WHO Launches First World Report On Vision

  • Recently, World Health Organisation (WHO) released its first world report on vision, addressing the increasing eye problems across the globe.

Aims

  • To raise awareness of the global magnitude and impact of eye conditions and vision impairment.
  • To draw attention to effective strategies to respond to eye care needs
  • To take stock of progress, and identify the main challenges facing the field of eye care
  • To make recommendations for action to be implemented by all countries to improve eye care.

Key Findings of the Report

  • Globally, at least 2.2 billion people have a vision impairment or blindness.
  • More than 1 billion people worldwide are living with vision impairment because they do not get the care they need for conditions like short and far sightedness, glaucoma and cataract.
  • Rates of cataract and trachomatous trichiasis are higher among women, particularly in low- and middle-income countries.
  • The burden of eye conditions is far greater in people living in rural areas, those with low incomes, women, older people, people with disabilities, ethnic minorities and indigenous populations.
  • Vision impairment in low and middle-income regions is estimated to be four times higher than in high-income regions.
  • Low- and middle-income regions of western and eastern sub-Saharan Africa and South Asia have rates of blindness that are eight times higher than in all high-income countries.
  • US$14.3 billion is needed to address the backlog of 1 billion people living with vision impairment or blindness.
  • The report hailed India’s National Programme for Control of Blindness (NPCB). NPCB has provided cataract surgery to 6.5 million people- a cataract surgical rate of over 6,000 per million population in 2016-17.

Causes of Rising Vision Impairment

  • Due to weak or poorly integrated eye care services, many people lack access to routine checks that can detect conditions and lead to the delivery of appropriate preventive care or treatment.
  • Eating habits are also a factor, since, in type 2 diabetes, the number of retinopathy cases increase.
  • Increased time spent indoors and increased “near work” activities are leading to more people suffering from myopia. Increased outdoor time can reduce this risk.

Different Eye Disorders

Myopia

  • It is a common vision condition in which one can see objects near to him clearly, but objects farther away are blurry.
  • It occurs when the shape of your eye causes light rays to bend (refract) incorrectly, focusing images in front of your retina instead of on retina.

Age-Related Macular Degeneration (AMD)

  • AMD is a disease that blurs the sharp, central vision needed to see straight-ahead. It affects the part of the eye called the macula that is found in the center of the retina. The macula lets a person see fine detail and is needed for things like reading and driving.

Glaucoma

  • There are different types of glaucoma, but all of them cause vision loss by damaging the optic nerve. Glaucoma is called the “sneak thief of sight” because people don’t usually notice a problem until some vision is lost.
  • The most common type of glaucoma happens because of slowly increasing fluid pressure inside the eyes.

Diabetic Retinopathy

  • It is basically a diabetes complication, which affects eyes by causing damage to the blood vessels spread throughout the light sensitive tissues of the retina (the back of the eye).
    Anyone having type 1 or type 2 diabetes can develop this eye condition, especially those who have diabetes for a long time with fluctuating blood sugar levels. Usually, both eyes get affected by diabetic retinopathy.

Presbyopia

  • It occurs when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging.

Trachomatous Trichiasis

  • It is caused by a bacterium called Chlamydia trachomatis. This infection causes inflammation and scarring of the surface of the eye, which results in the eyelid turning in (entropion) so that the eyelashes touch the eyeball. This is known as trachomatous trichiasis.

Impact

  • Young children with early onset severe impairment can experience delayed motor, language, emotional, social and cognitive development with lifelong consequences.
  • School-age children with vision impairment can also experience lower levels of educational achievement and self-esteem.
  • Vision impairment severely impacts quality of life (QoL) among adult populations.
  • Adults with vision impairment often have lower rates of workforce participation and productivity and higher rates of depression and anxiety than the general population.
  • In the case of older adults, vision impairment can contribute to social isolation.
  • It can lead to higher rates of violence and abuses, including bullying and sexual violence are more likely to be involved in motor vehicle accidents and can find it more difficult to manage other health conditions.
  • Vision impairment also poses an enormous global financial burden as it impacts the loss of productivity and efficieny.

International Initiative towards Eye Care

Universal Eye Health: Global Action Plan (2014 – 2019)

  • It was adopted by Member States at the World Health Assembly (WHA) in 2013 WHA resolution 66.4.
  • The plan supports the provision of effective and accessible eye care services for effectively controlling visual impairment including blindness.

Aims

  • To reduce visual impairment as a global public health problem
  • To secure access to rehabilitation for visually impaired services

 

VISION 2020: The Right to Sight

  • Launched in 1999, it is the global initiative for the elimination of avoidable blindness, a joint programme of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB).
  • The initiative was set up to intensify and accelerate prevention of blindness activities so as to achieve the goal of eliminating avoidable blindness by 2020.

 

National Initiative        

National Programme for Control of Blindness and Visual Impairment (NPCB&VI)

  • It was launched in the year 1976 as a 100% centrally sponsored scheme (now 60:40 in all states and 90:10 in North East States) with the goal of reducing the prevalence of blindness to 0.3% by 2020.

Suggestive Measures

  • Integrated Eye Health System: The report sets out concrete proposals to address challenges in eye care. The key proposal is to make integrated people centred eye care, embedded in health systems and based on strong primary health care, the care model of choice and scale it up widely
  • Integrated People-Centred Eye Care (IPCEC): It seeks to stimulate action in countries to address these challenges by proposing integrated people-centred eye care (IPCEC) as an approach to health system strengthening that builds the foundation for service delivery to address population needs
  • Universal Health Coverage: IPCEC will also contribute to achieving universal health coverage (UHC) and Sustainable Development Goal 3 (SDG3): “Ensure healthy lives and promote well-being for all at all ages”.

Way Forward

  • The government not only in India but across the globe should reorient the model of care based on a strong primary care by engaging and empowering the people and communities in order to raise awareness about eye care needs.
  • It should focus on creating an enabling environment, specifically the inclusion of eye care in national health strategic plans, the integration of relevant eye care relevant data within health information systems, and the planning of the eye care workforce according to population needs.
  • In addition, International organizations, donors, and the public and private sectors must work together to provide the long-term investment and management capacity to scale up integrated people-centred eye care.

Source : Civil Services Chronicle Online, October, 2019