Indian Journal of Ophthalmology
Vol. 60, No.5 / Sept 2012
Click here for Free Full Text
In conjunction with the 9th General Assembly 2012 of the Int. Agency for the Prevention of Blindness ( IAPB ) Hyderabad September 2012 — Eye Health: Everybody’s Business, the Indian Journal of Ophthalmology ( IJO ) dedicated their Sept. 2012 issue to the prevention of blindness, worldwide. I would like to review this special issue of the IJO which was actually given out at the Hyderabad assembly. As previously, I will draw closely on the observations/ comments of many of the authors. Please note that credit will not always be acknowledged to these international ophthalmic leaders. However, the free full text is available online <http://www.ijo.in/showBackIssue.asp?issn=0301-4738;year=2012;volume=60;issue=5;month=September-October>.
There is currently no greater eye success story than the all- Indian efforts to reduce the prevalence of blindness in India. India’s cataract surgery figures increased dramatically from about half a million in 1980 to more than six million by 2010. This greater than 10-fold increase has handily exceeded the previously dreaded incidence of three million new cataract cases each year. In fact, many eye success stories in disease control/prevention have been achieved throughout the world ( Onchocerciasis, RoP, WHO Global Elimination of Trachoma, etc. ).
S. Natarajan ( editor, IJO ) gave a good overview of milestones in the Indian blindness prevention efforts. He discussed where we are and where we need to travel with our international blindness reduction efforts. Al Sommer with a guest editorial gave a brief succinct history of the IAPB and the way forward. Much has been accomplished, much still needs to happen.
The largest obstacle faced in the fight against blindness in different parts of the world is the lack of access to good quality and to affordable eye care services, especially in isolated rural areas. Urban dwellers are far more likely to receive eye care/ surgery than those in rural areas.
There was an article by Bruce Spivey and other Int. Council of Ophthalmology ( ICO ) players concerning the training of ophthalmic residents in the concepts and the practice of community eye health ( CEH ) which incorporates primary eye care and a public health approach to the main causes of blindness and low vision. The upcoming version of the ophthalmological residency curriculum that was developed by the ICO includes a new specific section on CEH.
Health inequality refers to differences or inequalities in health among social groups that are unnecessary, avoidable, unfair, and intolerable. These inequalities are related to social determinants based on gender, socioeconomic status, ethnicity, race, or having a specific health condition. Inequality, poverty, exploitation, violence, and injustice are causes of illness (blindness) and death of the poor and marginalized.
Eye care inequality exists in a variety of ways around the world. Many sub-Saharan African countries still have only one ophthalmologist per one million persons and the goal is to reach a ratio of 1 per 250,000 persons by the year 2020. There is a common social gradient across global society — the lower the socioeconomic position of an individual, the poorer their health. This is probably also true in industrialized countries. With regard to gender inequality, women have a higher prevalence of visual impairment and blindness which can not be explained based only on age or access to service.
There was an article [ Ravilla ] on advocacy for eye care which can be a useful strategy for all of us in the developed and developing world. Examples given were diabetic retinopathy and pediatric eye care.
An excellent article by Peter Ackland, current president of IAPB, outlined the accomplishments of the global initiatives Vision 2020: The Right to Sight and the focus for the next 8 years of the campaign. Dr. Acland discussed where we have been, where we are, and what needs to happen in the next eight years. We need more programs, better programs, and faster progress toward our goals.
To achieve the goals of Vision 2020 considerable scaling up of current efforts will be required. Two key areas will be:
- Successful advocacy and engagement at the individual country level for enhanced national government commitment to finance their own Vision 2020 plans and
- A new approach to Vision 2020 thinking that integrates eye health into health system development and develops new partnerships with wider health development initiatives. Two separate health programs were mentioned— the Neglected Tropical Disease movement and the Non-Communicable Disease ( NCD ) movement.
Well, I hope my last several blogs on the international effects to reduce blindness have been interesting and also informative. There are a lot of persons and organizations that have contributed to our ongoing success.
Peace,
Baxter