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First Author: A.Diandomba CONGO
Co Author(s): P. Bensaid
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This work evaluate the incidence of blindness, both reversible and irreversible in an isolated, rural, clinic-based population in the Extreme North of Congo , present data on the variety of pathology present and enumerate the technical difficulties of proper management of its pathologies.
Ouesso is an urban community in northern Republic of Congo, on the banks of the Sangha River, a tributary of the Congo River, and surrounded by rainforest. Its river port is one of the most active in the northern part of the country. The city has an airport is served by regular air link from Brazzaville. It serves as the administrative center for one of the main areas of logging Republic of Congo. It located 900 km from the capital city. In this rural area, there is an absence specialized services compounded by preferential installation ophthalmologists in capital city at the expense of rural populations.
Visual acuity, slit-lamp examination, explanation tension, Schiotz tonometer, and dilated examinations with the direct ophthalmoscope were performed. Based on the diagnoses, an assessment of treatment availability versus possibility was established to determinate reversibility of blindness. Blindness was defined as a visual acuity of count fingers or less.
138 new consultations (44 females, 94 males) were seen in a four week period. 38% (52/138) of patients presented with bilateral blindness and 36% (49/138) presented with unilateral blindness. Of the 52 bilaterally blind patients, 13 or 25% were irreversibly blind with an additional 6 patients (12%) having a reversible condition for wich the means to correct were unavailable. Of the 49 unilaterally blind patients, 12 or 25% were irreversibly blind with an additional 10 patients (20%) having a reversible condition without access to technology. The four leading causes of bilateral blindness were: cataract 38% (20/52), combination 25% (13/52), glaucoma 17% (9/52), and corneal pathology 12% (6/52). The four leading causes of unilateral blindness were: cataract 43% (21/49), corneal pathology 18% (9/49), glaucoma 12% (6/49), and phthisis 10% (5/49). Out of the 101 patients that were either unilaterally or bilaterally blind, 41% (41/101) were due to cataracts, 15% (15/101) were due to glaucoma, 15% (15/101) from corneal pathology.
Cataract is the leading cause of reversible blindness in Ouesso. This is followed by glaucoma and corneal pathology which produce irreversible blindness in this under-developed region due to lack of preventive care and available technology. Strategies for cataract surgery, Treatment or prevention of blindness in the rural department of developing countries need to be revised to create amendable conditions to greater productivity.