Brown April warns of diseases that can lead to blindness

In the month of prevention and fight against blindness, known as Abril Marrom, the Brazilian Retina and Vitreous (SBRV) and Diabetes (SBD) societies come together to show society and educate people about diseases that can affect the eyes and be detected preventively, to avoid irreversible loss of vision.

“Either you can reverse the condition and treat it, or you can, detecting it at an early stage, control it to prevent it from causing damage,” said doctor Fernando Malerbi, coordinator of the Department of Eye Health at SBD and director of SBRV. Brown was chosen because it is the color of the iris (the most visible and colorful part of the eyes) of most Brazilians.

According to the Brazilian Institute of Geography and Statistics (IBGE), the number of visually impaired Brazilians is around 6.5 million. Data from Atlas Vision, published by the International Agency for Blindness Prevention (IABV) in 2020, indicated that Brazil had an estimated 28.6 million people with vision loss.

For the World Health Organization (WHO), 80% of the causes of visual impairment can be prevented or treated. The first world report on vision, released by the WHO in 2019, pointed out that at least 2.2 billion people have visual impairment or blindness, of which at least 1 billion have visual impairment that could have been prevented or that has not yet been prevented. treated.

According to the publication “As Conditions da Saúde Ocular no Brasil 2019”, by the Brazilian Council of Ophthalmology (CBO), blindness affected 1.577 million Brazilians (0.75% of the population), with 74.8% of cases having prevention or cure, which means that these people could be seeing if they had received appropriate treatment in time.

Fernando Malerbi said that the main causes of blindness in adults are cataracts, glaucoma, age-related macular degeneration (AMD) and diabetes (or diabetic macular edema – DME). Cataract is a disease that usually causes progressive low visual acuity. “The person will start to see the image blurrier, more misty.” It is a disease whose treatment is done through surgery, and the patient manages to recover his vision. Of the four diseases mentioned, cataract is the treatment that most ensures regression. The other three have different characteristics and need prevention.

There are several types of glaucoma, a disease that is expected to affect 111.8 million people in 2040, according to the WHO projection. The most common type is chronic simple glaucoma. “It’s a silent disease, it doesn’t show symptoms. It is only noticeable when it is terminal. And, unlike cataract, the loss it (glaucoma) causes is irreversible.” Therefore, there is a great concern of ophthalmologists and doctors in general, in detecting initially, when the disease is installed. “When we detect it at the beginning, we can control it. The disease has no cure, but it is possible to control it with the use of eye pressure drops, in order to avoid damage to the optic nerve, which can cause loss of vision”.

Age-related macular degeneration affects the older population, after 60 or 70 years. The WHO estimates that around 30 million people worldwide currently have AMD. The disease has two forms: dry and wet. For the dry form, the proposal is a compound of vitamins to slow down the evolution. For the wet form, when in activity, the treatment is with intraocular pharmacotherapy, which often manages to control it.

Malerbi highlighted the importance of periodic consultation with the ophthalmologist, from the age of 40, at least once a year, to detect, in addition to changes in refraction, degree and, eventually, cataract, if there is evidence of glaucoma and, in older adults, early signs of macular degeneration, to guide follow-up, frequency of return, or use of vitamin compounds to slow progression or, in the case of active disease, treatment.

Diabetes is considered the main cause of preventable visual loss in the economically active population in several countries. It is considered that 95% of cases of visual loss due to diabetes are preventable or treatable. A person who has diabetes will need an eye evaluation, which includes an examination of the retina (membrane at the back of the eye) at least once a year. In this exam, changes can be detected that people sometimes don’t notice or affect their vision at that moment, but that can already represent damage and should be treated.

The fact that there are between 13 million and 14 million people with diabetes in Brazil emphasizes the importance of preventive exams. “The great battle of the medical profession is to be able to carry out diagnostic coverage of patients who need the exam”, said Fernando Malerbi.

In order to allow this test to be carried out in a large number of diabetic patients, SBD launched a program for physicians to voluntarily receive, in their offices, young patients with diabetes who do not have access to this type of investigation. The pilot project was launched in Rio de Janeiro and is coordinated by the institution’s vice president, Solange Travassos. Other entities engaged in the project, such as SBRV, the Brazilian Council of Ophthalmology and the Brazilian Society of Ophthalmology.

A routine of visits to the ophthalmologist is essential to improve the eye health conditions of people in the country”, said André Gomes, a member of the SBRV advisory board. He stated that three factors are decisive for maintaining eye health: balanced lifestyle, early diagnosis and appropriate treatment.

A survey on eye health, carried out in person by the Datafolha Institute in October last year, with 2,088 Brazilians aged 16 or over, in all regions of the country, found that half of the population had some difficulty seeing. Most (58%) did not have the habit of going to the ophthalmologist annually and 10% said they had diabetes, the main cause of preventable blindness.

One in three Brazilians admitted not going to a specialist’s office and among those who used to go, 34% reported that the last consultation was two years ago or more. Only about 40% underwent other exams and not just the test to measure the degree of correction lens. According to the survey, 95% of people who visited an ophthalmologist performed only the “letter test” to measure the degree of visual correction. Other tests, such as retinal mapping, were performed by four out of ten patients and 5% of those who consulted with specialists did not undergo any tests.

The director of SBRV said that the vast majority of patients, whose visual problems are related to glasses, will only know if they have something more serious if they have an eye fundus exam, measurement of eye pressure with the ophthalmologist, with an annual frequency. .

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