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Sultonova Fazilat Aminboevna, Urgench branch of the Tashkent Medical Academy
Scientific applicant Dadamuhamedova Shokhida Mubashirovna, Bukhara State Medical Institute, Ph D., E-mail: [email protected]
PREVALENCE OF DISEASES OF VISUAL ORGANS AMONG CHILDREN: REVIEW
Abstract. In the various countries of the world, much attention is paid to studying the causes, development and prevalence of eye diseases, especially among children. The article provides a review of the literature in recent years and described current state the incidence of children and adolescents in ophthalmic pathology.
Keywords: diseases of the organ of vision, refractive pathology, children, prevalence, regional characteristics.
Currently, a person faces the growing effects on his body of various external, chemical and biological factors. Organ of sight, as part of the body, is also subject to the influence of given factors that might include environmental. These factors affect not only the structure of the organ of vision, but also violate its activity, which is expressed by the development of various pathologies.
In various countries of the world, much attention is paid to the study of the causes, development and prevalence of eye diseases, especially among children. There is also an acute problem regarding the study of eye injuries, disability from eye diseases and the influence of various harmful factors on the organ of vision of children of different ages.
To date, clinical features, diagnosis, conservative and surgical treatment of various eye diseases studied extensively, with the development and supply in the practice of modern, advanced methods of diagnosis and treatment of diseases [1; 17; 21].
The study of the prevalence of eye diseases, as well as the problems of clinical examination, disability and prophylaxis with them, is devoted to the study of some scientists from near and far abroad [16; 25].
A special place in the state of health of the children's population was occupied by diseases of the organ of vision. In the structure according uptake incidence proportion eye diseases whether composed of 4-5%. In the Russian Federation, children with physical and mental disabilities made up about 4.5% of the children of the population, of whom 18% are children with visual organ damage. Pathological affected children in Russia diseases of the eye and its appendages was compiled 144.6. The structure of the pathological affection whether prevailing refraction and accommodation disorders (74.1%), strabismus and other disorders binocular movement (10.6%), inflammatory diseases (7.7%). Observe that with increasing age, an increase in the pathological infestation of children from 73.0%o (up to 3 years) to 364.6%o (during adolescence). Due to violations of refraction and accommoda-
tion, the incidence of girls is higher than boys. The prevalence of diseases of the organ of vision had regional features [17].
Disability of the child population is an important medical and social problem. Among the children of the Russian Federation revealed a trend of growth prevalence eye diseases, while in children in the first year of life in 11.1%, in children under 14 years old in 12.1%, in adolescents 15-17 years old in 5.9%. Occupying a dominant place if disturbances in visual acuity (32.8% among children, 56.1% of adolescents). A significant impact of the socio-economic development of the regions on the formation of ophthalmologic pathology in children has been established [15; 20].
In the Republic of Azerbaijan, the total number of newly recognized disabled people was 3015 children. The level of primary disability ranged from 2.7 to 1.8 per 10,000 children. The total number of children re-recognized as disabled due to ophthalmopathology was 4090 children. The level of disability ranged from 1.9 to 4.2 per 10,000 children [18].
Isakhanov A. L. [12] studied in detail the causes of reduced vision in schoolchildren with different motor activity. The influence of the motor activity of schoolchildren on the development of their shortsightedness was proved, which should seriously affect the preparation of methodological manuals for the prevention of this disease.
According to WHO, there are currently 45 million blind people in the world and 135 million people with serious visual impairments, the number of blind children may double by 2020. At the same time, according to WHO experts, 80% of cases of blindness can be avoided. The WHO initiative aims to fight the diseases of the eye, which causes blindness and can be prevented and treated [8].
Mirskaya N. B. et al. [19] believe that the high prevalence of pathological conditions ofthe organ ofvision in modern schoolchildren is an objective medical and social prerequisite for developing effective measures for the prevention and correction of disorders and diseases of the organ of vision in schoolchildren.
Research has established [2; 14] that the prevalence of diseases of the organ of vision in children in Kazan was on average 205.4 ± 0.3%o. The most frequent were refractive errors, conjunctivas diseases and eyelid pathology. The prevalence of diseases of the organ of vision among children living in the area with heavy traffic was higher and amounted to 223.1 ± ± 0.3%, whereas in the control area 97,9 ± 0,4%. In the area with heavy traffic in the structure of the pathology of the organ of vision, the first place was occupied by refractive errors, the second - conjunctivas diseases, the third - eyelid pathology.
When analyzing diseases of the organ of vision in children living in ecologically unfavorable conditions, the authors noted functional and organic changes in the visual analyzer, indicating the negative role of air pollution. There were violations of microcirculation, biochemical metabolism, affecting the sclera frame properties. The authors assumed that the effect of anthropogenic pollution on the organ of sight of children was mediated and caused various ophthalmologic diseases, including refractive errors [3,10].
The increased proportion of refractive pathology in the structure of low vision is due to the fact that due to the great advances in computer technology, the increasing visual load, especially in children aged 10-14 years, non-compliance and discrepancy of the elementary physiological and hygienic requirements for the organization of the educational process contribute to changes and worsening of many health indicators, including acquired eye diseases in schoolchildren [13; 20].
Analyzing the data of Lin L. L. et al. from Taiwan, it was concluded that from 1983 to 2000, there was an increase in myopia from 5.8% to 21% in 7-year-old children. When examining schoolchildren at the age of 12, an increase in the number of patients with myopia from 36.7% to 61% was revealed [20].
A survey of Singaporean schoolchildren aged 7-9 years from 1999 to 2002 revealed a progression of myopia (47.7%) from 1.0 to 2.5 diopters. As a result of studies conducted in Mexico, it was found that among 1035 schoolchildren of Mexico City at the age of 12-13 years, visual impairment is represented mainly in the form of refractive pathology.
A study of the prevalence of ocular pathology among schoolchildren in the eastern part of Sydney by Australian scientists revealed the predominant role of ametropia, mainly myopia - 8.3% in 12-year-olds. However, the percentage of patients with myopia among multiethnic groups of students in eastern Sydney was much lower compared with the same type of students in the United States and Asia. During the examination of 217 students aged from 6 to 18 years old school for the blind in Saudi Arabia, cases of bilateral blindness were detected in children with retinal degeneration, congenital glaucoma and optic nerve atrophy. In 89% of children, blindness was due to hereditary or congenital diseases [4; 5; 11].
By Djalilov E. D. et al. [7] were examined 29 children aged 4-8 years. The prevailing number of sick children (62%), were children from related and closely related marriages. Microphthalmos and atrophy of optic nerve were the leaders in the structure of diseases of the organ of vision. It should be noted that these diseases are registered in children born from closely related marriages.
Many different risk factors have caused impairment of normal retinal vasculogenesis in very premature babies. It is the violation of retinal vasculogenesis that underlies the development of retinopathy of prematurity, in connection with which it can rightfully be called the disease of the developing vessels [24].
According to G. Nikolaev [22] retinopathy premature is given the third place in the nosological structure of children's disability. The main forms of pathology leading to childhood blindness: optic nerve atrophy (32%), congenital cataract (20%), retinopathy premature (18%), degenerative myopia (18%), congenital glaucoma (4%), others (8%).
The significant influence of the socio-economic development of the regions on the formation of the ophthalmo-logical morbidity of children and adolescents has been established. High incidence rates were noted in economically and medically-well-organized regions. The incidence rates were associated with the development of transport infrastructure in the territory and the provision of telephony to the apartments [9; 20].
Daynogo V. N. et al. [6] believe that the presence of children and adolescents in a light environment with an excessive dose of blue light can lead to degradation of the retina 10 years earlier than when exposed to natural light. When LED lighting white first-generation LEDs (blue crystal and yellow phosphor), which have a dip in the spectrum at 480 nm, there is a significant increase in the area of illumination of the retina in the blue part of the spectrum. For maternity homes, children's institutions and schools, it is preferable to use the latest generation of lamps with a biologically adequate spectrum of white light. But according to Polish researchers, refractive pathology in 3636 children aged 6 to 18 years revealed, regardless of sanitary conditions on sight - the use of fluorescent lamps. The authors have not established a link between the type of room lighting and the prevalence of violations of the optical structure of the eye.
WHO expert [27] conducted a meta-analysis of the epidemiology of eye injuries: 55 million injuries occurred each year leading to disability for more than 1 day, 750000 injuries requiring hospitalization, 200 000 open eye injuries. Due to eye injury 19 one million people lost sight in one eye; 2.3 million had bilateral vision reduction and 1.6 ml n. lost sight in both eyes.
In the Russian Federation in large ophthalmological centers, the proportion of patients with eye injuries and their consequences accounts for up to 1/3 cases. About 22% of hospitalized patients are children under 16 years old.
In Kazakhstan, among working-age people, amongst the causes of disability, eye injuries are in the first place, and in children - in the third place. Up to 50% of all accidents of eye injury occur at the age of 18 years. It turned out that boys aged 5-7 years in relation to girls are most prone to eye injuries. The group of children aged 3-9 males had the highest frequency of injuries at home, at school and on the street [26].
In the Khabarovsk Territory of the Russian Federation, the proportion of pediatric ophthalmic injuries was 46%
among all treated children [23]. In Tajikistan, the proportion of children's eye injuries was 27-35%, while in Kyrgyzstan this figure was 20.5-35% [28].
The above problems are relevant in the Republic of Uzbekistan, in the literature there are few scientific works devoted to this problem. Rare scientific works devoted to environmental issues incidence of eye diseases, problems am forecasting the development of eye diseases. In addition, there are practically no works related to modern aspects, a conceptual approach to the prevention, correction of disorders of eye diseases in children of preschool and school age.
In connection with these arguments, the solution of the above problems through the implementation of research and development works is a modern, relevant and sought-after.
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