One of the most important part of building sustainable healthcare in a developing country is training and employing local specialists.

Grandfather Pijota Andida from Ethiopia is overwhelmed with joy. His cataract was treated during an outreach visit of LIGHT FOR THE WORLD. After years living in darkness he can see again.

Prevention of blindness

Ten years ago the World Health Organisation (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. 2010 marks the halfway point of this global initiative – time to take stock.

The facts: 161 million people worldwide are visually impaired, 37 million of them are blind. In addition uncorrected refractive errors account for 8 million blind and 145 million visually impaired people. Cataract is still the most common cause of blindness as people living in poverty generally do not have access to basic eye care. Over 85 % of visually impaired persons live in developing countries.

The progress: ‘VISION 2020 – The Right to Sight’ has had success in keeping the absolute numbers of blind persons at the same level, despite predictions of rising blindness levels with the increase of the world’s population. Onchocerciasis is largely controlled. Blinding trachoma affects 40 Million people today, compared to 360 Million people in 1985. Blindness and visual impairment in children caused by Vitamin A deficiency and infectious diseases has decreased significantly. In countries like Ethiopia, where LIGHT FOR THE WORLD has been engaged in this process since the beginning, the success of this co-ordinated and comprehensive approach is visible: compared to the situation 10 years ago the number of eye care professionals has increased four times. Today four universities train eye care staff on various levels, and trachoma is treated effectively in a number of regions.

The mission: Still a lot has to be done: In some areas the work has just started, such as in addressing uncorrected refractive errors. 80 % of all blindness in adults 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, nongovernmental organisations, professional associations and educational institutions. LIGHT FOR THE WORLD is engaged in National Blindness Prevention Programmes in Ethiopia, Burkina Faso, DR Congo, Mozambique, Rwanda, Southern Sudan, Northeast India and Pakistan.

Major causes of preventable blindness

Cataract

Cataract is the most common cause of blindness worldwide and responsible for the loss of vision of 18 million people. Cataract is 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, and some other eye diseases. The sight of a person blind from cataract can be restored in a surgical procedure that takes about 15 minutes. Under local anesthetic the opaque lens is replaced by an artificial intraocular lens. Having regained their sight, the patients can return home the following day. Cataract surgeries are among the most effective health interventions according to the WHO. In the last 20 years, LIGHT FOR THE WORLD has made over 375.000 cataract surgeries possible.

Trachoma

84 million people worldwide are affected by trachoma. 40 million are at risk of losing their sight, 8 million people are already blind or severely visual 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 eye lashes inwards and rubbing the cornea. The process of going blind from trachoma is long and very painful. Once sight is lost it cannot be restored again. 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 396,000 people in 2009, 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 North East India and Pakistan, LIGHT FOR THE WORLD supports child screenings in schools for early identification and treatment and the provision of spectacles. In addition, the programmes address parents and teachers to raise awareness on preventing childhood blindness. In Tanzania, we support a programme for childhood cataract surgeries.

Onchocerciasis (River Blindness)

Onchocerciasis is an insect-borne disease caused by a parasite and transmitted by blackflies. The parasite moving into the eye causes 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 blackfly and mass treatments with the drug Mectizan have brought huge success in treating Onchocerciasis. LIGHT FOR THE WORLD is involved in South Western Ethiopia in treating 1,450,000 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 the eye clinics often lack equipment to diagnose or treat glaucoma. It is important to train ophthalmologists in this field. In preventing trachoma in developing countries, we are still at the very beginning.

Low Vision and uncorrected refractive error

About 124 million people worldwide live with Low Vision. A person with Low Vision has a moderate to severe visual impairment, even after all possible medical intervention was performed. Persons with Low Vision need suitable medical attention, assistive devices and rehabilitation to develop their abilities and manage their daily lives.

Additionally, 153 million people live with uncorrected refractive errors. Without adequate visual aids they have limited access to education and employment opportunities and consequently cannot lead an independent life. In the majority of Africa only 20 % 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 Eyecare Education. A major point is the education of local staff.