endoscopy ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Postoperative Complications ; prevention & control

BACKGROUND"Vision 2020" was initiated in 1999 and many relevant activities are ongoing, but little information is available on what it has achieved and what constraints it faces. It is not yet clear if funding is the most important constraint. Nepal is one of the underdeveloped countries, but an advanced country in preventing avoidable blindness. The aim of this study was to compare the situation in China and in Nepal in prevention of avoidable blindness.

METHODSData from literature review and a field visit were combined. All statistical analyses were carried out with SPSS Version 11.5. The chi-square test was used for comparisons involving categorical variables.

RESULTSThe blindness rate is higher in Nepal than that in China (P < 0.05). The average number of cataract operations performed by one ophthalmologist is much lower in China than in Nepal. The cataract surgical rate (CSR) is much lower in China than in Nepal (P < 0.001). High cost of the surgery and inadequate qualifications of human resources were found in China. Cataract surgical outcome in China compared well with international standards.

CONCLUSIONSProgress towards the "Vision 2020" target in China is much slower than that in Nepal. Further attention to address this issue is urgently needed.

Blindness ; prevention & control ; Cataract Extraction ; economics ; instrumentation ; China ; Humans ; Nepal

INTRODUCTIONThe purpose of this study was to characterise and describe the epidemiology of all eye injuries presenting to the National University Hospital (NUH).

MATERIALS AND METHODSA prospective study was conducted over a 7-week period (11/4/2005 to 29/5/2005) on all ophthalmic trauma patients seen by the Department of Ophthalmology in NUH. Data on patient presentation, source of injury and intervention were collected via a standardised interview and examination, and documented using a validated datasheet.

RESULTSA total of 133 patients, and 139 eyes, were included in the study. The average age was 33.5 years, with a range of 5 years to 88 years, and 84.2% (n = 112) were men. Close to half (46.6%, n = 62) of the patients studied were non-Singaporeans. 56.4% (n = 75) of all eye injuries were work-related and only 5% (n = 7) of eyes were open-globe injuries. Common sources of eye trauma included: Use of high-powered tools in activities such as grinding, welding and hammering (38.3%, n = 51), human-inflicted injuries (12.0%, n =16) and road traffic accidents (8.3%, n = 11). Of the work-related eye injuries, 29.3% (n = 22) reported to having used personal protective equipment (PPE) at the time of injury, 38.7% (n = 29) had been issued PPE but had not used them, while 32% (n = 24) reported that PPE had not been issued. An initial visual acuity of 6/12 or better was found in 63.0% (n = 88) of patients and a reading of 6/60 or worse was found in 10.0% (n =14). Superficial foreign bodies (22.4%, n = 55) were the most common clinical finding, followed by periorbital bruise (12.2%, n = 30), lid ecchymoses (6.9%, n = 17), orbital fractures (6.5%, n = 16), lid laceration (6.1%, n = 15) and corneal abrasions (5.7%, n = 14).

CONCLUSIONThere is a broad spectrum of causes, mechanisms and severity of ophthalmic injuries seen in the hospital, of which work-related trauma makes up a significant proportion. The patients who suffer occupational injuries are a well-defined group: Young, non-Singaporean males, working with power tools in the construction industry are at particular risk. Although preventive strategies are in place for this high-risk group, the lack of awareness and compliance limit their effectiveness. The adequacy and functionality of PPE should be emphasised. In addition, preventive efforts are equally important in domestic, recreational, sports and transport settings. Eye trauma research and prevention can be further aided by a collaborative registry of eye injuries. A long-term islandwide database of all ophthalmic injuries is recommended.

Accident Prevention ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blindness ; epidemiology ; Child ; Child, Preschool ; Databases as Topic ; Eye Injuries ; epidemiology ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Singapore ; epidemiology

Adolescent ; Adult ; Blindness ; epidemiology ; etiology ; prevention & control ; Female ; Global Health ; Humans ; Incidence ; Male ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

We are living in exciting times with many challenges and new opportunities to overcome diseases. The concept and definition of blindness and their major causes worldwide are discussed with reference to the Vision 2020 initiatives launched in 1999 for blindness prevention, with an updated summary. The peculiar problems that exists in Singapore are also presented. Yet, if the world's major causes of blindness: cataracts, onchocerciasis, trachoma, refractive errors and low vision, and childhood blindness (inherent problems of the Third and Fourth World) can be overcome with international concerted efforts by year 2020, there will emerge new causes as yet unknown. Noble as our aims may be to achieve short- and long-term targets, we have to face the continuous reality of our inability to fulfil them.
Blindness ; etiology ; prevention & control ; Global Health ; Healthy People Programs ; Humans ; World Health Organization