Eye diseases take increased toll in Ukraine

A growing number of people in Ukraine are becoming visually disabled due to eye disease, according to researchers.

"The issue of proper follow-up, early diagnostics and implementation of appropriate therapeutic and preventive measures in POAG [primary open-angle glaucoma] subjects requires special attention from the governmental authorities," reports Olena Kryvoviaz, head of the pharmacy department, Vinnytsia National Pyrohov Memorial Medical University, Vinnytsia, Ukraine. Her results are presented in the Journal of Pharmacy and Pharmacology.

Previous research has shown the prevalence of disability due to eye diseases has tripled in the past decade, Dr Kryvoviaz found vision-related disability is taking a toll on society because of its effects on labour and education, she wrote.

Glaucoma plays an important part in the problem, and not enough attention is being given to prevention, timely diagnosis and treatment, she said.

To compare the structure and trends of disability caused by glaucoma and other vision-related disorders, Dr Kryvoviaz sampled data from medical documents and the MSEK (Physical Disability Board of Review) statistics for the Vinnytsia region of Ukraine. Trends in the region correlate well to nationwide data, she said.

From 2008 to 2014, the proportion of people who were disabled as a result eye diseases other than glaucoma increased from 2.58% to 15.29%, and averaged 7.05% over the 7 years. The proportion of people with POAG who were disabled increased from 2.08% to 31.71% over this period, averaging 9.99%.

For the year 2008, Dr Kryvoviaz found that 1742 individuals were classified as disabled due to eye diseases other than glaucoma. That number grew to 2144 in 2011 before dipping again to 1807 in 2013, then climbing once more to 1969 in 2014.

The number of people recognised per year as disabled by POAG grew from 96 in 2008 to 129 in 2012, then declined to 77 in 2014. The number of people with other kinds of glaucoma increased from 113 to 151 in 2012, then dropped to 94 in 2014.

In each year, some of the people in the sample were identified as disabled for the first time, whereas others had previously been recognised for this condition. Over the 7 years studied, 1334 people were identified as disabled for the first time. The proportion recognised for the first time was highest in 2012 (18.55%) and 2013 (18.87%), compared with only 2.58% in 2008 and 15.29% in 2014.

Similarly, in 2008 only 2.08% were recognised for the first time as disabled as a result of POAG, and in 2014 this percentage increased to 31.17%.

The fact that more than 90% of the people recognised with disabilities each year had previously been recognised indicates the "long duration, complexity and lack of effectiveness in medical, occupational, social and in-home rehabilitation," according to Dr Kryvoviaz.

Also, she noted an increasing number of people have been categorised as permanently disabled, which discourages rehabilitation efforts.

Among the disabled people with POAG, 19.86% were senior and 17.16% were classified as "senile."

Three-quarters of the people in the study were male, and they accounted for at least 70% of each of the subgroups.

The proportion of people whose disabilities were severe also increased over time, suggesting deterioration in the quality of diagnostics and screening.

About 26.59% of this cohort of visually disabled people and one-sixth of the people disabled with POAG were employed. Dr Kryvoviaz speculates there were not enough jobs that matched their work history. More vocational rehabilitation is needed for this population, she wrote.

Among working-age people with POAG, the rate of disability decreased from 70.83% in 2008 to 50.79% in 2011, before increasing to 58.44% in 2014. Over the course of the observation period, the average was 61.70%.

"The findings indicate a lack of modern science-based approaches to diagnostics, rehabilitation, medical and social examination of patients with [ophthalmologic] pathologies, thus stipulating further [detailed] study of this problem," Dr Kryvoviaz concluded.