Some causes of blindness seen at Noor Eye Institute, Afghanistan.

This is a survey of the causes of blindness recorded by three students of The City University during a six-week stay at NOOR Eye Institute in Kabul, Afghanistan. The nature of the sample used makes it unsuitable for direct comparison with surveys from other countries. Nevertheless, broad conclusions can be drawn. Severe eye disease is a considerable problem in Afghanistan, in common with other developing countries. The survey included all new patients seen in the outpatient clinic, blind to the extent of being unable to count fingers at more than three metres, in one eye or both. The sample of patients was examined by an ophthalmologist working with our team. A diagnosis was made and various social and demographic questions were asked with the help of an interpreter. In all, 473 patients were examined and included in our survey sample, a very high proportion of the new patients attending the clinic (40.46 per cent). The main causes of blindness were found to be cataract (31.12 per cent), corneal scarring (19.8 per cent), chorioretinal degenerations (6.79 per cent), glaucoma (6.65 per cent) and aphakia (5.52 per cent). Of the major causes of blindness, about forty per cent of the cases were considered remediable, and about thirty per cent could have been prevented. An outstanding difference between the causes of blindness in developed nations and those seen in Afghanistan was the amount of blindness caused by infection, especially in the younger age groups (up to 30 years). Cataract is a major cause of blindness in the older age groups of both societies. People suffering from ocular disease in Afghanistan wait until their sight is badly impaired or lost completely before seeking treatment. This results from a lack of knowledge of what could be done to conserve sight, the irreversible nature of many eye diseases, the distances involved in travelling to the clinic, and even a lack of knowledge of its existence.