The magnitude of diabetic retinopathy, its determinants, and coverage of laser treatment for diabetic retinopathy among registered people with diabetes in Oman are presented. 2249 randomly selected subjects representing 5564 registered diabetics were examined. WHO recommended definitions of diabetes, retinopathy, and other related conditions were used. Physicians reported the profile of the diabetes while ophthalmologists reported ocular profile and the eye care provided to them. The prevalence of diabetic retinopathy was 14.39% (95% CI 13.46 to 15.31). Men had significantly higher rate of retinopathy than women. The retinopathy rate was higher in age groups 50-59 years and 60-69 years. The rates of background retinopathy, proliferative retinopathy, and diabetic maculopathy were 8.65%, 2.66%, and 5.12%, respectively. The rate was higher among subjects with longer duration of diabetes than those with a shorter duration. Those with an HbA 1c level more than 9% had significantly higher rates of diabetic retinopathy than those with an HbA 1c level less than 9%. The retinopathy rate was higher in cases with hypertension, nephropathy, and neuropathy. Of those with diabetic retinopathy who were advised to have treatment at the time of registration, only 20% were treated with laser therapy. Diabetic retinopathy is the leading cause of visual disability in the industrialised countries. Changes in lifestyle have increased the risk of diabetes as well as blindness in many developing countries 1 and it is important that organised efforts are undertaken to address eye complications of diabetes. Around 20% of people with diabetes are projected to develop retinopathy. Duration of diabetes, type of diabetes, control of blood sugar, associated systemic conditions, age and sex are found to be associated with retinopathy and its progression.2 However, reliable information on the magnitude and determinants of ocular manifestations of diabetes in many countries, including Oman, is lacking.Oman's 2.4 million population has undergone rapid socioeconomic development and lifestyle in the past two decades. There has been a marked decline in communicable diseases and nutritional disorders. Non-communicable diseases, like diabetes, have increased.3 Owing to obesity, a sedentary lifestyle, smoking, consanguinity, and other factors 10% of the Omani population aged over 20 years have diabetes mellitus, 4 resulting in an estimated 80 000 people with diabetes. 5The Ministry of Health has promoted health for all and initiated a comprehensive primary healthcare approach. At nearly 140 primary health institutions, health care is provided free of charge and is accessible even in remote places. Trained physicians identify, register, and manage people with diabetes. In 10 secondary institutions, diabetologists assess people with diabetes annually. The "Diabetes Control Programme" initiated the National Diabetes Registry in 2000 and 27 450 people with diabetes were registered by the end of 2001.6 From June 2000, a system to refer the registered peopl...

Aim: To determine the magnitude and causes of low vision and blindness in the Gurage zone, central Ethiopia. Methods: A cross sectional study using a multistage cluster sampling technique was used to identify the study subjects. Visual acuity was recorded for all adults 40 years and older. Subjects who had a visual acuity of <6/18 were examined by an ophthalmologist to determine the cause of low vision or blindness. Results: From the enumerated population, 2693 (90.8%) were examined. The prevalence of blindness (<3/60 better eye presenting vision) was 7.9% (95% CI 6.9 to 8.9) and of low vision (6/24-3/60 better eye presenting vision) was 12.1% (95% CI 10.9 to 13.3). Monocular blindness was recorded in 16.3% of the population. Blindness and low vision increased with age. The odds of low vision and blindness in women were 1.8 times that of the men. The leading causes of blindness were cataract (46.1%), trachoma (22.9%), and glaucoma (7.6%). While the prevalence of vision reducing cataract increased with age, the prevalence of trachoma related vision loss did not increase with age, suggesting that trichiasis related vision loss in this population might not be cumulative. Conclusion: The magnitude of low vision and blindness is high in this zone and requires urgent intervention, particularly for women. Further investigation of the pattern of vision loss, particularly as a result of trachomatous trichiasis, is warranted.

The risk of recurrence after electro-epilation and bilamellar tarsal rotation surgery is high; strategies that account for recurrence need to be introduced.

Br J Ophthalmol 2002;86:957-962 Aims: To estimate the magnitude and the causes of blindness through a community based nationwide survey in Oman. This was conducted in 1996-7. Methods: A stratified cluster random sampling procedure was used to select 12 400 people. The WHO/PBD standardised survey methodology was used, with suitable adaptation. The major causes of blindness were identified among those found blind. Results: A total of 11 417 people were examined (response rate 91.8%) The prevalence of blindness in the Omani population was estimated to be 1.1% (95% CI 0.9 to 1.3), blindness being defined according to the WHO Tenth Revision of the International Classification of Diseases. Prevalence of blindness was clearly related to increasing age, with estimates of 0.08% for the 0-14 age group, 0.1% for the 15-39 age group, 2.3% for the 40-59 age group, and 16.8% for the group aged 60 +. There was a statistically significant difference between the prevalence in females (1.4%) and males (0.8%). The northern and central regions had a higher prevalence of blindness (1.3% to 3%). The major causes of blindness were unoperated cataract (30.5%), trachomatous corneal opacities (23.7%), and glaucoma (11.5%) Conclusions: Despite an active eye healthcare programme, blindness due to cataract and trachoma remains a public health problem of great concern in several regions of the sultanate. These results highlight the need, when planning effective intervention strategies, to target the eye healthcare programme to the ageing population, with special emphasis on women.

At ≥1 year postoperatively, the absolute success rate of treating advanced glaucoma by endocyclophotocoagulation and phacoemulsification was low. However, medication burden was reduced. Owing to the significant variation in the success rate based on the type of glaucoma, patients with advanced glaucoma should be carefully selected and counseled.

'F' & 'E' implementation made a significant contribution to the reduction of active trachoma. Community participation and collaborative efforts of partners are crucial. The indicators used to monitor F & E strategies are interrelated and therefore should be evaluated together.

Agents and activities responsible for ocular injuries in our study differed from those reported in the industrialized countries. Late presentation was very common in our tribal area. Management improved the vision in eyes with trauma, but eyes with 'closed globe' type of ocular injuries had better results than 'open globe' type.

Diabetic retinopathy (DR) is a complication of diabetes mellitus that can cause blindness. As the prevalence of diabetes increases globally and patients live longer, the cases of DR are increasing. To address the visual disabilities due to DR, screening of all diabetics is suggested for early detection. The rationale and principles of DR screening are discussed. Based on the available evidence, the magnitude of DR in countries in the Eastern Mediterranean region (EMR) is presented. Public health strategies to control visual disabilities due to DR are discussed. These include generating evidence for planning, implementing standard operating procedures, periodic DR screening, focusing on primary prevention of DR, strengthening DR management, health information management and retrieval systems for DR, rehabilitating DR visually disabled, using low-cost technologies, adopting a comprehensive approach by integrating DR care into the existing health systems, health promotion/counseling, and involving the community. Although adopting the public health approach for DR has been accepted as a priority by member countries of EMR, challenges in implementation remain. These include limitations in the public health approach for DR compared to that for cataract, few skilled workers, poor health systems and lack of motivation in affecting health-related lifestyle changes in diabetics.Visual disabilities due to DR are likely to increase in the coming years. An organized public health approach must be adopted and all stakeholders must work together to control severe visual disabilities due to DR.