Year : 1983 | Volume
: 31 | Issue : 4 | Page : 463--465
Worldwide prevention of blindness
President, International Agency for the Prevention of Blindness
President, International Agency for the Prevention of Blindness
|How to cite this article:|
Kupfer C. Worldwide prevention of blindness.Indian J Ophthalmol 1983;31:463-465
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Kupfer C. Worldwide prevention of blindness. Indian J Ophthalmol [serial online] 1983 [cited 2020 Sep 24 ];31:463-465
Available from: http://www.ijo.in/text.asp?1983/31/4/463/27580
Participation in a global campaign to prevent blindness is a major challenge that awaits the response of the world's ophthalmologists. About 40 million of the world's people are blind; most are in the developing nations of Asia, Africa, and Latin America where cataract, trachoma, onchocerciasis, and xercphthalmia are the major causes of visual disability.
Cataracr is the leading cause of blindness in the world. In India alone more than six million people are blind from this disorder. It is estimated that trachoma affects 500 million people throughout the world. Of these, a minimum of two million are blind. Onchocerciasis affects over 25 million people worldwide. In the Volta River Basin of West Africa alone, one million of a total population of ten million are victims of onchocerciasis; of these, 70,000 are blind. Xerophthalmia or blindness fram malnutrition and vitamin A deficiency afflicts five million children every year, of whom 250,000 become blind.
Most of the technology to prevent or treat these diseases is available and has led to the elimination or significant reduction of blindness from these diseases in the developed areas of the world, such as the United States, Singapore, Japan, Hong Kong, and the nations of western Europe. Indeed, it has been estimated that half of all the world's blindness is preventable or treatable. Cataract, for example, is well on its way to being eliminated as a major cause of blindness in developed nations. Improvements in cataract surgery have resulted in an operation that is 95% successful and is considered one of the safest and most efficacious of all major operations- Thanks to the sophisticated procedures used today, hospital stays have been reduced from eight to two or three days.
The development of anti-inflammatory and antibacterial drugs has allowed ophthalmologists to treat corneal and other eye infections aggressively. Glaucoma also can be controlled in most cases through the use of medication or surgery, and new drugs are being developed that are relatively free of side effects. Also the laser is now an important alternative to conventional iridectomy in treating angle-closure glaucoma. This is of particular importance for many areas of the developing world where angleclosure glaucoma is highly prevalent.
Lasers have been proved effective in treating other ocular disorders, such as senile macular degeneration and proliferative diabetic retinopathy. A major advantage of laser treatment is that it can be performed on an outpatient basis without requiring expensive hospital facilities and staff or exposing patients to hospital-borne infections.
Finally, advances in corneal transplantation have restored the sight of many people who a generation ago would have been permanently blinded by corneal injury or infection. During the last decade, complication rates for this operation have been greatly reduced because of better surgical techniques, use of finer sutures, and improved methods of tissue handling and preservation.
Advanced ophthalmic technologies and eye care delivery systems are available to most of those in the developed world. However, people in countries with about 80%, of the world's population are engaged in what could be a losing battle against the ravages of blindness. Their weapons in this battle are not only outmoded, their ophthalmic health care delivery systems are virtually nonexistent. Trained manpower and financial resources are sorely lacking. Without sight these people will not be able to answer the challenges of everyday life, let alone satisfy the requirements for economic growth needed to upgrade their standard of living. The widening gap in visual health between the developed and the developing nations can have only ominous consequences in the future. Unless greater action is taken soon, the number of blind people in the world will double by the end of the century because of population growth and aging.
The new technology needed for further advances against the leading causes of blindness is being developed. For example, a portable laser that can be attached to a slit lamp and used to make an iridotomy in patients with angle-closure glaucoma can have a significant impact in Southeast Asia, where this form of glaucoma is a major cause of blindness. Application of this type of low-cost, effective technology is feasible when it is coupled with improved health care delivery systems and where there is a local commitment to its use.
Effective programs for prevention of blindness in these developing countries require mass treatment at a low cost per unit. In many situations, the only acceptable technology is that which fits the cultural pattern if it is too complicated, sophisticated, or expensive, it is self-defeating and it may postpone the development of something less elaborate but more practical.
A worldwide movement has been created to meet the challenge of devastating eye disease. At the forefront of this activity is the World Health Organization which has established a global program of technical cooperation and has accorded high priority to the prevention of blindness. Programs for the prevention of blindness are now in operation in 20 countries, but this number must be doubled. The International Agency for the Prevention of Blindness, formed in 1975 with the encouragement of the World Health Organization, can make a major contribution to achieving this goal. Because the World Health Organization can only provide assistance when a nation's government requests it, the degree of political support for blindness prevention within each country is the primary factor in determining the extent of the World Health Organization's role. Because of this, when the International Agency for the Prevention of Blindness was founded, one of its goals was to stimulate formation of nongovernmental committees for blindness prevention in nations that lacked such organizations. These committees are expected to keep their governments informed about needs and opportunities concerning prevention of blindness and encourage them to request appropriate assistance from the World Health Organization. Today, sight conservation committees from 62 countries participate in the International Agency for the Prevention of Blindness.
Over the past several years its role has grown beyond that of simply stimulating interest. Now the Agency facilitates cooperation and collaboration among. organizations to mobilize local resources for blindness programs, provide special skills to operate programs, and develop innovative approaches to blindness prevention through targeted clinical research.
In November 1982, at the Second General Assembly of the Agency held in Washington. D.C., I was elected President. In the months to come, I will be calling upon several ophthalmological organizations and individual ophthalmologists to work together to establish a series of programs to aid our colleagues throughout the world in treating those who are already blind and preventing other people from becoming blind.
The global problems of blindness are staggering and we will need all the help that can be mustered. I therefore earnestly solicit all ophthalmologists to join with me in this effort.