调查北京市盲人学校在校学生视力状况与致盲原因并对比研究30年间的纵向变化。

于2019年7月对北京市盲人学校110例在校学生进行横断面调查。其中，男性76例，女性34例；年龄7~33岁，平均年龄(15.6±5.1)岁。参考世界卫生组织(WHO)防盲计划盲与低视力儿童检查记录表格和工作手册设计调查表。通过家长问卷形式采集并详细记录学生的基本信息、眼病史、全身病史、出生史和家族遗传史等。所有学生集中完成远近视力、裂隙灯显微镜和眼底照相等眼部系统检查。根据WHO标准对视觉障碍程度进行评级。综合病史和眼科检查结果，选择主要因素作为致盲或视觉障碍的原因。对比1989年和2000年的调查结果比较学生视觉障碍和致盲原因30年的纵向变化。性别、病因及视觉障碍程度等计数资料以例数和百分比描述，年龄以范围及均数±标准差描述，对3次调查结果采用列表方式进行比较。

在110例受检学生中，盲、重度视觉障碍及中度视觉障碍分别有87例、20例和3例，分别占79.1%、18.2%和2.7%。导致视觉障碍的解剖部位依次为玻璃体和(或)视网膜、视神经、全眼球、晶状体、角膜及脑源性，分别有39例、30例、11例、11例、6例和5例，分别占35.5%、27.3%、10%、10%、5.5%及4.5%。排列前3位的主要致盲和重度视觉障碍的眼部疾病为先天性青光眼、先天性白内障、视神经萎缩和视网膜色素变性，分别有14例、10例、10例及9例，分别占12.7%、9.1%、9.1%及8.2%。可避免盲和重度视觉障碍者共计57例，占51.8%。其中，可预防病因和可治疗病因者分别为15例和42例，分别占13.6%和38.2%。对比1989年、2000年和2019年3次调查的结果，盲在盲校学生中所占的比例由58.9%升至79.1%，而致盲和重度视觉障碍最主要的原因均为先天性和遗传性因素。其中，先天性青光眼由第3位上升为第1位致盲眼病。

先天性眼病和遗传性眼病仍然是北京市盲人学校学生中导致盲和重度视觉障碍的主要原因，应加强对这类疾病的早期诊断和规范治疗。推进儿童眼病筛查和低视力康复是儿童盲防治工作的重点。

To compare the visual impairment and blindness causes of students in the Beijing School for the Blind over 30 years.

The cross-sectional survey was conducted in July, 2019. Among of 110 students in the Beijing School for the Blind, there were 76 males and 34 females with an average age of (15.6±5.1) years-old (ranging from 7 to 33 years-old). The record and self-designed survey form were collected according to World Health Organization (WHO)/Prevention of Blindness eye examination record system. The basic information, history of ocular disease, history of systemic disease, birth history and family history were recorded in detail through parent questionnaire. All students were couducted ophthalmological examinations including far and near visual acuity, slit-lamp microscope, and fundus photography. Students′ visual impairment were graded according to WHO′s standard. The main causes of blindness/severe visual impairment were analyzed by the medical history and results of examinations. Meanwhile, surveys in the years of 1989, and 2000 were compared to analyze the longitudinal trends of visual impairment and blindness causes. Countable data such as gender, causes, classification of visual impairment were expressed as cases and percentages. Age was expressed as ±s. The results of 3 surveys were analyzed by tabular comparisons.

Of 110 students, blindness, the numbers of students with severe visual impairment and moderate visual impairment were 87, 20, and 3, accounting for 79.1%, 18.2%, and 2.7%, respectively. The common anatomical sites caused visual impairment were retina/vitreous, optic nerve, whole globe, lens, cornea, and brain. The corresponding numbers of students were 39, 30, 11, 11, 6, and 5, accounting for 35.5%, 27.3%, 10%, 10%, 5.5%, and 4.5%, respectively. The top 3 of main ocular diseases caused blindness/severe visual impairment were 14 cases with congenital glaucoma, 10 cases with congenital cataract, 10 cases with optic nerve atrophy and 9 cases with retinitis pigmentosa, accounting for 12.7%, 9.1%, 9.1% and 8.2%, respectively. Blindness/severe visual impairment was considered as avoidable in 57 cases (51.8%), of which 13.6% (15 cases) were preventable and 38.2% (42 cases) were treatable. The longitudinal study (in 1989, 2000, 2019) showed that the proportion of blindness raised from 58.9% to 79.1%, and the leading etiological causes of blindness/severe visual impairment were congenital and hereditary factors. Among of causes, congenital glaucoma ascending from the third to the first.

Congenital and hereditary ocular diseases remain the major causes of visual impairment in the Beijing School for the Blind. Early diagnosis and standardized treatment for diseases should be strengthened. The preschool screening and low-vision rehabilitation should be carried forward, which became the priority of prevention and treatment of childhood blindness.