Cambodian Eyes: An Overview of Ocular Anatomy and Health

The human eye’s characteristics are influenced by genetics and environmental exposure, which results in distinct anatomical traits and health considerations for Cambodian populations. This article explores these anatomical features, prevalent health conditions, and the context of eye care within Cambodian communities.

Ocular Anatomy in Cambodian Populations

In many individuals of Cambodian descent, a common feature is the epicanthal fold, a segment of skin on the upper eyelid that covers the inner corner of the eye. While not exclusive to Cambodians, this trait is frequently observed across East and Southeast Asian populations. Prevalence estimates in these groups range from 50% to 90%.

The specific form of this fold can vary, with the epicanthus tarsalis type, where the fold originates from the upper eyelid, being most common in East Asians. Another anatomical consideration is the structure of the eyelid crease. In many Asian populations, the eyelid may present as a “single eyelid” without a visible crease, or with a lower-sitting crease compared to other ethnic groups. These variations are normal and do not intrinsically affect vision.

Eye Health Conditions in Cambodian Populations

Primary angle-closure glaucoma (PACG) is a notable concern. This condition, where the eye’s drainage angle becomes blocked, increases intraocular pressure. Studies indicate that Asians are disproportionately affected, accounting for over 80% of PACG cases worldwide. The prevalence in Southeast Asian populations is approximately 0.66%, increasing with age and being more common in women.

Pterygium, a growth of tissue from the conjunctiva onto the cornea, is also widespread. Its development is linked to long-term ultraviolet (UV) radiation exposure. A Cambodian study found the highest prevalence (21.41%) in those aged 50-59, with over 70% of participants with the condition reporting they never used eye protection.

Cataracts, the clouding of the eye’s lens, are the leading cause of blindness in Cambodia, accounting for 65% of cases. While cataracts are a common age-related condition globally, the backlog of untreated cases in the country is substantial. Uncorrected refractive errors are another cause of visual impairment, contributing to the burden of avoidable vision loss.

Factors Impacting Eye Health in Cambodian Communities

Environmental, lifestyle, and socioeconomic factors influence eye health. Cambodia’s location within the “pterygium belt”—a region near the equator—results in high levels of ambient UV radiation. Occupations that involve extensive outdoor work, such as farming and fishing, increase cumulative sun exposure, a risk factor for both pterygium and cataracts.

Genetic predispositions also play a part. The anatomical structure of the eye common in some Asian populations, including a shallower anterior chamber, can be a risk factor for developing angle-closure glaucoma. Furthermore, socioeconomic conditions contribute to eye health outcomes. In rural areas, limited access to clean water and sanitation can increase the risk of infectious eye diseases like trachoma.

Health literacy and economic status are also determinants of eye health. A lack of awareness about preventable conditions and the importance of eye protection can delay diagnosis. For many in rural or impoverished communities, the cost of accessing care and the inability to take time off work present barriers to receiving treatment.

Ophthalmological Care and Public Health in Cambodian Contexts

The eye care system in Cambodia faces challenges related to infrastructure, workforce, and accessibility, particularly in rural areas. An estimated 180,000 Cambodians are blind, with a high percentage of these cases being preventable or treatable. In 2019, only about one-third of the nation’s hospitals were equipped to provide eye health services, and a shortage of ophthalmologists persists outside of major cities.

To address these gaps, the Cambodian Ministry of Health works with non-governmental organizations (NGOs) like The Fred Hollows Foundation and the Eye Care Foundation. These partnerships are instrumental in delivering services through surgical outreach camps, training local healthcare workers, and running community awareness campaigns. Initiatives like the Integrated People-Centered Eye Care (SEE-IPEC) project aim to strengthen the governance and quality of eye health services.

Public health strategies are focused on reducing preventable blindness. The National Strategic Plan for the Management and Prevention of Blindness 2021-2030 aims to lower the blindness rate to 0.3% by 2030. Efforts also include integrating eye care into screening programs for non-communicable diseases such as diabetes, which can cause diabetic retinopathy.