Trends in the Prevalence of Blindness and Correlation With Health Status in Korean Adults: A 10-Year Nationwide Population-Based Study

Na Kyeong Ik,Lee Won June,Kim Young Kook 대한의학회 2023 Journal of Korean medical science Vol.38 No.28

Background: Contemporary data on vision impairment form an important basis for public health policies. However, most data on the clinical epidemiology of blindness are limited by small sample sizes and focused not on systemic conditions but ophthalmic diseases only. In this study, we examined the ten-year trends of blindness prevalence and its correlation with systemic health status in Korean adults. Methods: This study investigated 10,000,000 participants randomly extracted from the entire Korean population (aged ≥ 20 years) who underwent a National Health Insurance Service health checkup between 2009 and 2018. Participants with blindness, defined as visual acuity in the better-seeing eye of ≤ 20/200, were identified. The prevalence of blindness was assessed, and the systemic health status was compared between participants with blindness and without blindness. Results: The mean prevalence of blindness was 0.473% (47,115 blindness cases) and tended to decrease over ten years (0.586% in 2009 and 0.348% in 2018; P < 0.001). The following factors were significantly associated with blindness: female sex, underweight (body mass index < 18.5), high serum creatinine (> 1.5 mg/dL), and bilateral hearing loss. In addition, except for those aged 30–39 and 40–49 years, high fasting glucose (≥ 126 mg/dL) and low hemoglobin (male: < 12 g/dL, female: < 10 g/dL) were significantly correlated with prevalent blindness. Conclusion: Our ten-year Korean nationwide population-based study suggested a gradual decrease in the prevalence of blindness and its association with specific systemic health status. These conditions might be the cause or consequence of blindness and can be used as a reference for the prevention and/or rehabilitation of blindness to establish public health policies.

일측 중도시각장애인과 가족의 체험연구

김경란 ( Kyung Ran Kim ) 부모자녀건강학회 2015 부모자녀건강학회지 Vol.18 No.2

Purpose: The purpose of this study is to discover the nature from the life experience of a person with unilateral acquired blindness and his/her family after losing the eyesight and adapting in the environment and to find the meaning of life and how to solve the problem in psychosocial aspect. Methods: This study uses one of the qualitative research methods which explains how families with the unilateral acquired blind perceive blindness after experiencing it and observes how they signify it. starts with interest in lifestyles of individuals and their families and tries to understand the subjective existences of participants in accessible ways and draw the experiences after becoming one-side blind. It cyclically uses deductive verification process through inductive method and establishing hypothesis using materials. Results: According to the results of this study, unilateral acquired blindness studies, due to shattered life, they did not know what to do. Also, discomfort from struggling in a big tunnel and even will to live were found. trying to go out to the world, seeing the new world, and trying to encourage myself, strong attachment to life was shown to by saying, appeared. Each includes sub-topics such as feeling abandoned after confirmed the blindness, feeling disappointed to doctors, family, and friends, trying to live with hope, struggling in a tunnel with thinking how to live, closing the mind from the world, seeing outside the world in the midst of struggling, trying to forget the past with the will of life, having hope to live with care of family, and trying to keep the rest vision. Conclusion: Firstly, in nursing aspect for their adaptation, programs for disable people and nursing intervention focused on their families should be developed. Secondly, since it can be economic and psychological burden for their families and acquaintances, it is necessary to support the blind so that they can find fitted rehabilitation programs and come back to society. Thirdly, active participation of health care providers may influence social interest the improvement of national welfare policy for the unilateral acquired blind.

J. M. 쿳시의 『야만인을 기다리며』와 주제 사라마구의『눈먼 자들의 도시』를 통해 본 인간의 ‘눈멂’이 갖는 상징적 의미

이정일(Jeongil Lee) 한국동서비교문학학회 2017 동서 비교문학저널 Vol.0 No.40

In this article, I address how blindness has held a particular fascination in literature due to the fact that the loss of sight, an internal state of disaster, is ironically assumed to be a sign of wisdom or maturity. In J.M. Coetzee’s novel Waiting for the Barbarians and José Saramago’s novel Blindness, however, blindness is primarily used as a sign of the symbolic transformation process in which blindness reinforces characters such as the Magistrate, the doctor’s wife, etc. in the process of becoming animal. In both novels, blindness or suffering can function as a source of transforming a human from a citizen into a barbarian, or from a majoritarian into a woman/minoritarian. To articulate the concept, the concept of “becoming animal” by Gilles Deleuze and Felix Guattari and the theory of torture by Elaine Scarry are used as a metaphor to say that the animality is exposed when the suffering is forced against their will. In this regard, I argue that in both novels, many chose to be an animal when they were deprived of their sight or social position. But a small group of people (doctor’s wife, the magistrate, etc) refused to be an animal by accepting the process of becoming-woman or becoming minoritarian. I argue that their choice confirms that we gain insight by accepting our limits of moral blindness.

Transient Blindness in a Patient with Severe Metformin-Associated Lactic Acidosis(MALA)

Jae Wan Jeon,Wonjung Choi,Hae Ri Kim,Young Rok Ham,Dae Eun Choi,Ki Ryang Na,Kang Wook Lee,Soo Ya Bae,Seong Hoon Kim 전해질고혈압연구회 2019 Electrolytes & Blood Pressure Vol.17 No.1

A 68-year-old man presented at the emergency room with sudden blindness. The day before, he had eaten sashimi and eel and drank alcohol for dinner. He experienced nausea, vomiting, and dizziness afterward. His medical his- tory included hypertension and diabetes, and the latter was treated with met- formin. Initial laboratory tests revealed severe metabolic acidosis(lactic aci- dosis). Massive hydration and intravenous sodium bicarbonate replacement therapies were initiated, but severe metabolic acidosis(lactic acidosis) did not resolve, in turn, leading to hemodialysis, which decreased metabolic aci- dosis. The patient’s blindness improved, and his vision gradually recovered. As it is not easy to distinguish between blindness related to metformin-asso- ciated lactic acidosis(MALA) and blindness related to other causes, rapid correction of metabolic acidosis through hemodialysis might be helpful in differentiating this from of blindness from blindness related to other causes.

『맹인의 나라』와 『눈먼자들의 도시』의 원형 : 인간의 정체성 추구

심상욱(Shim Sang-wook) 신영어영문학회 2003 신영어영문학 Vol.24 No.-

This paper is to examine the archetypal myth in the English writer and critic H. G. Wells' The Country of the Blind (1911) and Portuguese Jose Saramago's The Blindness (1995), the 1998 Nobel Prize for Literature. Using the approach of a parallel literary study in comparative literature, it is possible to fundamentally observe a representation of human life and the universality of humanity. In recent years, the field of comparative literature has broadened its scope beyond tracing direct influences to focus on comparisons of cultural significance and on analyses of analogues and contrasts. Bulfinch, a scholar of mythology, has already mentioned that mythology is the handmaid of literature in The Age of Fable, and its relationship between mythology and literary work is closely connected, and therefore, some critics define archetype as a universal symbol. According to Northrope Frye, who wrote Anatomy of Criticism as a synthesis book for archetypal criticism, he emphasized to apply scientific methods to study literary works. Although a lot of scholars attacked him for this endeavor, by the 1990s, his archetypal criticism began to receive more acceptance. Wells' The Country of the Blind is a warning work against the contemporary culture in crisis, and in the story a climber Nunez fell into the valley of the blind and experienced a lot of bizarre things which men who were unable to see requested to do as their customs, but because he had eyes to see, he couldn't accomplish thing as the other men could do. Some critics say Wells' works like this have an archetypal myth, such as the falling into the valley of the blind. Saramargo's The Blindness also consisted of the same archetypal myth as Wells using a quest motif in searching for the personal identity of mankind. And so, we can determine in The Country of the Blind and The Blindness, the archetypal myth of Tiresias in Greek mythology, who is blind but has prophetic power. As Frye indicated the imagination of myth, we can be seen as we emphasize it to live out the power of liberal arts through the search for the personal identity of mankind as it relates to mythology.

집단인식의 법리와 의도적 인식회피 -결합론에 대한 비판과 조직모델적 대안의 검토-

안성조 ( Seong Jo Ahn ) 안암법학회 2011 안암 법학 Vol.0 No.34

The problem of how to assign mens rea to a corporation in a criminal prosecution has been a troubling one for courts and commentators alike. After the decision in United States v. Bank of New England, N.A., most commentators thought that new method of easily imputing criminal intent to a corporation had arisen. This is the collective knowledge doctrine. Under this doctrine, courts supposedly may collect the knowledge possessed separately by different employees within a corporation so as to create the requisite guilty corporate state of mind, even if there is no single employees entirely at fault. However, some commentators argue that Bank of New England has been misread, because it allowed collectivized employee knowledge on in the face of culpable corporate conduct, namely the corporation`s willful blindness to factual information and legal requirements. They tried to demonstrate that the willful blindness prerequisite for knowledge aggregation is a powerful for explaining every other leading cases included within the collective knowledge doctrine. Also they argue, to aggregate corporate knowledge without the presence of willful blindness would violate the Constitution, and conclude that the collective knowledge doctrine is not an independent method for establishing corporate mens rea, but rather exists as a logical corollary to the much more common method of establishing scienter through willful blindness. This paper examines these argument critically and in the end concludes that firstly, in the view of organizational model, the leading cases need not be interpreted to require willful blindness, because they could be understood as reflecting the organizational model and secondly the doctrine could be regarded as independent method for establishing corporate intent, and finally the doctrine without the presence of willful blindness does not violate the Constitution.

중도 시각장애인의 좌절감 유발 기제 연구

정임순 ( Im Soon Jeong ) 한남대학교 사회과학연구소 2015 사회과학연구 Vol.24 No.-

중도 시각장애인의 경우 시각장애에 의한 정신적 충격이 선천성 시각장애인에 비해 더크다. 이는 실명 이전에는 세상의 만물을 보아왔기 때문이다. 따라서 어느 날을 기점으로 하여 이제부터는 세상을 보지 못한다는 두려움과 공포에 의한 정신적 충격과 좌절은 실로 상당히 크다. 이처럼 중도 시각장애인은 정신적으로 좌절감을 겪게 되는데 이의 좌절감이 심하면 자살이라는 극단적 선택까지 하게 된다. 때문에 중도 시각장애인의 심리적 재활에 있어 좌절감은 대단히 중요한 문제이다. 이에 본 연구에서는 중도 시각장애인에게 좌절감을 유발하는 기제가 무엇인지 Max van Manen의 해석학적 현상학적 질적연구에 의해 밝혀보고자 하였다. 본 연구에서는 중도 시각장애인에게 좌절감을 유발시키는 기제를 확인하기 위하여 ‘치료’, ‘실명’, ‘직업’, ‘격리와 우롱’이라는 본질적 주제와 ‘실명통보’, ‘치유에 대한 체념’, ‘진행성실명’, ‘실명인정’, ‘직업상실’, ‘취업을 위한 재교육’, ‘의사소통 단절’, ‘소외’, ‘조롱’이라는 하위 주제를 도출하였다. 그리고 본질적 주제를 범주화하여 분석한 결과 이들 하위 주제가 곧중도 시각장애인에게 좌절감을 유발하는 기제가 된다는 것을 확인하였다. Person with lately visual impairments is more than shocked to psychology of the congenital blind by visual impairment. The reason is that they have seen all things of the world. Therefore, it is a severe mental shock and frustration to newly blinded person with fear and panic that they cannot see the world from now on. Based on this, newly blinded person get psychologically frustrated resulting in committing suicide; thus, controlling frustration is the vital factor in psychological rehabilitation of newly blinded person. Herein, we demonstrate which mechanism results in people’s frustration with acquired visual impairments by Max van Manen’s hermeneutic phenomenological qualitative research approach. In this study, in order to check mechanism which induces newly blinded person’s frustration, it was divided into essential subjects, ‘treatment’, ‘blindness’, ‘occupation’, ‘isolation and derision’, and sub-themes, ‘blindness notice’, ‘resignation for healing’, ‘progressive blindness’, ‘blindness recognition’, ‘job loss’, ‘re-education for employment’, ‘communication disconnection’, ‘alienation’, ‘ridicule’. As a result of analysis by classification of the essential subject matter, it was confirmed that these sub-topics was the mechanism which induced newly blinded person’s frustration.

The Uncanny, Normalcy, and the EnLIGHTenment: Reversing the Hegemony of Vision in H. G. Wells’s “The Country of the Blind”

( Boosung Kim ) 한국근대영미소설학회 2018 근대 영미소설 Vol.25 No.1

H. G. Wells’s 1904 story “The Country of the Blind,” in which a Western explorer happens upon a village in an isolated valley where all the citizens are blind, produces multiple effects by reversing the hegemony of normalcy. Following the protagonist Nunez’s cognitive path, the reader experiences the uncanny that can be summed up as “cognitive estrangement” and “estranged familiarity.” Encountering something familiar yet strange in this otherworldly setting, the readers sense something has long been repressed in the process of constructing normalcy keeps returning. The blind townspeople’s way of treating Nunez’s eyes questions the ideas of disability in nineteenth-century Britain and suggests alternative ways of thinking about the abnormal by exposing how blindness has been conceived in society. Blindness in this story also brings the hegemony of vision to the front and functions to unravel it as Nunez’s failed project of enlightenment to educate the townspeople debunks ocularcentrism associated with the project of enlightenment in Western Europe. Depicting Nunez’s downgraded status in the valley, the story undermines vision’s firm connection with the notions pertinent to the Enlightenment such as knowledge, power, and freedom. The story encourages readers to question the hegemony of normalcy constructed in their own society and to reconcile between estrangement and familiarity.

Sleight of Mind: Choice Blindness at a Simple Feature Level

나종인,김민식 한국인지및생물심리학회 2020 한국심리학회지 인지 및 생물 Vol.32 No.3

Choice blindness, the failure to notice mismatches between an intended choice and presented outcome, has mostly been documented in decision-making tasks focusing on preferences, opinions, and facial recognition. To expand upon the existing choice blindness literature, we investigated whether the effect occurs in a non-ambiguous decision-making situation. To test this, we examined if conspicuous mismatches were detected when a simple single feature was manipulated using unidimensional stimuli. In Experiment 1, participants were presented with two bars of differing length and were told to choose the longer bar. Afterwards, their selection was presented on screen and participants had to enter how much longer their selection was than the other. In a few trials, however, the relationship between choice and outcome was manipulated and participants received the bar they did not choose. Consistent with previous experiments, only 20% of the manipulations were detected. To make sure participants actually interacted with the stimuli, in Experiment 2, participants had to adjust the length of the chosen bar themselves. While detection rates rose, choice blindness was still existent. Experiment 3 investigated the effect of task-relevancy on choice blindness. Participants were more susceptible to choice blindness when a task-irrelevant feature was swapped rather than a task-relevant feature. The principal finding was that, though all accurately remembered the difference, most were unaware of the mismatch even when the sole feature was manipulated. Also, both task-relevancy and stimulus similarity moderated the effect, hinting that both top-down and bottom-up attention plays a role.

중도 시각장애인의 레질리언스에 관한 근거이론 적용

권기범,최하나,정종화 한국장애인복지학회 2017 한국장애인복지학 Vol.- No.35

The purpose of this research is analyzing resilience in people with acquired blindness who are in the midst of confusion, discouragement and social isolation. Data collection was conducted by in-depth interviews with the 8 volunteers and analyzed by Strauss and Corbin method. Results were deduced through open coding, classified into 168 concepts, 47 subcategories and 13 categories. The central phenomenon of the resilience study of the acquired blindness was 'The mind-strike of being disabled' and the causal conditions were 'Factors of casting darkness', 'Choosing surgery to avoid encroaching disability' and 'Swept away by the storm of darkness'. The contextual conditions were ‘Side effects of being blind', 'Life falling apart after the loss of a treasured sight' and 'Recovery obstacles'. The mediating conditions were 'Engraved experiences prior to disability', 'Immediate reaction to becoming blind' and 'Bearing the pain'. The action/interaction strategy has been designated as 'Overcoming disability' and 'Recovering mentality'. The result was ‘Inflorescence over the thorn of disability'. The research presents basic data for practical intervention by introducing individual, family, community and nation-wide standards of situational models affecting resilience of the acquired blindness. 본 연구는 중도실명으로 인한 시각장애인의 혼란과 낙심의 사회적 고립을 회복해 가는 레질리언스에 관한 연구이다. 질적 데이터의 자료 수집은 연구 참여자 8명의 중도실명자를 대상으로 심층인터뷰를 통하여 수집되었고, 분석방법은 스트라우스와 코빈이 제시한 방법을 사용하였다. 연구결과로 168개의 개념과 47개의 하위범주, 13개의 범주로 도출되었다. 중도 시각장애인 레질리언스의 중심현상은 ‘장애의 폭풍우가 마음을 헤집어 놓음'으로 드러났으며, 인과적 조건으로는 ‘눈에 어두움을 드리운 인자들’, ‘폭풍우에 잠식당하지 않기 위한 수술을 결정함’, ‘흑암의 폭풍우가 쓸고 지나간 결과’들로 드러났다. 맥락적 조건은 ‘시각장애로 오는 부작용들’, ‘보배인 눈을 잃으니 전 생애가 무너짐’, ‘회복을 위한 저해요인들’이였다. 중재적 조건은 “장애를 갖기 전의 삶에 새겨진 경험”, “시력을 잃은 직후에 충격 속에서의 반응”, “아픔의 대상들을 끌어안음”이었다. 작용/상호작용 전략은 ‘장애를 박차고 일어남’, ‘심력이 회복됨’으로 나타났고, 그 결과는 ‘장애의 가시 위에 꽃이 핌’으로 구성되었다. 결론적으로 전문적인 초기상담과 장애인식교육, 심리적 고통경감의 노력, 장애인 당사자의 자기주도적인 삶을 위한 사회적지지망 구축의 절실함을 제언하였다.