Community Eye Care, Community optometry.

1. Primary Eye Care and
Community Participation
Dr. Saman Wimalasundera MBBS, DO, PhD
Senior lecturer in community medicine
& community ophthalmologist
Community Ophthalmology center
Department of community medicine
P.O.Box 70,
Galle
Sri Lanka

2. Primary eye care and
community participation
Delivery of primary eye care has its specific
roles and targets in the community and good
community participation is an essential
component in the successful prevention of
blindness program.

3. Primary eye care is the primary health
care approach to the prevention of
blindness.

4. Essential components of
primary eye care
1. Promotive
2. Preventive
3. Curative
4. Rehabilitative

5. (1) Promotive eye care
1.Creating and awareness of the
blinding diseases existing in the
community and the ways of preventing
or curing it.
2.How to use the available recourses to
overcome the problems.

6. (2) Preventive eye care
1.Motivation of individuals and their
communities to participate in blindness
prevention activities.
2.Social and community development that
promotes health
3.Change of behavior and environment

7. Examples
❖ Provision of adequate safe water.
construction of latrines &refuse pits
❖ maintenance of environmental
hygiene.
❖ Consumption of food rich in vitamin A.
❖ Care for individuals at risk.

8. ❖ Prevention of measles, malnutrition and
diarrhea in children
❖ Protection of eyes against injuries.
❖ Immunization (E.g. Measles)
❖ Screening of antenatal mothers for sexually
transmitted diseases.
❖ Family planning

9. (3) Curative activities
1. To carry out treatment procedures for simple
common diseases that lead to blindness or
impaired vision if not treated
e.g. corneal ulcers, refractive errors etc.
2. First aid treatment for eye injuries.
3.Timely referral to secondary level.
4.Identification of potentially blinding disease
conditions for proper management
5.Identification of curable blinding diseases
e.g.cataract and referral for treatment

10. (4) Rehabilitative activities
Target group: Incurably blind people
What can the primary eye care workers
do to them ?
They should be assured that they are
not
completely useless

11. Some carefully selected appropriate
training should be given to them to
acquire some skills
Make them functional and do not allow
to depend on the others totally.

12. Development of primary eye
care program
A good primary Eye care Program will depend
on :
(1) existing health care services and availability
of trained health care workers (Manpower)
(2) Political and professional motivation

13. (3) Resources for training, to conduct programs
and to monitor it.
(4) Supplies for primary eye care workers.
(5) Funding for capital and recurrent expenditure.
(6) Close liaison with secondary and tertiary
centers
(7) Careful Planning and evaluation

14. Basic equipment essential for
PEC program
• Snellens chart and pinhole
• Hand magnifying lens
• Good source of light (Torch with
batteries)
• Eye dressings
• Teaching materials

15. Different Types of Primary Eye care
Programs that can be used in the
community
• Depend on the need of the local community
and available resources
1. Need assessment Programs
2. Screening for blinding diseases
3. Comprehensive care Eye camps
4. Out reach Surgical Camps
5. Health Education Programs

16. Sustainability of the PEC
programs
Depend on the following areas
1. Technical sustainability :- Training
of technical staff
2. Financial sustainability :-
Continuous allocation of funds necessary
3. Operational sustainability :-
Monitoring of the activities regularly.

17. Community Participation

18. Ottawa charter and health
promotion
In 1986 an international conference
called Ottawa charter adopts five principal
elements that improve health promotion.

19. The Five principals are
1. Healthy public policy
2. Personnel skills development
3. Community participation
4. Healthy and supportive environment
5. Re-organization of health services
Community participation is a major
emphasis in eye health promotion.

20. The promotion of eye health and to
reduce the risk of blindness though
community ophthalmology needs good
community participation

21. Community participation is
influenced by
1. Community beliefs and perceptions
2. Motivation of people in the community
3. Awareness of the problems related to
blindness

22. Community participation can
be improved by
1. Encouraging the people with early
symptoms by their families to attend to
available health services

23. 2. By creating and awareness through
health education programs
- Mass media programs
- Through volunteers or community
health workers by small group
discussions
- Through community leaders
- Self help groups
- Improving education of children
through schools

24. Community participation
enhances eye health
1. By attending to the community health
programs for early detection
2. By following treatment procedures until
full recovery

25. 3. By adopting changes in life style that
encourages eye health
4. By improving the living environment in
the communities to reduce the risk of
transmission of eye diseases
5. By creating a community demand by
the people of the community to develop
infra structure facilities by policy makers
that improves eye care services.

26. There is a high demand for a
community based approach in the
prevention of blindness. That needs
proper community participation.