Prevention of blindness
Ten years ago the World Health Organization
(WHO) together with international NGOs and professional
societies in eye care launched the initiative
'VISION 2020 – The Right to Sight'. Its ambitious
objective: To eliminate avoidable blindness by
the year 2020'. In this partnership between the World Health Organisation and the International Agency for the Prevention of Blindness, 120 NGOs and professional societies working on eye health are together addressing three main issues: infrastructure, human resources, and disease control.
The facts:
285 million people worldwide are
visually impaired, while 39 million are blind. Over the last five years the number of blind people has significantly decreased from 45 to 39 million.
Cataract is still the most common cause of blindness
in the developing world as people living in poverty
generally do not have access to basic eye care.
Over 80 % of those who are visually impaired
live in developing countries.
The progress:
In 2010, at the halfway point of the global
Vision 2020 initiative, WHO published encouraging
figures: blindness globally has decreased significantly
from 45 to 39 million:
• Onchocerciasis is largely controlled.
• Great strides have been made with the SAFE
trachoma strategy as the number affected by
blinding trachoma has dropped from a high of
360 million 1985 to 40 million today.
• Blindness and visual impairment in children
caused by Vitamin A deficiency and infectious
diseases has decreased significantly.
• In Ethiopia, where LIGHT FOR THE WORLD has
been engaged in Vision 2020 since the beginning,
the success of this approach is clearly
visible: in ten years the number of eye care
professionals has doubled, three universities
train ophthalmologists and five programmes
upskill ophthalmic nurses to work as cataract
surgeons. As a result, in 2010 41,000 cataract
surgeries were carried out in Ethiopia, compared
to 15,000 per year before the launch of
Vision 2020.
The mission:
However, much remains to be done
if we are to really address the 80 % of blindness that
is preventable or treatable. To do this effectively, 'VISION
2020 – The Right to Sight' has put the development
of National Prevention of Blindness plans at
its core, linking respective government institutions,
NGOs, professional associations and educational institutions.
LIGHT FOR THE WORLD is engaged in
National Blindness Prevention Programmes in Ethiopia,
Burkina Faso, DR Congo, Mozambique, Rwanda,
South Sudan, Northeast India and Pakistan and we
will continue to work towards the goal of eliminating
avoidable blindness by 2020.
Major causes of preventable blindness
Cataract
Cataract is the most common cause of blindness
worldwide (48 %) and is responsible for 18 million
people losing their sight. Cataract is a clouding of
the eye's lens which impedes the passage of light.
Although most cases of cataract are related to
the ageing process, occasionally children can be
born with the condition or a cataract may develop
after eye injuries, inflammation or other eye disease.
A person with cataract can have their sight
restored in a simple 15 minute operation completed
under local anaesthetic, where the cloudy lens
is replaced with an artificial intraocular lens. The
results are quick and often dramatic with patients
being able to return home the day after surgery
with their sight restored. According to WHO, cataract
surgeries are among the most effective health
interventions.
In the last 20 years, LIGHT FOR THE WORLD
has made possible over 410,000 cataract surgeries.
Trachoma
84 million people worldwide are affected by trachoma.
40 million are at risk of losing their sight,
while 8 million people are already blind or severely
visually impaired because of trachoma. Trachoma is
one of the oldest infectious diseases known to mankind,
and strongly linked to poverty. Repeated infections
can cause the lid to develop scars, turning
the eyelashes inwards, slowly and painfully scraping
the cornea and causing blindness. In hyperendemic
areas active trachoma is most common in pre-school
children with prevalence rates as high as 60 – 90 %.
In Ethiopia, LIGHT FOR THE WORLD supports the
mass distribution of antibiotics in highly endemic
areas, reaching 850,000 people in 2011, and also
provides assistance for the eyelid surgery necessary
at a more advanced stage of the infection.
Childhood blindness
Around 1.4 million children worldwide are blind
due to preventable causes like Vitamin A deficiency,
cataract, untreated infections and unidentified
refractive errors.
In Northeast India, Rwanda, DR Congo and
Pakistan, LIGHT FOR THE WORLD supports child
screenings in schools for early identification and
treatment and the provision of glasses. In addition,
the programmes raise awareness among parents and
teachers to prevent childhood blindness.
Onchocerciasis (River Blindness)
Around 1.4 million children worldwide are blind
due to preventable causes like Vitamin A deficiency,
cataract, untreated infections and unidentified
refractive errors.
In Northeast India, Rwanda, DR Congo and
Pakistan, LIGHT FOR THE WORLD supports child
screenings in schools for early identification and
treatment and the provision of glasses. In addition,
the programmes raise awareness among parents and
teachers to prevent childhood blindness.
In Tanzania, Rwanda and DR Congo we support
programmes for childhood cataract surgeries: in
2010 about 400 children underwent cataract surgery
there.
Onchocerciasis (River Blindness)
Onchocerciasis is an insect-borne disease caused by a parasite and transmitted by black flies. The parasite moves into the eye causing inflammation, bleeding and other complications that ultimately lead to blindness or other disabilities. It is estimated that there are about half a million people blind from onchocerciasis. The interventions to control the black fly and mass treatments with the drug Mectizan have brought huge success in treating Onchocerciasis. In Southern Ethiopia LIGHT FOR THE WORLD is involved in treating 1.5 million people with an annual dose of Mectizan.
Glaucoma
Glaucoma is a common cause of blindness worldwide, responsible for 4.5 million people's sight loss. In developing countries eye clinics often lack the equipment to diagnose or treat glaucoma. Preventing glaucoma in developing countries is still in its infancy and the training of ophthalmologists in this field is vital.
Low vision and uncorrected refractive error
More than 100 million people worldwide live
with low vision, which means that someone has a
moderate to severe visual impairment, even after all
possible medical intervention has been tried. So, in
addition to suitable medical attention, people with
low vision need assistive devices and rehabilitation
to develop their abilities and support them in their
daily lives.
Additionally, more than 150 million people live
with uncorrected refractive errors. Without adequate
visual aids such as glasses, they have limited
access to education and employment opportunities
and consequently cannot lead an independent life.
In the majority of Africa only 20 % of those who
need them have access to adequate visual aids. In
Uganda, LIGHT FOR THE WORLD supports the first
national programme for the correction of refractive
errors, in partnership with the International Centre
for Eye care Education. A major aspect of this
work is the education of local staff in identifying
and dealing with refractive errors.