目的 探讨云南省高海拔农村多民族聚居区贡山县盲和低视力患病率及分布特点。方法 采用整群随机抽样的方法。2008年2至4月选取云南省贡山县全年龄组常住居民作为调查对象。调查地点为人选居民所在的村庄。调查程序包括问卷调查、预调查、视力检查、眼压、裂隙灯显微镜检查及眼底检查。盲定义为较好眼最佳矫正视力＜0.05，低视力定义为较好眼最佳矫正视力≥0.05且＜0.3。按年龄、性别、职业、教育程度、民族及居住地海拔高度分别计算盲和低视力的患病率，同时确定盲和低视力的原因。患病率的分层比较采用四格表卡方检验、Rx2卡方检验、趋势卡方检验。结果 3070名入选对象中2460名接受检查，受检率为80.1％。其中有159例视力损伤，总体患病率为6.46％，包括19例双眼盲患者，46例单眼盲患者，49例双眼低视力患者，45例单眼低视力患者。视力损伤在不同民族之间差异无统计学意义(x2 =0.75，P=0.388)，而视力损伤在不同海拔居住地的居民之间差异有统计学意义(x2 =18.34，P=0.000)。年龄大（≥70岁）、文盲和从事体力劳动者视力损伤患病率高，分别为2.24％、4.19％、5.65％。42.1％(8/19)的双眼盲患者的致盲原因是白内障，角膜混浊占26.32％ (5/19)及眼底异常占21.1％ (4/19)。白内障也是双眼低视力的主要原因，占42.9％ (21/49)。结论 白内障是云南省贡山县的主要致盲原因，需要当地卫生机构采取措施来降低当地盲和低视力患病率，尤其是白内障盲。%Objective To estimate the prevalence and causes of visual impairment by a populationbased survey conducted in Gongshan County of Yunnan Province. Methods Cluster sampling method was used for sample selection. In person interriew, pilot study, visual acuity (VA) check, intraocular pressure,slit lamp microscopy and fundus examination were performed. The diagnoses of blindness ( VA ＜ 0. 05 ) and visual impairment ( VA ＜0. 3 to ≥0. 05) were based on best-corrected visual acuity in the better eye. The prevalence of visual impairment was calculated as to age, gender, education, ethnic group and altitude of living area. The dominant causes of blindness and visual impairment were then identified. The comparison of prevalence among different group examined by four-fold table Chi-square test, R x 2 Chi-square test and trend Chi-square test. Results Among 3070 eligible residents, 2460 (80. 1％ ) were finally enrolled in the present study. The total prevalence of visual impairment was 6. 46％. The bilateral blindness and unilateral blindness was 19 and 46 respectively. The bilateral and unilateral low vision was 49 and 45 respectively.There was no statistical significant difference of prevalence of visual impairment among different ethnic groups ( x2 =0. 75, P =0. 388 ). There was significantly statistical difference of prevalence of visual impairment among groups who lives in different altitude area (x2 =18.34, P =0.000). High prevalence were also observed in the elder ( ≥ 70 years), illiterate and outdoor-workers, which was 2. 24％, 4. 19％, 5. 65％respectively. The leading causes of bilateral blindness was cataract (42. 1％, 8/19), corneal opacity (26. 3％, 5/19), and retinal abnormality (21.1％, 4/19). The leading cause of bilateral low vision was also cataract (42. 9％, 21/49). Conclusions Cataract was the dominant cause of visual impairment in Gongshan County of Yunman Province. The study highlights an urgent need of visual impairment prevention program conducted by local public heath intervention, especially focusing on cataract treatment.
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