BASICS ON BLINDNESS

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BY :BRIG DR HEMANT KUMAR
BLINDNESS

5. 1. 285 million people are estimated to be visually
impaired ,246 have low vision while 39
million are blind worldwide.
2. About 90% of the world's visually impaired live
in low-income settings.
3. 82% of people living with blindness are aged
50 and above.
4. 80% of all visual impairment can be prevented
or cured.
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Fact Sheet N°282 WHO- August 2014

6. • With 7.8 million blind people in India, while 45
million are visually challenged. the country
accounts for 20 per cent of the 39 million blind
population across the globe.
• It is estimated that prevalence of Childhood
blindness in India is 0.8/1000 children in <16
years age group, implying a total of 300,000
blind children in our country.
6http://www.deccanherald.com/content/240119/india-accounts-20-per-cent.html

7.  Out of these 62 per cent are on account
of cataract, 19.7 per cent refractive error,
5.8 per cent glaucoma and one per cent
corneal blindness
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8. There are 4 levels of visual function, according to
the International Classification of Diseases -10
(Update and Revision 2006):
 NORMAL VISION
 MODERATE VISUAL IMPAIRMENT
 SEVERE VISUAL IMPAIRMENT
 BLINDNESS.
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9.  Visual acuity is usually measured with a
Snellen chart. The Snellen chart displays
letters of progressively smaller size.
"Normal" vision is 20/20.
 This means that the test subject sees the
same line of letters at 20 feet that
a normal person sees at 20 feet.
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10. Visual impairment is defined as the
limitation of actions and functions of the
visual system.
The National Eye Institute defines low
vision as “a visual impairment not
correctable by standard glasses, contact
lenses, medication or surgery that
interferes with the ability to perform
activities of daily living”
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11. WHO Definition:-
Visual Acuity less than 3/60 (Snellens)or
its equivalent. •
NPCB Definition:-
Inability of a person to count fingers from
a distance of 6 meters or 20 feet. – Vision
6/60 or less with the best possible
spectacle correction – Diminution of field
vision to 20 degrees or less in better eye
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12.  1.Economic Blindness
 2.Social Blindness
 3.Manifest Blindness
 4.Absolute Blindness
 5.Curable Blindness
 6.Preventable Blindness
 7.Avoidable Blindness
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13. Visual Acuity:-
Sharpness of vision, measured as
maximum distance a person can see a
certain object, divided by the maximum
distance at which a person with normal
sight can see the same object •
Economic blindness:- – Inability of a
person to count fingers from a distance of
6 meters or 20 feet.
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14.  Social blindness:- – Vision 3/60 or
diminution of field of vision to 10 degrees
 Manifest blindness:- – Vision 1/60 to just
perception of light.
 Absolute blindness:- – No perception of
light
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15. Curable blindness:- – That stage of
blindness where the damage is
reversible by prompt management
e.g. cataract •
Preventable blindness:- – The loss
of vision that could have been
completely prevented by institution
of effective preventive or
prophylactic measures.
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16. Is a level of vision loss that has
been legally defined to determine
eligibility for benefits.
The clinical diagnosis refers to a central
visual acuity of 20/200 or less in the better
eye with the best possible correction,
and/or a visual field of 20 degrees or less
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17. GLOBAL
 Cataract , glaucoma, DM, vascular disease,
accidents & degeneration of ocular tissue
 Leading causes of childhood blindness
 Xerophthalmia, congenital cataract,
congenital cataract, congenital glaucoma &
optic atrophy.
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19. INDIA
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Main causes of blindness are as follows:
1. Cataract (62.6%)
2. Refractive Error (19.70%)
3. Corneal Blindness (0.90%),
4. Glaucoma (5.80%),
5. Surgical Complication (1.20%)
6. Posterior Capsular Opacification (0.90%)
7. Posterior Segment Disorder (4.70%),
8. Others (4.19%)
9. Estimated National Prevalence of Childhood
Blindness /Low Vision is 0.80 per thousand

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21.  Age:
◦ In children & young: Refractive error,
trachoma, conjunctivitis, malnutrition.
◦ In adults: cataract, refractive error,
glaucoma, DM
 Sex:
◦ Higher prevalence of trachoma,
conjunctivitis and cataract in women leading
to higher prevalence of blindness in women
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22.  Malnutrition:
◦ Infectious diseases of childhood especially
measles & diarrhoea
◦ PEM
◦ Severe blinding corneal destruction due to
vit. A deficiency in first 4 to 6 years of life.
 Occupation:
◦ People working in factories, workshop,
industries are prone to eye injuries because
of exposure to dust, airborne particles, flying
objects, gases, fumes, radiation.
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23.  Social class:
◦ Surveys indicate that blindness twice
more prevalent in poorer classes than
in the well to do.
 Social factors:
◦ Basic social factors are ignorance,
poverty, low standards of personal and
community hygiene and inadequate
health care services.
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24. The components for action in national
programmes for the prevention of blindness
comprise the following
 Initial assessment
 Methods of intervention
◦ primary eye care
◦ secondary care
◦ tertiary care
 Long term measures
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25. Primary care
Wide range of eye conditions can be treated or
prevented at grass root level by locally trained health
workers who are first to make contact with the
community.
They are also trained to refer the difficult cases to the
nearest PHC or district hospital.
Their activities also involve promotion of personal
hygiene, sanitation, good dietary habits and safety
in general.
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26. Secondary care:
Involves definitive management of common
blinding conditions as cataract, trichiasis,
entropion, ocular trauma, glaucoma.
It is provided in PHCs and district hospitals
where eye depts are established.
May involve the use of mobile eye clinics
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27. Tertiary care
◦ Established in the national or regional capitals and are
often associated with medical colleges and institutes of
medicine.
◦ Provide sophisticated eye care such as retinal
detachment surgery, corneal grafting which are not
available in the secondary centres.
◦ Other measures of rehabilitation comprise education of
blind in the special schools & utilisation of their
services in the gainful employment.
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28. SPECIFIC PROGRAMMES
◦Trachoma control
◦School eye health services:
Screening and treatment , Health
education
◦Vit. A prophylaxis
◦Occupational eye health services
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29. Aimed at improving quality of life and
modifying the factors responsible for eye
problems.
Poor sanitation
Lack of adequate safe water supply
Poor nutrition
Lack of personal hygiene
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30. 1. Was launched in the year 1976 as a 100%
Centrally Sponsored scheme with the goal to
reduce the prevalence of blindness from 1.4%
to 0.3%.
2. Survey conducted during 2006-07 showed
reduction in the prevalence of blindness from
1.1% (2001-02) to 1% (2006-07).
3. Now the target is to achieving the goal of
0.3% by the year 2020.
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31. The four pronged strategy of the
programme is:
 strengthening eye care service delivery,
 developing human resources for eye care,
 promoting outreach activities and public
awareness .
 developing institutional capacity.
 Increase and expand research.
 Participation of NGOs
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32.  6-7 % children age to 10-14 years – Eye
sight problem
 Children – screened by school teachers.
 Suspected refractive error are seen by
ophthalmic assistants & spectacles are
prescribed free of cost.
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34. VISION 2020: The Right to Sight 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).It was launched in
1999 to promote:
“A world in which nobody is needlessly visually
impaired, where those with unavoidable vision
loss can achieve their full potential.”
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35.  The Global Initiative aims to:
 “Intensify and accelerate prevention of blindness
activities so as to achieve the goal of
eliminating avoidable blindness by 2020.”
 It sought to do this by:
focusing on certain diseases which are the main
causes of blindness and for which proven cost
effective interventions are available.”
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36. “Universal Eye Health: A global action plan
2014 – 2019" (GAP) was unanimously adopted
by Member States at the World Health Assembly
in 2013 as part of WHA resolution
 The Vision of the GAP is:
 “A world in which nobody is needlessly visually
impaired, where those with unavoidable vision
loss can achieve their full potential and where
there is universal access to comprehensive eye
care services.”
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37. 1. Reduce Visual Impairment as a global public
health problem
2. Secure access to rehabilitation for visually
impaired services
The Objectives of the GAP are to:
1. Develop and implement integrated national eye
health policies and plans;
2. Ensure multi-sectoral engagement and effective
partnerships
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