Causes of irreversible unilateral or bilateral blindness in the Al Baha region of the Kingdom of Saudi Arabia

Purpose: To determine the causes of irreversible unilateral and bilateral blindness that cannot be rehabilitated medically, optically nor surgically in Al Baha province, Kingdom of Saudi Arabia. Methods: There were a retrospective chart review and examination of patients presenting to King Fahad Hospital Al Baha, Saudi Arabia, with unilateral or bilateral blindness from June 2011 to September 2011. Blindness was defined as best corrected visual acuity (BCVA) of less than 0.05 (Snellen, 20/400) or a visual field no greater than 10 degrees around central fixation. Data were collected on patient demographics, ocular disease either primary or secondary to systemic diseases and laterality if unilateral involvement. Results: One hundred consecutive patients were enrolled in the study. The mean age of the study sample was 58 +/- 2.28 years (range, 1-90 years). The male to female ratio was 3:2. The most common cause of blindness in one or both eyes per person was diabetes (30% of patients) followed by glaucoma (23%). Reclassification of the causes of the blindness according on World Health Organization (definition of blindness which included both eyes) did not change the causes of blindness. There were 76% patients with unilateral blindness. The most common causes of unilateral blindness were diabetes mellitus (DM) (19 patients; 27%), glaucoma (17 patients; 23%) and retinal diseases (other than that caused by DM) (17 patients; 23%). In the entire study sample, the male-to-female ratio for patients with blindness from DM was 2:1. Diabetic macular edema caused 87% of the cases of blindness in patients with DM mostly in the left eye. Conclusion: Diabetes mellitus and then glaucoma are the major causes of irreversible blindness in the Al Baha region in Saudi Arabia. Public health plans should be developed to encourage proper patient health education in the region. Additionally, effective screening should be performed at the primary health care centers for diabetes.