WORLD SIGHT DAYWORLD SIGHT DAY
Dr. Madhuri. DixitDr. Madhuri. Dixit.. M.S.(Ophth)M.S.(Ophth)
Managing Trustee Managing Trustee Vivekanand Nertalaya . Belgaum.Vivekanand Nertalaya . Belgaum.
W S DW S D
• World Sight Day (WSD) is an annual day of awareness held on the second Thursday of October, to focus global attention on blindness and vision impairment.
The global day for awareness of blindness and vision impairment
W H Y W S DW H Y W S D
• Raise public awareness of blindness & vision impairment as major international public health issues
• Influence Governments/Ministers of Health to participate in and designate funds for national blindness prevention programmes
• Educate target audiences about blindness prevention, about VISION 2020 and its activities, and to generate support for VISION 2020 programme activities
What is VISION 2020What is VISION 2020
VISION 2020 : the Right to Sight
VISION 2020 Working together to eliminate avoidable blindness
VISION 2020 PartnershipsVISION 2020 Partnerships
W H O
Technical Assistance
CapacityBuilding
National Partners - National Vision 2020 PlansSustainable program delivery
What is Avoidable BlindnessWhat is Avoidable Blindness
• Avoidable blindness is defined as blindness which could be either treated or prevented by known, cost-effective means.
Global Avoidable Blindness Global Avoidable Blindness
37 million
INDIAN SENARIOINDIAN SENARIO
India has HIGHEST number of blind globaly-12 MILLION
Every year 2 MILLIONS are added
62% are from CATARACTNPCB from 1976 supported by
World bank
• Very Rich
• Levels of rising “overnutrition”
• World class academies and institutes.
• World class health care facilities and booming health tourism
• Women with education, power and influence
• A third of the world’s poor, nearly 400million living on less than $1/day
• 46% of children malnourished
• Highest number of illiterate people in the world
• The infant mortality rate of 57/1000 live births.
• Sex ratio of 933 females/1000 males
Source: 1) Sample Registration System 2003- Annual Report, Office of the Registrar General, India 2) census of India 2001 3) Department of International Development (DFID)
India: a land of contrasts
•Gender disparity are high in almost in every sector of health sector
Prevalence of cataract more in females than males
• In addition, there exists spatial disparities between urban and rural areas, and across Sates
Gender DisparityGender Disparity
• RAAB 2007: prevalence of blindness 9.2% in women and 6.6% in men (over 50)5% lower rate of IOL implantation
• State to State Cataract Surgical Rate (CSR) varies from 500 to 6,000
INNOVATIVE INITIATIONSINNOVATIVE INITIATIONS
• Vivekanand Netralaya.Belgaum.(Priyadarshini Eye Health Care
&Reseach Foundation)
• Clear Mission for VISION-”Comprehensive qwality eye care for poor & underpriviledged blind people , free of cost & training medical & paramedical peressonel for this noble cause .”
INNOVATIVE INITIATIONSINNOVATIVE INITIATIONS Vivekanand Netralaya How we work?
• Focus is only on underpriveledged• Reaching out to them in remote places • Identifying cataract patients• Trasporting them to base hospital• Catract removal with IOL Implantation• Transporting back to their villages • Follow up
Vivekanand Netralaya Vivekanand Netralaya BelgaumBelgaum
• Total No. of Cataract operations 5070
• 99.99% with IOL
• More females than males
35%
11%
41%
13%
Pvt. Hosp.
NGO Hosp
Govt. Hosp.
Eye Camp
Causes of Blindness in India
62.2%19.7%
5.8%
0.9%
11.4%
CataractUncorrected Refractive Errors GlaucomaDiseases of CorneaOthers including Leprosy, diabetic retinopathy etc
Blindness Scenario in IndiaBlindness Scenario in India
Emerging priorities and patterns of eye diseases
• Cataract remains the leading cause of blindness despite impressive advancements in surgical services.
• Uncorrected Refractive Errors is now recognised as the second leading cause, followed by Glaucoma, cornea.
• Childhood Blindness is now gaining attention.
• Diabetic Retinopathy is now becoming a major problem.
• Despite an over increasing need, low vision services are dramatically lacking
CataractCataract
First cause of blindness (~50%)
– backlog: 20 million un-operated cases
– only 10 million surgeries year
• major constraints :– coverage– access – quality
Cataract operations/million population/year
0
1000
2000
3000
4000
5000
6000
USA EU India Lat.Am Africa China
CSR
Cataract Surgical Rate in India
2001 - 2002 2003 - 2004
WHO 2004
SICS Ray of hope to combat SICS Ray of hope to combat avoidable blindness due to avoidable blindness due to
CataractCataract
• Easy
• Effective
• Economical
Childhood Blindness in IndiaChildhood Blindness in India
• 320,000 children are blind (19% of the world’s blind children) • 50% of these cases are treatable or preventable
• In addition, an estimated 9.2 million children are visually impaired
• Causes: Cataract, Ref Errors, Corneal ulcer/ opacity, ROP, Glaucoma
• Life expectancy of a blind child is assumed to be 48 years, resulting in a loss of 33 working years
• Burden of childhood blindness measured in blind-person years is next only to cataract.
• Loss estimated to India’s GNP is US$11.1 billion
Analysis of blindness profile in Blind SchoolAnalysis of blindness profile in Blind School
Blindness profile in Blind SchoolBlindness profile in Blind School
Congenital Cause25 %
Acquired Cause75 %
TreatableTreatable and Curable62.5 %
Not Treatable37.5 %
37.5 % of 25 % i.e. 9 out of 100 cases untreatable
Corneal Blindness Scenario - IndiaCorneal Blindness Scenario - India
Backlog of corneal blind people : 1.1 million
Added every year : 25,000 - 30,000
Corneas required / year : 75,000 - 1,00,000
Corneas collected / year : 28,000 - 30,000
Cornea utilized for sight restoration: 12,000 - 15,000
Collection vs. Utilization : 40-55%
Need for Eye BankingNeed for Eye Banking
Non availability of grafts
Lack of quality in preservation & assessment
of cornea tissue
Lack of trained human resources
Lack of standardized protocols, accreditation
& need for appropriate legislation
Lack of awareness of eye donation (gap
between pledge and actual donation)
• Nearly 171 Million Worldwide have Diabetes
• Likely to double to nearly 366 million by 2030.
Diabetes rising worldwideDiabetes rising worldwide
India China US Russia Germany
Pop
ulat
ion
[Mill
ion]
Diabetic Population [Million]
29 31.7
40.9
57
79.4
0
10
20
30
40
50
60
70
80
90
1995 2002 2007 #2025 #2030
• An estimated 200% increase in next two decades
• 5.5 % Diabetic prevalence Rate
• 1/3 to 1/5 of Diabetic patients have DR
• There may be approximately 11-20 million with diabetic retinopathy by 2025
• 75% diabetic for more than 20 years will develop some form of diabetic retinopathy
• If not contained, India may be home for the largest number of diabetic blind
(Source: WHO)
DR Scenario - IndiaDR Scenario - India
Reasons for Rise in DiabetesReasons for Rise in Diabetes
Denial of diabetes and no regular treatment
Limited awareness of diabetes and related eye disease
Asymptomatic nature of DR gives patient no warning
No routine eye examination as a health seeking behavior
Misconceptions:
Controlling blood sugar levels eliminates the risk of visual loss
If I can see well, why seek medical help
Poverty
Eye Care Delivery System
Quality
Equity
Supply and Equipment
National & sub national structures
Urban - rural divide
Life style
Long life expectancy
Human Resources:
Under utilized HR: 12,000 ophthalmologist Of them 50% surgically inactive (Need of 25,000 by 2020)
The ophthalmology population ratio Urban1:25,000 Rural 1:250,000
Lack of mid level personnel Current :24,000; need 75,000
Remoteness and lack of awareness & health promotion
Gaps in Eye Care Program
Eye Health Promotion is the “key” to early detection.
&Early Detection is the “key” to
early intervention. &
Early Intervention is the “key” to controlling avoidable blindness.
LET US ACT NOWLET US ACT NOW
• One person goes blind every 5 seconds and One child goes blind every minute
• Without proper interventions 76 million people could be blind by year 2020
Through collaboration let us commit to bring light & smile to as many as blind fellow human beings
Together we can make a difference. Thank you for your
kind attention