From 50.000 patients treated at Eye Department of University Hospital of Kinshasa (Zaire), 944 or 19% were registered legal blind. The male-to-female ratio was 2/1 and 24% of legal blind were in the age group of 0-19 years corresponding to preschool and school period.
Blindness incidence increased with advancing age.
Glaucoma (31%) was by far the commonest cause of
blindness in our sample and in all age groups.
Cataract (18,4%) and
optic atrophy (16,3%) respectively came in the second and the third position. Only
cataract not treatable surgically was considered.
Onchocerciasis (4,9%) appeared in the fourth position but this evaluation is a minimal one because Kinshasa is situated far away from some important endemic areas and villages.
Onchocerciasis was absent among legally blind younger than 20 years, its importance increased with advancing age.
Trachoma is unknown in Zaire and was absent from our list of blinding ocular diseases.
Xerophthalmia and
keratomalacia in its typical form was rarely a cause of
blindness. The common blinding affections in developed countries such as, senile
macular degeneration, hereditary chorioretinal dystrophies,
diabetic retinopathy are poorly represented in our statistics. Some prophylactic and therapeutic suggestions are given: Persons with
glaucoma are generally examined very late, and are difficult to be treated by either rigorous application of current
miotics or surgical techniques for
glaucoma.
Pilocarpine with high concentration (4%, 6%) alone or associated to
Timolol gives usually rather good tonometric results. Filtering operations for
glaucoma (Elliot
trepanation,
trabeculectomy) can improve or stabilize the
glaucoma but in some cases no improvement is noted.(ABSTRACT TRUNCATED AT 250 WORDS)