ASSESSMENT OF COMMUNITY PARTICIPATION
AND SOCIODEMOGRAPHIC CONDITIONS IN THE
DETECTION OF CONGENITAL EYE MALFORMATIONS
IN THE ISTHMUS OF TEHUANTEPEC,
OAXACA, MEXICO
EVALUACIÓN DE LA PARTICIPACIÓN COMUNITARIA Y
CONDICIONES SOCIODEMOGRÁFICAS EN LA DETECCIÓN
DE MALFORMACIONES OCULARES CONGÉNITAS EN EL ISTMO
DE TEHUANTEPEC, OAXACA, MEXICO
Iván Antonio García Montalvo
División de Estudios de Posgrado e Investigación, México
María José Ruiz Sanginéz
División de Estudios de Posgrado e Investigación, México
pág. 6312
DOI: https://doi.org/10.37811/cl_rcm.v9i5.19991
Assessment of Community Participation and Sociodemographic Conditions
in the Detection of Congenital eye Malformations in the Isthmus of
Tehuantepec, Oaxaca, Mexico
ABSTRACT
This study focused on the detection and analysis of congenital eye diseases in the communities of Salina
Cruz and Juchitán de Zaragoza, located in the Isthmus of Tehuantepec region, Oaxaca, Mexico. The
study population included twenty possible cases, of which only seven met the specific criteria
established for the study, ensuring the validity of the results. The region is characterized by its
predominantly Zapotec cultural diversity and a high percentage of indigenous language speakers, which
meant that interpreters were needed for effective communication during interviews with the parents or
guardians of the affected children. Sociodemographic questionnaires were administered to thirty-four
participants, noting that most are engaged in domestic work and have varying levels of education,
ranging from no schooling to postgraduate degrees. The collaboration of medical specialists in
ophthalmology was essential for the diagnosis and appropriate selection of cases. The study highlights
the importance of addressing cultural and linguistic barriers in public health research, as well as the
ethical commitment to encourage community participation. These findings provide a solid basis for
future interventions aimed at improving the detection, prevention, and management of congenital eye
diseases in this multi-ethnic region of Oaxaca, Mexico.
Keywords: congenital eye diseases, indigenous population, public health, cultural diversity, isthmus of
tehuantepec
1 Autor principal
Correspondencia: ivan.garcia@itoaxaca.edu.mx
Iván Antonio García Montalvo1
ivan.garcia@itoaxaca.edu.mx
https://orcid.org/0000-0003-4993-9249
División de Estudios de Posgrado e
Investigación, Oaxaca
México
María José Ruiz Sanginéz
mariaj.rsanginez@gmail.com
https://orcid.org/0009-0003-7181-6365
División de Estudios de Posgrado e
Investigación, Oaxaca
México
DOI: https://doi.org/10.37811/cl_rcm.v9i5.19991
Assessment of Community Participation and Sociodemographic Conditions
in the Detection of Congenital eye Malformations in the Isthmus of
Tehuantepec, Oaxaca, Mexico
ABSTRACT
This study focused on the detection and analysis of congenital eye diseases in the communities of Salina
Cruz and Juchitán de Zaragoza, located in the Isthmus of Tehuantepec region, Oaxaca, Mexico. The
study population included twenty possible cases, of which only seven met the specific criteria
established for the study, ensuring the validity of the results. The region is characterized by its
predominantly Zapotec cultural diversity and a high percentage of indigenous language speakers, which
meant that interpreters were needed for effective communication during interviews with the parents or
guardians of the affected children. Sociodemographic questionnaires were administered to thirty-four
participants, noting that most are engaged in domestic work and have varying levels of education,
ranging from no schooling to postgraduate degrees. The collaboration of medical specialists in
ophthalmology was essential for the diagnosis and appropriate selection of cases. The study highlights
the importance of addressing cultural and linguistic barriers in public health research, as well as the
ethical commitment to encourage community participation. These findings provide a solid basis for
future interventions aimed at improving the detection, prevention, and management of congenital eye
diseases in this multi-ethnic region of Oaxaca, Mexico.
Keywords: congenital eye diseases, indigenous population, public health, cultural diversity, isthmus of
tehuantepec
1 Autor principal
Correspondencia: ivan.garcia@itoaxaca.edu.mx
Iván Antonio García Montalvo1
ivan.garcia@itoaxaca.edu.mx
https://orcid.org/0000-0003-4993-9249
División de Estudios de Posgrado e
Investigación, Oaxaca
México
María José Ruiz Sanginéz
mariaj.rsanginez@gmail.com
https://orcid.org/0009-0003-7181-6365
División de Estudios de Posgrado e
Investigación, Oaxaca
México
pág. 6313
Evaluación de la Participación Comunitaria y Condiciones
Sociodemográficas en la Detección de Malformaciones Oculares
Congénitas en el Istmo de Tehuantepec, Oaxaca, Mexico
RESUMEN
Este estudio se centró en la detección y análisis de enfermedades oculares congénitas en las
comunidades de Salina Cruz y Juchitán de Zaragoza, ubicadas en la región del Istmo de Tehuantepec,
Oaxaca, México. La población de análisis incluyó veinte posibles casos, de los cuales solo siete
cumplieron con los criterios específicos establecidos para el estudio, garantizando la validez de los
resultados. La región se caracteriza por su diversidad cultural predominante zapoteca y un alto
porcentaje de hablantes de lenguas indígenas, lo que implicó la necesidad de intérpretes para una
comunicación efectiva durante las entrevistas con padres o tutores de los menores afectados. Se
aplicaron cuestionarios sociodemográficos a treinta y cuatro participantes, destacando que la mayoría
se dedica a labores del hogar y presenta distintos niveles educativos, desde ausencia de estudios hasta
posgrado. La colaboración de médicos especialistas en oftalmología fue fundamental para el
diagnóstico y la selección adecuada de los casos. El estudio subraya la importancia de abordar las
barreras culturales y lingüísticas en investigaciones de salud pública, así como el compromiso ético
para fomentar la participación comunitaria. Estos hallazgos ofrecen una base sólida para futuras
intervenciones dirigidas a mejorar la detección, prevención y manejo de enfermedades oculares
congénitas en esta región multiétnica de Oaxaca, México.
Palabras clave: enfermedades oculares congénitas, población indígena, salud pública, diversidad
cultural, istmo de tehuantepec
Artículo recibido 25 agosto 2025
Aceptado para publicación: 25 setiembre 2025
Evaluación de la Participación Comunitaria y Condiciones
Sociodemográficas en la Detección de Malformaciones Oculares
Congénitas en el Istmo de Tehuantepec, Oaxaca, Mexico
RESUMEN
Este estudio se centró en la detección y análisis de enfermedades oculares congénitas en las
comunidades de Salina Cruz y Juchitán de Zaragoza, ubicadas en la región del Istmo de Tehuantepec,
Oaxaca, México. La población de análisis incluyó veinte posibles casos, de los cuales solo siete
cumplieron con los criterios específicos establecidos para el estudio, garantizando la validez de los
resultados. La región se caracteriza por su diversidad cultural predominante zapoteca y un alto
porcentaje de hablantes de lenguas indígenas, lo que implicó la necesidad de intérpretes para una
comunicación efectiva durante las entrevistas con padres o tutores de los menores afectados. Se
aplicaron cuestionarios sociodemográficos a treinta y cuatro participantes, destacando que la mayoría
se dedica a labores del hogar y presenta distintos niveles educativos, desde ausencia de estudios hasta
posgrado. La colaboración de médicos especialistas en oftalmología fue fundamental para el
diagnóstico y la selección adecuada de los casos. El estudio subraya la importancia de abordar las
barreras culturales y lingüísticas en investigaciones de salud pública, así como el compromiso ético
para fomentar la participación comunitaria. Estos hallazgos ofrecen una base sólida para futuras
intervenciones dirigidas a mejorar la detección, prevención y manejo de enfermedades oculares
congénitas en esta región multiétnica de Oaxaca, México.
Palabras clave: enfermedades oculares congénitas, población indígena, salud pública, diversidad
cultural, istmo de tehuantepec
Artículo recibido 25 agosto 2025
Aceptado para publicación: 25 setiembre 2025
pág. 6314
INTRODUCTION
The assessment of community participation and sociodemographic conditions in the detection of
congenital eye malformations is a topic of relevance for regional development and public health,
specifically in regions or areas considered to be highly marginalized (Stapleton et al., 2023). The
Isthmus of Tehuantepec, a region in southeastern Mexico with significant ethnic and socioeconomic
diversity (Gómez-Martínez, 2010), provides a favorable setting for examining how these variables
influence the early detection of eye disorders. The relationship between community, sociodemographic
factors, and the detection of congenital eye malformations is fundamental to designing interventions
that seek to improve early diagnosis and comprehensive care, to contribute to the quality of life and
social development of the Oaxacan population in this region.
The Isthmus of Tehuantepec stands out as a strategic area in Mexico, characterized by a complex
interaction between its cultural wealth, ethnic diversity, and economic particularities (Hofmann, 2024).
Despite its significant potential in terms of connectivity and natural resources, the region faces
substantial challenges, as does the entire state of Oaxaca, in terms of health equity, reflected in limited
access to specialized services and educational and economic gaps (Padilla-Rivera et al., 2024). These
structural and sociodemographic conditions directly influence the identification and management of
congenital eye malformations, disorders that, when not detected promptly, can lead to permanent visual
impairments or functional loss that negatively impact the individual's overall development and social
integration (González-Villoria & Abeldaño-Zuñiga, 2018; Elam et al., 2022).
Congenital eye malformations comprise a diverse set of structural abnormalities of the eye and its
adnexa, present at birth or manifesting in the neonatal period and early childhood (Guercio & Martyn,
2007). These malformations include conditions such as anophthalmia (complete absence of the eye),
microphthalmia (small eye), coloboma (defect in the eye structure), optic nerve dysgenesis, and
deformities of the cornea or lens, among others. From a clinical perspective, these pathologies are often
associated with significant vision loss or blindness and usually require multidisciplinary interventions
ranging from reconstructive surgery to visual rehabilitation treatments (Russo et al., 2025; Harding &
Moosajee, 2019; Chen et al., 2021).
INTRODUCTION
The assessment of community participation and sociodemographic conditions in the detection of
congenital eye malformations is a topic of relevance for regional development and public health,
specifically in regions or areas considered to be highly marginalized (Stapleton et al., 2023). The
Isthmus of Tehuantepec, a region in southeastern Mexico with significant ethnic and socioeconomic
diversity (Gómez-Martínez, 2010), provides a favorable setting for examining how these variables
influence the early detection of eye disorders. The relationship between community, sociodemographic
factors, and the detection of congenital eye malformations is fundamental to designing interventions
that seek to improve early diagnosis and comprehensive care, to contribute to the quality of life and
social development of the Oaxacan population in this region.
The Isthmus of Tehuantepec stands out as a strategic area in Mexico, characterized by a complex
interaction between its cultural wealth, ethnic diversity, and economic particularities (Hofmann, 2024).
Despite its significant potential in terms of connectivity and natural resources, the region faces
substantial challenges, as does the entire state of Oaxaca, in terms of health equity, reflected in limited
access to specialized services and educational and economic gaps (Padilla-Rivera et al., 2024). These
structural and sociodemographic conditions directly influence the identification and management of
congenital eye malformations, disorders that, when not detected promptly, can lead to permanent visual
impairments or functional loss that negatively impact the individual's overall development and social
integration (González-Villoria & Abeldaño-Zuñiga, 2018; Elam et al., 2022).
Congenital eye malformations comprise a diverse set of structural abnormalities of the eye and its
adnexa, present at birth or manifesting in the neonatal period and early childhood (Guercio & Martyn,
2007). These malformations include conditions such as anophthalmia (complete absence of the eye),
microphthalmia (small eye), coloboma (defect in the eye structure), optic nerve dysgenesis, and
deformities of the cornea or lens, among others. From a clinical perspective, these pathologies are often
associated with significant vision loss or blindness and usually require multidisciplinary interventions
ranging from reconstructive surgery to visual rehabilitation treatments (Russo et al., 2025; Harding &
Moosajee, 2019; Chen et al., 2021).
pág. 6315
Early detection is crucial to maximizing functional potential and avoiding severe disabilities, which
depend mainly on active community participation and the availability of adequate diagnostic resources.
Congenital eye malformations have a complex multifactorial etiology, in which genetic and
environmental factors interact. Eye formation is a highly regulated process during embryogenesis,
involving multiple genes and signaling pathways (Bovolenta & Martinez-Morales, 2019). Genetic
alterations, whether due to point mutations, deletions, or duplications, can disrupt the normal
development of the eyeball and its associated structures. Adverse environmental exposures during
pregnancy, such as maternal infections (toxoplasmosis, rubella), nutritional deficiencies, use of
teratogenic medications, or maternal metabolic conditions, can increase the risk of malformations
(Cifuentes et al., 2025). In the Isthmus of Tehuantepec, health education and access to prenatal care are
limited, hindering the prevention and early detection of these risk factors, leading to a higher incidence
and late diagnosis, which further complicates appropriate clinical management.
By promoting awareness of the importance of early diagnosis and working together to reduce stigma
and cultural barriers, communities can strengthen their response capacity, facilitating timely referrals to
specialized services (Coombs et al., 2022). These aspects are crucial in preventing irreversible visual
impairment. For highly marginalized, low-income populations with limited medical infrastructure, the
lack of information, combined with poor access to pediatric ophthalmology services, limits the
opportunity for early diagnosis. In indigenous communities, language barriers, cultural differences, and
mistrust of formal health systems further hinder the identification and management of these cases
(Martínez-Martínez & Rodríguez-Brito, 2020). This study focuses on analyzing community
participation and the sociodemographic conditions that affect the detection of congenital eye
malformations in the Isthmus of Tehuantepec, to provide a comprehensive approach that facilitates the
formulation of contextualized intervention strategies.
METHODS
The research was conducted in the Isthmus of Tehuantepec region in Oaxaca, Mexico, a multi-ethnic
area characterized by its cultural diversity and predominance of indigenous language speakers,
specifically Zapotec. This area was selected due to its geographical, climatic, and social characteristics,
which influence the detection of congenital eye malformations, thereby determining community
Early detection is crucial to maximizing functional potential and avoiding severe disabilities, which
depend mainly on active community participation and the availability of adequate diagnostic resources.
Congenital eye malformations have a complex multifactorial etiology, in which genetic and
environmental factors interact. Eye formation is a highly regulated process during embryogenesis,
involving multiple genes and signaling pathways (Bovolenta & Martinez-Morales, 2019). Genetic
alterations, whether due to point mutations, deletions, or duplications, can disrupt the normal
development of the eyeball and its associated structures. Adverse environmental exposures during
pregnancy, such as maternal infections (toxoplasmosis, rubella), nutritional deficiencies, use of
teratogenic medications, or maternal metabolic conditions, can increase the risk of malformations
(Cifuentes et al., 2025). In the Isthmus of Tehuantepec, health education and access to prenatal care are
limited, hindering the prevention and early detection of these risk factors, leading to a higher incidence
and late diagnosis, which further complicates appropriate clinical management.
By promoting awareness of the importance of early diagnosis and working together to reduce stigma
and cultural barriers, communities can strengthen their response capacity, facilitating timely referrals to
specialized services (Coombs et al., 2022). These aspects are crucial in preventing irreversible visual
impairment. For highly marginalized, low-income populations with limited medical infrastructure, the
lack of information, combined with poor access to pediatric ophthalmology services, limits the
opportunity for early diagnosis. In indigenous communities, language barriers, cultural differences, and
mistrust of formal health systems further hinder the identification and management of these cases
(Martínez-Martínez & Rodríguez-Brito, 2020). This study focuses on analyzing community
participation and the sociodemographic conditions that affect the detection of congenital eye
malformations in the Isthmus of Tehuantepec, to provide a comprehensive approach that facilitates the
formulation of contextualized intervention strategies.
METHODS
The research was conducted in the Isthmus of Tehuantepec region in Oaxaca, Mexico, a multi-ethnic
area characterized by its cultural diversity and predominance of indigenous language speakers,
specifically Zapotec. This area was selected due to its geographical, climatic, and social characteristics,
which influence the detection of congenital eye malformations, thereby determining community
pág. 6316
participation factors and sociodemographic conditions. An observational, descriptive, and cross-
sectional design was used, focused on evaluating community participation and sociodemographic
conditions related to the detection of congenital eye malformations in two communities: Salina Cruz
and Juchitán de Zaragoza. The sample consisted of individuals with clinically suspected congenital eye
malformations detected during community eye care campaigns. To this end, medical specialists made
an initial diagnosis and applied specific inclusion criteria. An open call was made to the local population
to participate in the study.
Data collection techniques and instruments
The instruments used to collect information included semi-structured interviews designed and validated
with a Cronbach's alpha of 0.88, to capture not only basic sociodemographic data, but also aspects
related to the community's perceptions of congenital eye diseases, usual health practices, and barriers
faced in accessing specialized medical services. These interviews were conducted in a flexible format,
adapting to the context of the interlocutor to create an atmosphere of trust and openness.
The research team undertook a series of preliminary community outreach activities, including
informational meetings with local leaders and awareness sessions on the importance of early detection
of eye malformations. This initial engagement was crucial to increasing willingness to participate and
ensuring that the study was conducted with respect for local norms and worldviews.
In technical terms, the ophthalmological examinations were carried out using portable equipment
suitable for fieldwork, and standardized protocols for clinical diagnosis were applied to identify
congenital eye malformations with a high degree of reliability in non-hospital conditions. Prior training
of staff in intercultural care and communication skills facilitated patient-centered care that was sensitive
to cultural differences.
Data analysis and ethical considerations
The quantitative data collected were organized using SPSS statistical software version 22 to facilitate a
descriptive analysis that would identify sociodemographic patterns associated with community
detection and participation. At the same time, a qualitative study of the open-ended responses was
conducted to gain a deeper understanding of the sociocultural dynamics that influence the process of
identifying and managing these pathologies.
participation factors and sociodemographic conditions. An observational, descriptive, and cross-
sectional design was used, focused on evaluating community participation and sociodemographic
conditions related to the detection of congenital eye malformations in two communities: Salina Cruz
and Juchitán de Zaragoza. The sample consisted of individuals with clinically suspected congenital eye
malformations detected during community eye care campaigns. To this end, medical specialists made
an initial diagnosis and applied specific inclusion criteria. An open call was made to the local population
to participate in the study.
Data collection techniques and instruments
The instruments used to collect information included semi-structured interviews designed and validated
with a Cronbach's alpha of 0.88, to capture not only basic sociodemographic data, but also aspects
related to the community's perceptions of congenital eye diseases, usual health practices, and barriers
faced in accessing specialized medical services. These interviews were conducted in a flexible format,
adapting to the context of the interlocutor to create an atmosphere of trust and openness.
The research team undertook a series of preliminary community outreach activities, including
informational meetings with local leaders and awareness sessions on the importance of early detection
of eye malformations. This initial engagement was crucial to increasing willingness to participate and
ensuring that the study was conducted with respect for local norms and worldviews.
In technical terms, the ophthalmological examinations were carried out using portable equipment
suitable for fieldwork, and standardized protocols for clinical diagnosis were applied to identify
congenital eye malformations with a high degree of reliability in non-hospital conditions. Prior training
of staff in intercultural care and communication skills facilitated patient-centered care that was sensitive
to cultural differences.
Data analysis and ethical considerations
The quantitative data collected were organized using SPSS statistical software version 22 to facilitate a
descriptive analysis that would identify sociodemographic patterns associated with community
detection and participation. At the same time, a qualitative study of the open-ended responses was
conducted to gain a deeper understanding of the sociocultural dynamics that influence the process of
identifying and managing these pathologies.
pág. 6317
To cover ethical aspects, written informed consent was obtained from all participants or their legal
guardians. The study complied with current ethical standards for human research, ensuring
confidentiality, voluntariness, and safety for the subjects based on Mexican Official Standard 012-
SSA3-2012 (NOM-012-SSA3-2012).
RESULTS
Screening sessions were held in the communities of Salina Cruz and Juchitán de Zaragoza, Oaxaca,
inviting residents to participate. In this initial phase of the study, two ophthalmologists, two assistants,
and one researcher collaborated. Participants were recruited through an initial diagnosis provided by
the medical specialists, who applied specific selection criteria to identify pathologies related to
congenital eye diseases during interviews with participants. This approach ensured that the selected
subjects met the necessary requirements for the study, thus guaranteeing the validity and relevance of
the data collected.
A total of twenty possible cases of congenital eye diseases were treated in the communities of Salina
Cruz and Heroica Ciudad de Juchitán de Zaragoza, Oaxaca, Mexico. During the recruitment process,
various reasons were identified why eight of the subjects chose not to participate in the study, reflecting
the importance of addressing the concerns and needs of the local population to encourage their
involvement in scientific research.
In addition, five cases were excluded from the analysis because they did not meet the specific criteria
established for the study. These criteria are essential to ensure the validity and relevance of the results,
as they allow for the appropriate selection of participants with the congenital eye conditions of interest.
The rigorous application of these criteria ensures that the data collected is representative and valid for
a better understanding of the characteristics and prevalence of these conditions in the region. It is
essential to emphasize that this process is not limited to case selection, but also involves a commitment
to ethics and transparency in research.
During the fieldwork, face-to-face interviews were conducted, and questionnaires on sociodemographic
data were administered to a total of 34 parents or guardians of the selected subjects. It is important to
note that 77% of the participants were speakers of an indigenous language, which made it necessary to
use interpreters to ensure effective and accurate communication during the data collection process.
To cover ethical aspects, written informed consent was obtained from all participants or their legal
guardians. The study complied with current ethical standards for human research, ensuring
confidentiality, voluntariness, and safety for the subjects based on Mexican Official Standard 012-
SSA3-2012 (NOM-012-SSA3-2012).
RESULTS
Screening sessions were held in the communities of Salina Cruz and Juchitán de Zaragoza, Oaxaca,
inviting residents to participate. In this initial phase of the study, two ophthalmologists, two assistants,
and one researcher collaborated. Participants were recruited through an initial diagnosis provided by
the medical specialists, who applied specific selection criteria to identify pathologies related to
congenital eye diseases during interviews with participants. This approach ensured that the selected
subjects met the necessary requirements for the study, thus guaranteeing the validity and relevance of
the data collected.
A total of twenty possible cases of congenital eye diseases were treated in the communities of Salina
Cruz and Heroica Ciudad de Juchitán de Zaragoza, Oaxaca, Mexico. During the recruitment process,
various reasons were identified why eight of the subjects chose not to participate in the study, reflecting
the importance of addressing the concerns and needs of the local population to encourage their
involvement in scientific research.
In addition, five cases were excluded from the analysis because they did not meet the specific criteria
established for the study. These criteria are essential to ensure the validity and relevance of the results,
as they allow for the appropriate selection of participants with the congenital eye conditions of interest.
The rigorous application of these criteria ensures that the data collected is representative and valid for
a better understanding of the characteristics and prevalence of these conditions in the region. It is
essential to emphasize that this process is not limited to case selection, but also involves a commitment
to ethics and transparency in research.
During the fieldwork, face-to-face interviews were conducted, and questionnaires on sociodemographic
data were administered to a total of 34 parents or guardians of the selected subjects. It is important to
note that 77% of the participants were speakers of an indigenous language, which made it necessary to
use interpreters to ensure effective and accurate communication during the data collection process.
pág. 6318
This underscores the importance of considering language barriers in studies involving diverse
communities, ensuring that all participants can express their opinions and experiences without
difficulty.
The average age of respondents was 47.8 years; however, it is essential to mention that 85.7% of the
study subjects are minors (n=6). Therefore, the approval of their parents or guardians was required for
their participation in the study, which was formalized through the signing of an informed consent form.
This procedure is essential to protect the rights and safety of minors involved in scientific research.
Regarding the educational level attained by respondents, it was observed that 8.9% had no formal
education. In comparison, 26.7% had completed primary education, 20% had attended secondary
school, 27.8% had attained high school graduation, 13.3% had a bachelor's degree, and only 3.3% had
postgraduate studies. These data reflect a varied educational landscape that may influence the
understanding and management of health in the community.
About current occupations, it was found that 6.7% are merchants, 21.1% are employees in various areas,
and a notable 72.2% are engaged in household work. This occupational distribution highlights the
importance of unpaid work and its impact on family and community dynamics.
Taken together, these findings provide valuable context for understanding the sociodemographic
characteristics of the study population and their relationship to congenital eye diseases, which may
guide future interventions and public health policies in the region.
DISCUSSION
Oaxaca is one of the 32 states that make up the Mexican Republic, renowned for its extraordinary
cultural diversity, which is evident in the coexistence of numerous ethnic groups and the presence of
approximately 1.22 million speakers of indigenous languages. Among these groups, the Zapotec stands
out as the most predominant, reflecting a rich cultural and linguistic heritage.
The Isthmus of Tehuantepec region in the state of Oaxaca, Mexico, is the subject of analysis in this
study. It is strategically important due to its location. This area is home to a predominantly Zapotec
multi-ethnic population, where diverse ethnic groups contribute distinctive histories and languages that
enrich the local culture. This region has been a focal point for natural disasters such as floods and
earthquakes, as well as epidemics that have severely impacted its social and economic development.
This underscores the importance of considering language barriers in studies involving diverse
communities, ensuring that all participants can express their opinions and experiences without
difficulty.
The average age of respondents was 47.8 years; however, it is essential to mention that 85.7% of the
study subjects are minors (n=6). Therefore, the approval of their parents or guardians was required for
their participation in the study, which was formalized through the signing of an informed consent form.
This procedure is essential to protect the rights and safety of minors involved in scientific research.
Regarding the educational level attained by respondents, it was observed that 8.9% had no formal
education. In comparison, 26.7% had completed primary education, 20% had attended secondary
school, 27.8% had attained high school graduation, 13.3% had a bachelor's degree, and only 3.3% had
postgraduate studies. These data reflect a varied educational landscape that may influence the
understanding and management of health in the community.
About current occupations, it was found that 6.7% are merchants, 21.1% are employees in various areas,
and a notable 72.2% are engaged in household work. This occupational distribution highlights the
importance of unpaid work and its impact on family and community dynamics.
Taken together, these findings provide valuable context for understanding the sociodemographic
characteristics of the study population and their relationship to congenital eye diseases, which may
guide future interventions and public health policies in the region.
DISCUSSION
Oaxaca is one of the 32 states that make up the Mexican Republic, renowned for its extraordinary
cultural diversity, which is evident in the coexistence of numerous ethnic groups and the presence of
approximately 1.22 million speakers of indigenous languages. Among these groups, the Zapotec stands
out as the most predominant, reflecting a rich cultural and linguistic heritage.
The Isthmus of Tehuantepec region in the state of Oaxaca, Mexico, is the subject of analysis in this
study. It is strategically important due to its location. This area is home to a predominantly Zapotec
multi-ethnic population, where diverse ethnic groups contribute distinctive histories and languages that
enrich the local culture. This region has been a focal point for natural disasters such as floods and
earthquakes, as well as epidemics that have severely impacted its social and economic development.
pág. 6319
Recently, the COVID-19 pandemic has exacerbated existing vulnerabilities in the population.
The social, political, and cultural dimensions that affect these communities in the Isthmus, as well as
factors such as malnutrition, play a crucial role in the quality of life of their inhabitants. The combination
of all these elements makes it even more complex, given the context in which this research is being
conducted, highlighting the need to address local challenges from a comprehensive perspective that
takes into account cultural particularities as well as socioeconomic conditions.
The sociodemographic results obtained reflect a picture that coincides with observations in other
indigenous contexts. Studies in Amazonian indigenous communities in Venezuela and Colombia
documented similar difficulties in detecting eye diseases due to language barriers and mistrust of formal
health systems, which limit the early identification of visual pathologies (PAHO, 2018; Hernández-
Sarmiento et al., 2017). This phenomenon is comparable to the high proportion of indigenous language
speakers (77%) in our study, which required the inclusion of interpreters to ensure effective
communication, highlighting the need for culturally sensitive approaches that consider linguistic
particularities to achieve success in community eye care.
The prevalence of minors among subjects with congenital ocular malformations (85.7%) reflects the
marked importance of timely diagnosis in pediatric groups, a fact that is recognized internationally. A
study in communities in the Xingu Indigenous Park in Brazil highlighted the need for screening and
visual education campaigns among indigenous children, emphasizing that early correction of visual
defects can open up future educational and employment opportunities, improving the quality of
community life (Fernandes et al., 2021). These parallels may indicate that interventions targeting
indigenous populations should be prioritized in pediatric programs to maximize their impact.
The heterogeneous educational level found among parents and guardians has an incidental influence on
the understanding and management of eye health conditions in the community. This coincides with
international clinical reviews that link low education with lower participation in visual screening
programs and adherence to treatments (Burnett et al., 2018). Educational diversity poses a challenge in
designing education and awareness campaigns that cater to varying levels of literacy and knowledge
about eye health, a critical factor in increasing detection and providing better follow-up.
Recently, the COVID-19 pandemic has exacerbated existing vulnerabilities in the population.
The social, political, and cultural dimensions that affect these communities in the Isthmus, as well as
factors such as malnutrition, play a crucial role in the quality of life of their inhabitants. The combination
of all these elements makes it even more complex, given the context in which this research is being
conducted, highlighting the need to address local challenges from a comprehensive perspective that
takes into account cultural particularities as well as socioeconomic conditions.
The sociodemographic results obtained reflect a picture that coincides with observations in other
indigenous contexts. Studies in Amazonian indigenous communities in Venezuela and Colombia
documented similar difficulties in detecting eye diseases due to language barriers and mistrust of formal
health systems, which limit the early identification of visual pathologies (PAHO, 2018; Hernández-
Sarmiento et al., 2017). This phenomenon is comparable to the high proportion of indigenous language
speakers (77%) in our study, which required the inclusion of interpreters to ensure effective
communication, highlighting the need for culturally sensitive approaches that consider linguistic
particularities to achieve success in community eye care.
The prevalence of minors among subjects with congenital ocular malformations (85.7%) reflects the
marked importance of timely diagnosis in pediatric groups, a fact that is recognized internationally. A
study in communities in the Xingu Indigenous Park in Brazil highlighted the need for screening and
visual education campaigns among indigenous children, emphasizing that early correction of visual
defects can open up future educational and employment opportunities, improving the quality of
community life (Fernandes et al., 2021). These parallels may indicate that interventions targeting
indigenous populations should be prioritized in pediatric programs to maximize their impact.
The heterogeneous educational level found among parents and guardians has an incidental influence on
the understanding and management of eye health conditions in the community. This coincides with
international clinical reviews that link low education with lower participation in visual screening
programs and adherence to treatments (Burnett et al., 2018). Educational diversity poses a challenge in
designing education and awareness campaigns that cater to varying levels of literacy and knowledge
about eye health, a critical factor in increasing detection and providing better follow-up.
pág. 6320
CONCLUSIONS
In conclusion, we can say that the detection of congenital eye malformations is deeply influenced by
sociocultural and demographic factors, which lead to a lack of determination in the viability of effective
preventive or therapeutic interventions in marginalized regions of the state of Oaxaca. The
predominance of indigenous language speakers, together with low educational levels and high rates of
domestic work, reflects and perpetuates a context of structural inequality that directly affects access to
and follow-up of specialized medical services. It is essential to consider promoting awareness
campaigns and intercultural education to overcome linguistic and sociocultural barriers that can hinder
risk perception and the timely identification of visual pathologies in minors. The high proportion of
affected children and limited access to diagnostic resources highlight the urgent need to strengthen
community training, engage local leaders, and adapt screening methodologies that take into account
cultural diversity and differentiated literacy levels. Informed consent processes and the active
involvement of parents or guardians, verified through a rigorous ethical strategy, can be key elements
in strengthening trust and participation in epidemiological studies.
Acknowledgements
The authors would like to thank the Secretariat of Science, Humanities, Technology, and Innovation
(SECIHTI) for the funding and support provided through project CBF2023-2024-136, which was
essential for the completion of this work.
BIBLIOGRAPHIC REFERENCE
Bovolenta, P., Martinez-Morales, J. R. (2019). Genetics of congenital eye malformations: insights from
chick experimental embryology. Hum Genet, 138(8-9), 1001-6. Doi: 10.1007/s00439-018-
1900-5.
Burnett, A. M., Yashadhana, A., Lee, L., Serova, N., Brain, D., Naidoo, K. (2018). Interventions to
improve school-based eye-care services in low- and middle-income countries: a systematic
review. Bull World Health Organ, 96(10), 682-94D. Doi: 10.2471/BLT.18.212332.
Chen, H. Y., Lehmann, O. J., Swaroop, A. (2021). Genetics and therapy for pediatric eye diseases.
EBioMedicine, 67, 103360. Doi: 10.1016/j.ebiom.2021.103360.
CONCLUSIONS
In conclusion, we can say that the detection of congenital eye malformations is deeply influenced by
sociocultural and demographic factors, which lead to a lack of determination in the viability of effective
preventive or therapeutic interventions in marginalized regions of the state of Oaxaca. The
predominance of indigenous language speakers, together with low educational levels and high rates of
domestic work, reflects and perpetuates a context of structural inequality that directly affects access to
and follow-up of specialized medical services. It is essential to consider promoting awareness
campaigns and intercultural education to overcome linguistic and sociocultural barriers that can hinder
risk perception and the timely identification of visual pathologies in minors. The high proportion of
affected children and limited access to diagnostic resources highlight the urgent need to strengthen
community training, engage local leaders, and adapt screening methodologies that take into account
cultural diversity and differentiated literacy levels. Informed consent processes and the active
involvement of parents or guardians, verified through a rigorous ethical strategy, can be key elements
in strengthening trust and participation in epidemiological studies.
Acknowledgements
The authors would like to thank the Secretariat of Science, Humanities, Technology, and Innovation
(SECIHTI) for the funding and support provided through project CBF2023-2024-136, which was
essential for the completion of this work.
BIBLIOGRAPHIC REFERENCE
Bovolenta, P., Martinez-Morales, J. R. (2019). Genetics of congenital eye malformations: insights from
chick experimental embryology. Hum Genet, 138(8-9), 1001-6. Doi: 10.1007/s00439-018-
1900-5.
Burnett, A. M., Yashadhana, A., Lee, L., Serova, N., Brain, D., Naidoo, K. (2018). Interventions to
improve school-based eye-care services in low- and middle-income countries: a systematic
review. Bull World Health Organ, 96(10), 682-94D. Doi: 10.2471/BLT.18.212332.
Chen, H. Y., Lehmann, O. J., Swaroop, A. (2021). Genetics and therapy for pediatric eye diseases.
EBioMedicine, 67, 103360. Doi: 10.1016/j.ebiom.2021.103360.
pág. 6321
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medications: A EUROmediCAT study. Birth Defects Res, 117(2), e2435. Doi:
10.1002/bdr2.2435.
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(2021). Visual impairment and blindness in the Xingu Indigenous Park - Brazil. Int J Equity
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multiétnica y socioeconómica en una región. CDMX (México): CIESAS. Available in:
https://www.aacademica.org/emanuel.gomez/32.pdf.
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to the principal causes of morbidity and mortality in the Mexican state of Oaxaca. Int J Equity
Health, 17, 132. Doi: 10.1186/s12939-018-0849-2.
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North Am, 40(1), 113-40. Doi: 10.1016/j.otc.2006.11.013.
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Journal of Developmental Biology, 7(3), 16. Doi: 10.3390/jdb7030016.
Cifuentes, E. A., Beau, A., Caillet, A., Frémont, F., Neville, A. J., Ballardini, E., Dolk, H., Loane, M.,
Garne, E., Khoshnood, B., Lelong, N., Rissmann, A., O'Mahony, M., Pierini, A., Gatt, M.,
Bergman, J. E. H., Krawczynski, M. R., Latos-Bielenska, A., Echevarría-González de Garibay,
L. J., Cavero-Carbonell, C., Addor, M. C., Tucker, D., Jordan, S., Den Hond, E., Nelen, V.,
Barisic, I., Rouget, F., Randrianaivo, H., Hoareau, J., Perthus, I., Courtade-Saïdi, M., Damase-
Michel, C., Dubucs, C. (2025). Risk of congenital ocular anomaly after prenatal exposure to
medications: A EUROmediCAT study. Birth Defects Res, 117(2), e2435. Doi:
10.1002/bdr2.2435.
Coombs, N. C., Campbell, D. G., Caringi, J. (2022). A qualitative study of rural healthcare providers'
views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res,
22(1), 438. doi: 10.1186/s12913-022-07829-2.
Elam, A. R., Tseng, V. L., Rodriguez, T. M., Mike, E. V., Warren, A. K., Coleman, A. L. (2022).
American academy of ophthalmology taskforce on disparities in eye care. Disparities in vision
health and eye care. Ophthalmology, 129 (10): e89-113. Doi: 10.1016/j.ophtha.2022.07.010.
Fernandes, A. G., Alves, M., Nascimento, R. A. E., Valdrighi, N. Y., de Almeida, R. C., Nakano, C. T.
(2021). Visual impairment and blindness in the Xingu Indigenous Park - Brazil. Int J Equity
Health, 20(1), 197. Doi: 10.1186/s12939-021-01536-w.
Gómez-Martínez, E. (2010). Diagnóstico regional del Istmo de Tehuantepec. En Nahmad, Salomón,
Dalton, Margarita y Nahón, Abraham Aproximaciones a la región del Istmo. Diversidad
multiétnica y socioeconómica en una región. CDMX (México): CIESAS. Available in:
https://www.aacademica.org/emanuel.gomez/32.pdf.
González-Villoria, A. M., Abeldaño Zuñiga, R. A. (2018). Social vulnerability and its possible relation
to the principal causes of morbidity and mortality in the Mexican state of Oaxaca. Int J Equity
Health, 17, 132. Doi: 10.1186/s12939-018-0849-2.
Guercio, J. R., Martyn, L. J. (2007). Congenital malformations of the eye and orbit. Otolaryngol Clin
North Am, 40(1), 113-40. Doi: 10.1016/j.otc.2006.11.013.
Harding, P., Moosajee, M. (2019). The molecular basis of human anophthalmia and microphthalmia.
Journal of Developmental Biology, 7(3), 16. Doi: 10.3390/jdb7030016.
pág. 6322
Hernández-Sarmiento, J. M., Sánchez-Díaz, E., Martínez-Sánchez, L. M., Rendón-Villa, S., Vallejo-
Agudelo, E. O., Gallego-González, D., Marín-Cárdenas, J. S., Jaramillo-Jaramillo, L.,
Rodríguez-Gázquez, M. Á., Bahamón-Trujillo, J. A. (2017). Perfil clínico y epidemiológico de
las enfermedades oculares no infecciosas en comunidades indígenas de Chocó, Colombia
Archivos de Medicina (Col), 17(1), 91-9.
Hofmann, S. (2024). Infrastructure megaprojects as world erasers: Cultural survival in the context of
the Tehuantepec Isthmus interoceanic corridor. Latin American Perspectives, 51(5), 140-63.
Doi: 10.1177/0094582X241294080.
Martínez-Martínez, O. A., Rodríguez-Brito, A. (2020). Vulnerability in health and social capital: a
qualitative analysis by levels of marginalization in Mexico. Int J Equity Health, 19(1), 24. Doi:
10.1186/s12939-020-1138-4.
Organización Panamericana de la Salud (OPS). 2018. Comunidades indígenas de Amazonas son
evaluadas para la detección de tracoma. Available in: https://www.paho.org/es/noticias/24-8-
2018-comunidades-indigenas-amazonas-son-evaluadas-para-deteccion-tracoma. Accessed on:
02/09/2025.
Padilla-Rivera, A., Morales Brizard, M., Merveille, N., Güereca-Hernandez, L. P. (2024). Barriers,
challenges, and opportunities in the adoption of the circular economy in Mexico: An analysis
through social perception. Recycling, 9(5), 71. Doi: 10.3390/recycling9050071.
Russo, M., Palmeri, S., Zucconi, A., Vagge, A., Arioni, C. (2025). Management of anophthalmia,
microphthalmia and coloboma in the newborn, shared care between neonatologist and
ophthalmologist: a literature review. Ital J Pediatr, 51(1), 65. Doi: 10.1186/s13052-025-01882-
3.
Stapleton, F., Abad, J. C., Barabino, S., Burnett, A., Iyer, G., Lekhanont, K., Li, T., Liu, Y., Navas, A.,
Obinwanne, C. J., Qureshi, R., Roshandel, D., Sahin, A., Shih, K., Tichenor, A., Jones, L.
(2023). TFOS lifestyle: Impact of societal challenges on the ocular surface. Ocul Surf, 28, 165-
99. Doi: 10.1016/j.jtos.2023.04.006.
Hernández-Sarmiento, J. M., Sánchez-Díaz, E., Martínez-Sánchez, L. M., Rendón-Villa, S., Vallejo-
Agudelo, E. O., Gallego-González, D., Marín-Cárdenas, J. S., Jaramillo-Jaramillo, L.,
Rodríguez-Gázquez, M. Á., Bahamón-Trujillo, J. A. (2017). Perfil clínico y epidemiológico de
las enfermedades oculares no infecciosas en comunidades indígenas de Chocó, Colombia
Archivos de Medicina (Col), 17(1), 91-9.
Hofmann, S. (2024). Infrastructure megaprojects as world erasers: Cultural survival in the context of
the Tehuantepec Isthmus interoceanic corridor. Latin American Perspectives, 51(5), 140-63.
Doi: 10.1177/0094582X241294080.
Martínez-Martínez, O. A., Rodríguez-Brito, A. (2020). Vulnerability in health and social capital: a
qualitative analysis by levels of marginalization in Mexico. Int J Equity Health, 19(1), 24. Doi:
10.1186/s12939-020-1138-4.
Organización Panamericana de la Salud (OPS). 2018. Comunidades indígenas de Amazonas son
evaluadas para la detección de tracoma. Available in: https://www.paho.org/es/noticias/24-8-
2018-comunidades-indigenas-amazonas-son-evaluadas-para-deteccion-tracoma. Accessed on:
02/09/2025.
Padilla-Rivera, A., Morales Brizard, M., Merveille, N., Güereca-Hernandez, L. P. (2024). Barriers,
challenges, and opportunities in the adoption of the circular economy in Mexico: An analysis
through social perception. Recycling, 9(5), 71. Doi: 10.3390/recycling9050071.
Russo, M., Palmeri, S., Zucconi, A., Vagge, A., Arioni, C. (2025). Management of anophthalmia,
microphthalmia and coloboma in the newborn, shared care between neonatologist and
ophthalmologist: a literature review. Ital J Pediatr, 51(1), 65. Doi: 10.1186/s13052-025-01882-
3.
Stapleton, F., Abad, J. C., Barabino, S., Burnett, A., Iyer, G., Lekhanont, K., Li, T., Liu, Y., Navas, A.,
Obinwanne, C. J., Qureshi, R., Roshandel, D., Sahin, A., Shih, K., Tichenor, A., Jones, L.
(2023). TFOS lifestyle: Impact of societal challenges on the ocular surface. Ocul Surf, 28, 165-
99. Doi: 10.1016/j.jtos.2023.04.006.