blindness awareness month 2013

7/30/2019 Blindness Awareness Month 2013

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Focus on Dominica - Dr. Hazel Shillingford Ricketts (Consultant Ophthalmologist)

The month of May has been designated as “Blindness Awareness Month”.

This means that during the month of May there will be a number of programmes geared towards

informing the general public about blindness.

The Dominica

Association of

Persons with

Disabilities must be

congratulated for

their efforts in

putting together a

programmes under

the theme:“Preventing blindness and assisting those whose sight

cannot be restored”.

Their goal is to create a more enabling and

accessible environment for persons with impaired

vision.

The term blind means the loss of sight. However for

the purpose of standardizing the level of loss of

vision referred to as blindness, it is defined as the

best-corrected visual acuity (that is with corrective

lenses) of less than 20/400 or a visual field of less

than 10 degrees (The normal being 180 degrees

horizontally), in the better eye.

Visual Impairment refers to the level of best-

corrected visual acuity of 20/70 to 20/200 or a

visual field of less than 20 degrees in the better eye.

(WHO classification)

The Snellen Fraction used to designate the level of

vision (example 20/400) means that this person can

only see letters at 20 feet which a person with

normal 20/20 vision can see 400 feet away.

There are about 285 million people around the

world who are blind or visually impaired. InDominica it is estimated that there about 700

persons who are blind and 2100 visually impaired.

There are many causes of blindness. Most of the

causes of blindness

can be treated to

restore vision or

prevent loss of

vision. However

there are some

causes of blindness

that cannot be

treated. About 80%

of blindness can be prevented. The majority of

people who are blind are older than 50 years. 90%

of the those who are blind in the world live in

developing countries and most live in poverty.

Blindness Awareness Month

Dr. Hazel Shillingford-Ricketts

http://www.eyecarecaribbean.com/






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The number of persons who are blind continues to rise as the world’s population is

increasing, people live longer and the prevalence of Diabetes Mellitus is increasing. This is a

serious public health issue. It is a serious socioeconomic concern not only for the individual

but for their family, their country and the world. Measures must be put in place to address

this rowin roblem.

Vision 2020: ‘The Right to Sight’ is a global initiative of the World Health

Organization and The International Agency for the Prevention of Blindness to

eliminate preventable causes of blindness by the year 2020.

In 2000, the Caribbean Vision 2020 Programme was launched and the strategy

is to eliminate blindness caused by Cataracts, Glaucoma, Diabetic Retinopathy,

Childhood Blindness and Refractive Errors (need for glasses). The programme

is geared at mobilizing resources to provide more services to reduce this

growing public health issue of blindness.There are a number of measures

already in place across every sector which helps to prevent blindness in" " " " " Dominica. Eye care delivered by the Ophthalmological Team is integrated in

" " " " " Primary Health Care throughout the island making eyecare available,

" " " " " affordable and accessible.

Important causes of blindness in children are Measles, Rubella and Vitamin A

Deficiency. Immunization and a diet rich in vitamin A has eliminated those

causes of childhood blindness. Clean water to bathe and keep the face clean

prevents blindness from a bacterial eye infection called trachoma still prevalent

in Africa and some other developing countries.Premature babies are at risk of blindness from Retinopathy of Prematurity.

Screening of premature babies to detect and treat this condition to prevent

blindness is ongoing.School Health Programme conducted by the Family Nurse

Practitioners for 5 and 11 year olds detects children with vision problems. They

are referred to the Ophthalmologist for further evaluation and treatment.

In the working age population, Diabetic Retinopathy is the leading cause of

blindness. This affects the productive sector of our country. It is important that

the risk factors of obesity, lack of exercise and proper nutrition are addressed to

reduce the number of people developing diabetes which now affects about 18%

of our population.







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Those diagnosed with Diabetes have to control their Blood Sugar, Blood

Pressure and Cholesterol to reduce the risk of developing Diabetic

Retinopathy. In addition,Diabetics must have regular eye examinations to

detect the eye complications early. Early detection and treatment can prevent

blindness. There is a screening fundus photography programme for Diabetics

in the Primary Health Sector. Laser treatment is available for treating DiabeticRetinopathy.

Cataract

Cataract is the leading cause of

blindness in the world. It is

responsible for over half of the

causes of blindness. If everyone

live long enough they will

develop Cataracts, as aging is the

most common risk factor.

However blindness from Cataract

can be reversed with a day

surgery under local anesthetic. It

is one of the most cost effective

surgical interventions.

Glaucoma

Glaucoma is the most dreaded

cause of blindness. It is the

leading cause of irreversible

blindness. Regular eye

examination from the age of 40 is

a good practice to detect if one has

Glaucoma especially if they have

a family member with it. The risk

increases as one gets older. It

cannot be cured but it can be

controlled by lowering the

intraocular pressure with

eyedrops, laser and surgery. It is a

silent thief of sight as it causes nosymptoms until it is in the

advanced stage. Glaucoma

medications are subsidized in the

public health sector. Despite

treatment, some people still

become blind from Glaucoma but

most preserve their sight.

Refractive Error

Refractive Errors - the need for

glasses, are a significant cause of

functional blindness and visual

impairment. Some people cannot

afford to buy glasses which are

medical devices to correct poor

vision. The Rotary Club and the

VOSH team provide low cost

glasses to the public during their

Annual Eye Screening Programme

The VAT (Value Added Tax) on

eyewear increases the cost

especially for those with high

prescriptions. Considerationshould be given to removing VAT

on corrective eyewear.







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In addition to the Vision 2020 list of eye diseases discussed above, a degenerative retinal condition in older

persons on the east coast of Dominica is a significant cause of irreversible blindness. Albinism is an

irreversible cause of visual impairment.

People with Down Syndrome have a greater prevalence of high Refractive Errors and Keratoconus making

some of them either functionally blind or visually impaired. They should have regular eye examinations and

provided with corrective glasses. There are also children who suffered birth asphyxia or who have congenitalabnormalities of the optic nerve and brain who are irreversibly blind.

There are many other causes of blindness.

In addition to prevention of blindness, the needs of those whose vision cannot be

restored must be addressed. Persons who are blind or visually impaired are entitled to

basic services and opportunities wherever they live, and there is a great need to increase

understanding of the needs of blind and visually impaired persons.

Blind Awareness Month 2013, provides an opportunity to address the rights and needs

of the blind, and so, the agenda for the month’s programme are directed at creating a

more enabling and accessible environment for persons with blindness and impaired

vision.

The Dominica Association of Persons with Disability has organized workshops, media

and video programmes, educational tips, and school presentations.

Being blind does not mean one is helpless, can’t learn, can’t work, can’t

love and have children, does not have talent or potential.

I urge persons who are blind or visually impaired to make use of theopportunities to rehabilitate themselves to continue living fulfilling lives at

home, at school, at work and socially.

Being aware of how to assist blind or visually impaired persons will be

empower them to become independent. Therefore, the general public

especially the cooperate community, service providers, schools, social

groups, caregivers and family members of the blind are urged to support

and participate in the activities organized for Blindness Awareness Month.

Thanks to the Dominica Association for Persons with disability and others

in the community for their ongoing efforts in assisting blind and visually impaired persons.

Contributed by Dr. Hazel Shillingford Ricketts M.B.B.S. (U.W.I); F.R.C.S. (C)




blindness awareness month 2013

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