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Biomedical subjects

L Schwab

Publications and source records attributed to L Schwab.

At least 19 recordsLinked to original sources
PubMed1990

Blindness and eye disease in Kenya: ocular status survey results from the Kenya Rural Blindness Prevention Project.

A series of eight regional eye surveys were conducted in Kenya as part of the Kenya Rural Blindness Prevention Project. Each survey consisted of clinical examinations of about 1800 individuals selected by a random cluster sampling technique in geographically distinct and culturally homogeneous rural areas; 13,803 examinations were completed in all. Together these surveys provide the basis for national estimates of the prevalence and aetiology of visual loss and ocular pathology. The results showed that 0.7% of rural Kenyans are blind in the better eye by WHO standards, and another 2.5% suffer significant visual impairment. Rates of visual loss tend to increase five-fold in each 20-year age cohort. Females have higher prevalence of visual loss than males over age 20, and certain geographical areas have markedly higher rates. The commonest cause of both blindness and visual impairment is cataract, accounting for 38% of all visual loss. Trachoma (a localised problem), glaucoma, macular degeneration, and severe refractive errors follow cataract as leading causes of blindness in the better eye. Trauma, corneal scars of various causes, phthisis, and staphyloma are important causes of monocular blindness. Nutritional eye disease does not appear to be a problem of any magnitude in rural Kenya.

Adolescent↗
PubMed1989

Intraocular lens implantation in developing countries: an ophthalmic surgical dilemma.

Rapid and remarkable development of intraocular lens technology during the past 10 years has made intraocular lens (IOL) implantation the standard of practice with cataract surgery in wealthy industrialized nations. However, although visual results of IOL implantation are vastly superior to aphakic spectacle correction after cataract surgery, several factors mitigate against the widespread implantation of IOLs in most developing nations: the high cost of surgical equipment, ancillary drugs, and intraocular lenses; difficulty in postoperative follow-up of cataract surgical patients; and a dearth of surgical personnel properly trained in IOL technology in developing nations. While many of these problems could be addressed through national initiatives, a major area of concern remains that of manpower, since the number of unoperated cataract patients is immense. One strategy for alternative surgical manpower development is the training of medical assistants to perform cataract surgery, as is presently being carried out in several African nations. The question arises, however, as to whether medical assistants, as opposed to ophthalmologists, are qualified to select patients and implant IOLs.

Aphakia↗
PubMed1989

Childhood blindness: dateline Africa.

Prevalence rates of childhood blindness and infant and childhood mortality in Africa are the highest in the world. Major factors contributing to these high rates are similar for both blindness and mortality: malnutrition, measles and other acute febrile infections, malnutrition with xerophthalmia, and limited or poor access to preventive and curative health services. Because of high national growth rates, stagnant economies, and the failure of national health care systems to expand with rapidly growing populations, childhood blindness in Africa likely will remain a significant international public health problem for the foreseeable future.

Adolescent↗
PubMed1988

The epidemiology of trachoma in southern Malawi.

A population-based prevalence survey of ocular disease was conducted in the Lower Shire River Valley of Malawi in 1983. A total of 5,436 children less than 6 years of age and 1,664 persons greater than or equal to 6 years were examined. The prevalence of inflammatory trachoma peaked in the 1-2-year-old age group at 48.7% and declined rapidly with age to less than 5% by age 15. The prevalence of cicatricial trachoma was low in young children and climbed gradually with age to greater than 40% among those greater than or equal to 50 years. Risk factors for inflammatory disease in young children included low socioeconomic status of the family, long walking distance to the household's primary source of water, absence of a latrine in the family compound, and presence of trachoma among siblings. Indices of crowding practices were not associated with inflammatory disease. An apparent inverse association of facewashing and inflammatory trachoma in children did not hold up when adjusted for other risk factors.

Adolescent↗
PubMed1987

Trachoma grading: observer trials conducted in southern Malawi.

A variety of grading schemes have been proposed for the clinical classification of inflammatory trachoma. During a population based study of ocular disease conducted in southern Malawi we tested a simplified version of the current WHO grading scheme. Intraobserver agreement statistics were less than satisfactory for three of four graders. Interobserver agreement when compared against either a well experienced standard ophthalmologist or a consensus grade improved over time for two of the three graders. However, initial agreement for all three graders was only fair to moderate. Previous studies of trachoma grading schemes support these unsatisfactory results. A new system of classification is needed that is both accurate and reliable in a field setting.

Adult↗
PubMed1987

Cost-effective cataract surgery in developing nations.

Today approximately twenty million people are blind (visual acuity less than 3/60 [10/200]) and tens of millions more are visually disabled (visual acuity less than 6/18 [6/60]) from cataract. Most of these people live in impoverished developing nations. The logistics of providing cataract surgical care for them are complex. Simplifying the cataract operation, employing appropriate technology, and training non-physicians in intraocular surgery is efficient cost-effective strategy in many developing African nations.

Africa↗
PubMed1987

Conjunctival melanoma in Africa.

Malignant melanoma of the eye and adnexa is rare in blacks. A highly unusual malignant melanoma of the tarsal conjunctiva in an adult Ethiopian female, believed to be the first reported in a black patient, is described. Factors that contribute to melanoma in blacks and rates of occurrence are reviewed and discussed.

Adult↗
PubMed1987

Limbal vernal keratoconjunctivitis with a hypertrophic limbal mass lesion.

A case of limbal vernal keratoconjunctivitis associated with a hypertrophic mass lesion measuring 8 X 5 X 3 mm is reported. The histopathology of this mass, which consisted of hyperplastic epithelium with eosinophilic infiltration and thickened subepithelial stroma of irregular hyperplastic collagenous connective tissue interspersed with numerous eosinophils and inflammatory cells, is presented. A large limbal-mass lesion such as this has not been previously described in association with limbal vernal keratoconjunctivitis.

Child↗