Elimination Of Avoidable Blindness Research Articles

WHITE SENILE CATARACTS: INTERMEDIATE ASSESSMENT OF IMPACT OF VISION 2020-THE RIGHT TO SIGHT PROGRAM IN RURAL NORTHERN INDIA

Worldwide cataract is the leading cause of avoidable blindness. In India according to a survey, blindness due to cataract accounts for over 2 seventy percent of avoidable blindness. The goal of vision 2020 1 program is elimination of avoidable blindness. Since cataract is major cause of avoidable blindness in developing countries like India, the key to success of vision 2020 initiative lies in addressing cataract 3 blindness. India is the signatory of vision 2020 program, initiated by World Health Organization (WHO) in 1999. The latest reports assessing impact of the program in India indicate increase in number of 4 cataract surgery rate. The cataract surgery rate (CSR) is the number of cataract surgeries per million populations per year. CSR is an important quantitative measure of cataract surgical service delivery within dened population. However, CSR only partly measure the impact of a program designed to eliminate the avoidable blindness. Another indicator, which measures proportion of persons receiving cataract surgery of the eligible visually impaired individuals, is cataract surgical coverage (CSC). CSC serves as an indicator to measure the extent to which services have covered the need of the 5 population. Most of the published literatures assessing impact of vision 2020 program have focused on CSR, and only few have dealt 6, 7 with CSC. Senile cataracts turning white are consequence of normal maturity process of crystalline lens, and often considered as resultant of delayed cataract surgery. Their prevalence in community is an indirect indicator of impact of program targeting blindness due to cataract. The study was aimed to determine hospital based incidence of white senile cataracts and to nd causes for delay in uptake of cataract surgery

What are the priorities for improving cataract surgical outcomes in Africa? Results of a Delphi exercise

PurposeThe quality of cataract surgery delivered in sub-Saharan Africa (SSA) is a significant constraint to achieving the elimination of avoidable blindness. No published reports from routine SSA cataract services attain the WHO benchmarks for visual outcomes; poor outcomes (<6/60) often comprise 20% in published case series. This Delphi exercise aimed to identify and prioritise potential interventions for improving the quality of cataract surgery in SSA to guide research and eye health programme development.MethodsAn initial email open-question survey created a ranked list of priorities for improving quality of surgical services. A second-round face-to-face discussion facilitated at a Vision 2020 Research Mentorship Workshop in Tanzania created a refined list for repeated ranking.ResultsSeventeen factors were agreed that might form target interventions to promote quality of cataract services. Improved training of surgeons was the top-ranked item, followed by utilisation of biometry, surgical equipment availability, effective monitoring of outcomes of cataract surgery by the surgeon, and well-trained support staff for the cataract pathway (including nurses seeing post-operative cases).ConclusionImproving the quality of cataract surgery in SSA is a clinical, programmatic and public health priority. In the absence of other evidence, the collective expert opinion of those involved in ophthalmic services regarding the ranking of factors to promote quality improvement, refined through this Delphi exercise, provides us with candidate intervention areas to be evaluated.

Generating Evidence for Program Planning: Rapid Assessment of Avoidable Blindness in Bangladesh

ABSTRACTPurpose: There is a lack of data on the prevalence and causes of blindness in Bangladesh, which is important to plan effective eye health programs and advocate support services to achieve the goals of Vision 2020.Methods: We conducted a rapid assessment of avoidable blindness (RAAB) in 8 districts of Bangladesh (January 2010 – December 2012) to establish the prevalence and causes of blindness. People aged ≥50 years were selected, and eligible participants had visual acuity (VA) measured. Ocular examinations were performed in those with VA<6/18. Additional information was collected for those who had or had not undergone cataract surgery to understand service barriers and quality of service.Results: In total, 21,596 people were examined, of which 471 (2.2%, 95% confidence interval, CI, 2.0–2.4%) were blind. The primary cause of blindness was cataract (75.8%). The majority of blindness (86.2%) was avoidable. Cataract and refractive error were the primary causes of severe visual impairment (73.6%) and moderate visual impairment (63.6%), respectively. Cataract surgical coverage for blind persons was 69.3% (males 76.6%, females 64.3%, P<0.001). The magnitude of blindness among people aged ≥50 years was estimated to be 563,200 people (95% CI 512,000–614,400), of whom 426,342 had un-operated cataract.Conclusions: In Bangladesh, the majority of blindness (86.2%) among people aged ≥50 years was avoidable, and cataract was the most important cause of avoidable blindness. Improving cataract surgical services and refraction services would be the most important step towards the elimination of avoidable blindness in Bangladesh.

Costs of Eye Care Services: Prospective Study from a Faith-based Hospital in Zambia

Purpose: To estimate the mean costs of cataract surgery and refractive error correction at a faith-based eye hospital in Zambia.Methods: Out-of-pocket expenses for user fees, drugs and transport were collected from 90 patient interviews; 47 received cataract surgery and 43 refractive error correction. Overhead and diagnosis-specific costs were determined from micro-costing of the hospital. Costs per patient were calculated as the sum of out-of-pocket expenses and hospital costs, excluding user fees to avoid double counting.Results: From the perspective of the hospital, overhead costs amounted to US$31 per consultation and diagnosis-specific costs were US$57 for cataract surgery and US$36 for refractive error correction. When including out-of-pocket expenses, mean total costs amounted to US$128 (95% confidence interval [CI] US$96--168) per cataract surgery and US$86 (95% CI US$67--118) per refractive error correction. Costs of providing services corresponded well with the user fee levels established by the hospital.Conclusion: This is the first paper to report on the costs of eye care services in an African setting. The methods used could be replicated in other countries and for other types of visual impairments. These estimates are crucial for determining resources needed to meet global goals for elimination of avoidable blindness.

Preventive eye health approach and elimination of avoidable blindness in remote rural areas - a vision health guardian approach

Preventive eye health approach and elimination of avoidable blindness in remote rural areas - a vision health guardian approach

Where are we in elimination of avoidable blindness after ten years of implementing ′VISION 2020 The Right to the sight′ in Oman?

Where are we in elimination of avoidable blindness after ten years of implementing ′VISION 2020 The Right to the sight′ in Oman?

Integrative Innovation: The Scientist's Challenge

Eye disease is a devastating illness with multiple complications and a steady march to blindness. Normally even with aggressive interventions, eye disease tends to progress. Given the increasing number of patients with eye disease, and according to the mission of VISION 2020 (The Right to Sight), it is imperative to find solutions to prevent the loss of vision and its complications. VISION 2020 program is the global initiative for the elimination of avoidable blindness, a joint program of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB). According to the WHO, it has been estimated that the number of blind people will rise to 76 million by 2020. Close to 75% of this blindness is avoidable. Meeting these crucial goals can be only accomplished through research. Early detection and interventions to slow down the progression of eye disease are urgently and critically needed.

Current status of cataract blindness and Vision 2020: The right to sight initiative in India

India is a signatory to the World Health Organization resolution on Vision 2020: The right to sight. Efforts of all stakeholders have resulted in increased number of cataract surgeries performed in India, but the impact of these efforts on the elimination of avoidable blindness is unknown. Projection of performance of cataract surgery over the next 15 years to determine whether India is likely to eliminate cataract blindness by 2020. Data from three national level blindness surveys in India over three decades, and projected age-specific population till 2020 from US Census Bureau were used to develop a model to predict the magnitude of cataract blindness and impact of Vision 2020: the right to sight initiatives. Using age-specific data for those aged 50+ years it was observed that prevalence of blindness at different age cohorts (above 50 years) reduced over three decades with a peak in 1989. Projections show that among those aged 50+ years, the quantum of cataract surgery would double (3.38 million in 2001 to 7.63 million in 2020) and cataract surgical rate would increase from 24025/million 50+ in 2001 to 27817/million 50+ in 2020. Though the prevalence of cataract blindness would decrease, the absolute number of cataract blind would increase from 7.75 million in 2001 to 8.25 million in 2020 due to a substantial increase in the population above 50 years in India over this period. Considering existing prevalence and projected incidence of cataract blindness over the period 2001-2020, visual outcomes after cataract surgery and sight restoration rate, elimination of cataract blindness may not be achieved by 2020 in India.

The role of optometry in primary health care delivery in Nigeria: A case study of Abia State University, Uturu, Nigeria

Optometry as a profession has a very important place in the Primary Health Care Programme for us to achieve health for all by 2010. Optometry is the art and science of vision care. An optometrist as defined by the Optometrists and Dispensing Opticians Registration Board of Nigeria is a health-care professional specializing in the art and science of vision care and whose scope of practice include: eye examinations to determine refractive errors and other departures from the optimally healthy and visually efficient eye; corrections of refractive errors of binocularity by means of vision training (orthoptics); diagnosis and management of minor ocular infections which do not pose a threat to the integrity of the ocular or visual system; and ocular first aid. The Optometrist by training is in the position to move vision and eye care delivery as close as possible to where people live and work. The global initiative, “Vision 2020. The right to Sight” established by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness, has created valuable and effective collaboration with organizations involved in a wide range of eye care and community healthcare activities aimed at the elimination of avoidable blindness and impaired vision. The Vision 2020's major priorities are the tackling of cataract, trachoma, onchocerciasis; childhood blindness, refractive error, low vision and so on. These have been selected not only because of the burden of blindness that they represent but, also because of the feasibility and affordability of interventions to prevent and treat these conditions.Global Journal of Mathematical Sciences Vol. 6 (1) 2007: pp.25-28

Trachoma: looking forward to Global Elimination of Trachoma by 2020 (GET 2020).

There is fortunately increasing international awareness of the problem of needless blindness from trachoma and enhanced international cooperation. This is exemplified by the World Health Organization Alliance for the Global Elimination of Blinding Trachoma by 2020 (GET 2020), the World Health Assembly resolution 51.11, 1998, and the inclusion of trachoma as a priority under the disease control component of the Global Initiative for the Elimination of Avoidable Blindness, Vision 2020--the Right to Sight. Evidence-based advances in knowledge and intervention strategies together with the additional financial resources now available offer opportunities for a concerted effort to control and eliminate blinding trachoma, long before the year 2020, in most countries.