NPCB & VISION 2020
School Eye Screening Programme, vision 2020, guidelines in INDIA, TYPES OF BLINDNESS, NPCB Definition of blindness,Prime minister’s -20 point programme, Magnitude Of Blindness
This PPT has all the necessary information about 'National Programme For Control of Blindness'. It is useful for students of Medical field learning 'Preventive & Social Medicine'.
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This PPT has all the necessary information about 'National Programme For Control of Blindness'. It is useful for students of Medical field learning 'Preventive & Social Medicine'.
Copyright Disclaimer - Use of these PowerPoint Presentation for any commercial purpose is strictly prohibited. The presentations uploaded on this profile are protected under Copyright Act,1957.
Prevention and control of blindness is one of the important healthcare programmes in India. The National Health Policy document of the Government of India, 1983, stipulates that 'One of the basic human rights is the right to see.’ We have to ensure that no citizen goes blind needlessly, or being blind does not remain so, if by reasonable deployment of skill and resources, his eyesight can be prevented from deterioration or if already lost, can be restored.
The National Programme for Control of Blindness (NPCB) was launched in 1976 with the goal of reducing blindness prevalence to 0.3% by the year 2020. India was the first country in the world to launch National Level Blindness Control Programme.
In 1999, the WHO launched Vision 2020: The Right to Sight, a joint endeavour with IAPB, to eliminate avoidable blindness by 2020. In 2013, the World Health Assembly adopted Universal Eye Health: Global Action Plan 2014-19 to reduce the prevalence of avoidable visual impairment by 25% by 2019 compared to the baseline prevalence in 2010.
Community Eye Care Programmes in India..Harsh Rastogi
Community Eye Care Programmes refer to initiatives aimed at providing comprehensive eye care services to communities, especially in underserved areas, through a combination of outreach activities, primary eye care services, and community involvement.
NPCBVI and DBCS
National programme for control of blindness and visual (npcb)anjalatchi
Blindness is a lack of vision. It may also refer to a loss of vision that cannot be corrected with glasses or contact lenses. Partial blindness means you have very limited vision. Complete blindness means you cannot see anything and do not see light. (Most people who use the term "blindness" mean complete blindness.
Community Ophthalmology is a new discipline in Medicine which promotes eye health and blindness prevention through various programs like Vision 2020, National blindness control programme, etc. It covers important causes like Cataract, Childhood blindness, Trachoma, Refractive Errors & low vision, Onchocerciasis. Includes, Eye camps, Eye banking and Rehabilitation of the blind.
The International Classification of Diseases 11 (2018) classifies vision impairment into two groups, distance and near presenting vision impairment.
Distance vision impairment:
Mild – visual acuity worse than 6/12 to 6/18
Moderate – visual acuity worse than 6/18 to 6/60
Severe – visual acuity worse than 6/60 to 3/60
Blindness – visual acuity worse than 3/60
Blindness Is defined as visual acuity in the better eye after best possible correction of < 3/60 or visual field less than or equal to 10° from point of fixation .
Avoidable blindness is either preventable or treatable.
Mainly caused by ocular diseases such as cataract, refractive errors, trachoma, Onchocerciasis and some eye conditions in children.
WHO’s early efforts on blindness prevention, starting in the 1950s and predating the formal establishment of a program for the prevention of blindness .
These efforts involved providing assistance to Member States to assess the magnitude of the problem and institute control activities, several research initiatives on treatment options.
The research activities included laboratory and field studies and, based on the results, strategies were evolved for the prevention and control of trachoma.
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Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
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4. DEFINITION OF BLINDNESS
WHO Definition
Visual Acuity less than 3/60 (Snellens)or its equivalent in better eye.
LOW VISION-
Visual acuity <6/18 (snellens) or its equivalents in better eye.
6. 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
8. Economic blindness
Inability of a person to count fingers from a distance of 6 meters or 20 feet.
Social blindness
Vision 3/60 or diminution of field of vision to 10 degrees
10. 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.eg:-
xerophtalmia,Trachoma
11. Avoidable blindness
The sum total of preventable or curable blindness is often referred to as
avoidable blindness
12. Criterion for blindness certificate in INDIA
Categories Better Eye Worse Eye % Blindness
Category- 0 6/9-6/18 6/24-6/36 -
Category-i 6/18-6/36 6/60- Nil 40%
Category-ii 6/40-4/60 Or Field Of
Vision 10-20 Degree
3/60-nil 75%
Category-iii 3/60-1/60 Or Field Of
Vision 10 Degree
Finger Count At 1 Ft To
Nil
100%
Category-iv Finger Count At 1ft To Nil
Or Field Of Vision 10
Deree
Finger Count At 1 Ft To
Nil
100%
One Eyed Persons 6/6 Finger Count At 1 Ft To
Nil To Field Of Vision 10
Degree
30%
13. HISTORY
INDIA was the first country in the world to launch National level Blindness
control program.
1976 : NPCB launched as 100% centrally sponsored programme.
It incorporates the earlier trachoma control programme started in the year
1968.
The programme was launched with the goal to reduce the prevalence of
blindness from 1.4 to 0.3 per cent.
As per 2006-07 survey the prevalence of blindness was 1.0 per cent
14. 1994-95: Programme decentralized with formation of District blindness
control society(DBCS) in each district
As per Survey in 2001-02, prevalence of blindness is estimated to be
1.1%. Rapid Survey on Avoidable Blindness conducted under NPCB
2006-07 showed reduction in the prevalence of blindness from 1.1%
(2001-02) to 1% (2006-07).
15. In 1982 ‘Prime minister’s -20 point programme’ was launched.
From 1994-2001 ‘Cataract Blindness Control project’ was launched which
was assisted by World Bank.
16. The project included 7 states
Uttar Pradesh
Tamil Nadu
Madhya Pradesh
Maharashtra
Andhra Pradesh
Rajasthan
Orissa
18. About 90 per cent of the world's visually impaired people live in
developing countries
Globally, uncorrected refractive errors are the main cause of visual
impairment
Cataracts are the leading cause of blindness
19. Cataracts remain the leading cause of blindness in middle and low income
countries.
80% of all visual impairment can be prevented or cured.
20. INDIA
Out of 39 million people across Globe who are blind , India has 15 million
blind persons.
Of total 15 million 9-12 million due to cataract.
Annual incidence of cataract blindness in india is 3.8 million
21. Causes of Blindness in India
Major causes of Blindness
Cataract (62.6%)
Uncorrected refractive errors (19.7%)
Glaucoma (5.50%)
Posterior segment pathology (4.70%)
Corneal blindness (0.9%)
Others (5%)
23. Main objectives of the programme in the 12th Five
Year Plan period are
Reduce the backlog of avoidable blindness at all levels-
1. Identification
2. Treatment
Develope and strengthen "Eye Health for All“ & prevention of visual
impairment-
1. provision of comprehensive universal eye-care services
24. Infrastructure
1. Strenthening
2. Developing human resource
Community awareness.
Research for prevention.
Participation of voluntary organizations.
25. PROGRAMME ORGANIZATION
Central level
National Programme Management Cell’ located in the office of Director
General Health Services (DGHS), Department of Health,Government of
India (GOI).
To oversee the implementation of the programme three national bodies
have been constituted as below:
National Blindness Control Board, chaired by Secretary Health to GOI.
National Programme Co-ordination Committee, chaired by Additional
Secretary to GOI.
National Technical Advisor Committee, headed by Director General Health
Services, GOI.
26. Central level activities include
Procurement of goods (major equipments, bulk consumables, vehicles,
etc.)
Non-recurring grant-in-aid to NGOs.
Organizing central level training courses.
Information, education and communication (IEC) activities (prototype
development and mass media).
Development of MIS, monitoring and evaluation
Procurement of services and consultancy.
Salaries of additional staff at the central level.
27. State level
State-level activities include
Execution of civil works for new units.
Repairs and renovation of existing units/ equipments.
State level training and IEC activities.
Management of State Project Cell.
Salaries for additional staff.
28. District level
District blindness control society
The concept of ‘District Blindness Control Society (DBCS)’ has been
introduced, with the primary purpose to plan, implement and monitor the
blindness control activities comprehensively at the district level under
overall control and guidance of the ‘NPCB'.
29. Objective of DBCS
To achieve the maximum reduction in avoidable blindness in the district
through optimal utilization of available resources in the district
30. Need for establishment of
DBCS
To make control of blindness a part of the Government’s policy of
designating the district as the unit for implementing various development
programmes.
To simplify administrative and financial procedures.
To enhance participation of the community and the private sector.
32. It is a global initiative to reduce avoidable (preventable and curable)
blindness by the year 2020
It was a joint programme of WHO (world health organization) & IAPB
(international agency for prevention of blindness) launched in 1999
Adopted at a meeting held in Goa on October 10-13, 2001 and constituted
a working group.
34. Strengthening Advocacy
Public awareness and information about eye care and prevention of
blindness.
Introduction of topics on eye care in school curriculum.
Involvement of professional organizations such as
All India Ophthalmological Society (AIOS),
Eye Bank Association of India (EBAI) and
Indian Medical Association (IMA) in the NPCB.
35. To strengthen the functioning of District Blindness Control Society (DBCS).
To enhance involvement of NGOs, local community societies and
community leaders.
To strengthen hospital retrieval programmes for eye donation through
effective grief counselling by involving volunteers, Forensic Deptt., Police
etc.
36. Reduction of disease burden
(disease-specific approach)
Target diseases identified for intervention under ‘Vision 2020’initiative in India
include:
Cataract,
Childhood blindness,
Refractive errors and low vision,
Corneal blindness,
Diabetic retinopathy,
Glaucoma,
Trachoma (focal)
37. Cataract
Objective.
To improve the quantity and quality of cataract surgery.
Targets and strategies include:
To increase the cataract surgery rate to 6000 (the number of operations
per million people, per year) by 2020.
IOL surgery for >80% by the year 2005 and for all by the year 2010 which
has been achieved.
YAG capsulotomy services at all district hospitals by 2010.
38. Childhood blindness
Prevalence of childhood blindness in India 0.8/1000 children
Common causes
vitamin A deficiency injuries,
measles, congenital cataract,
conjunctivitis, retinopathy of prematurity (ROP),
ophthalmia neonatorum childhood glaucoma.
,
39. Aim
Is to eliminate avoidable causes of childhood blindness by the year 2020.
Detection of eye disorders.
At the time of primary immunization,
At school entry,
Periodic check up every 3 years for normal and every year for those with
defects
40. Preventable childhood
blindness
Prevention of xerophthalmia
Prevention and early treatment of trachoma by active intervention
Refractive errors to be corrected at primary eye care centre.
Childhood glaucomas to be treated promptly.
Harmful traditional practices need to be avoided.
Prevention of ROP
41. Targets
Establishment of Pediatric Ophthalmology Units.
Establishment of refraction services and low vision centers
42. Glaucoma
As per the ‘National Survey on Blindness’ (1999-2001)
Govt. of India Report 2002 glaucoma is responsible for 5.8% cases of
blindness in 50+ population.
Failure of early detection of the disease poses a management problem
towards controlling glaucomatous blindness.
43. Following measures are recommended for opportunistic glaucoma screening
(case detection)
Opportunistic screening at eye care institutions should be done in all
persons above the age of 35 years, those with diabetes mellitus, and those
with family history of glaucoma.
Community based referral by multi-purpose workers of all persons with
diminution of vision, colored haloes, rapid change of glasses, ocular pain
and family history of glaucoma.
Opportunistic screening at eye camps in all patients above the age of 35
years.
44. Diabetic retinopathy
Following recommendations are made:
Awareness generation by health workers.
All known diabetics to be examined and referred to Eye Surgeon by the
Ophthalmic Assistant.
Confirmation by fundus fluorescein angiography (FFA) and laser treatment
of diabetic retinopathy at tertiary level.
45. Strategies for glaucoma and
Diabetic Retinopathy
• Immediate term :
Training ophthalmologists to handle these conditions. Comprehensive eye
evaluation via better clinical practice in slit lamp biomicroscopy, disc and
retinal evaluation and gonioscopy.
46. • Intermediate term:
Residency training prog in med colleges.
Training of Mid level ophthalmic personnel in handling these conditions in
peripheries.
Training non ophthalmic physicians on clinical profile of these conditions.
Public education.
47. • Long term:
To provide high quality eye care at all levels.
48. Corneal blindness
The major causes of this blindness are
corneal ulcers
ocular injuries
Keratomalacia
Trachoma
49. Objectives
To reduce prevalence of preventable and curable corneal blindness.
To identify the infants at risk in cooperation with RCH programme.
Strengthening of hospital corneal retrieval systems.
Assessment of persons needing corneal grafting.
For vitamin A deficiency related diseases focus on economically backward
classes is needed
50. Human resource development
Mid-Level Ophthalmic Personnel (MLOP)
Hospital Based MLOP Community Bases MLOP
Ophthalmic nurses Primary eye care worker
Ophthalmic technicians Ophthalmic assistant
Optometrists
Orthoptists
51. Eye care infrastructure development
Tertiary level----------Apex, Regional institutes, Medical Colleges
Secondary level------ District hospital & NGO Eye hospital
Primary level--------- Sub-district level hospitals/CHC Mobile ophthalmic
units, Upgraded PHCs ,Link workers/Panchayats
52. Services at each centre
PRIMARY LEVEL- SERVICE CENTRES- 20000
Screening & referral services
School eye screening programme
Primary eye care
Refraction & prescription of glasses
53. SECONDARY LEVEL : SERVICE CENTRE- 2000
Cataract surgery.
Other common eye surgeries.
Facilities for refraction.
Referral services.
54. TERTIARY LEVEL
a) Training centers- 200
Tertiary eye care : Retinal surgery
Corneal transplantation
Glaucoma surgery
Training & CME
55. b) Centre of excellence- 20
Professional leadership
Strategy development
CME
Laying of standards & quality assurance
Research
56. ACTIVITIES of NPCB
Cataract operations
Involvement of NGOs
Civil works
Commodity Assistant
IEC activities
Management Information System
Monitoring and Evaluation
School Eye Screening Programme
Collection and utilization of donated Eyes
Control of Vitamin A deficiency
57. School Eye Screening Programme
•Children aged 10-14 years having vision problem : 6-7 %.
First screened by trained teachers(1 for 150 students)
Ophthalmic assistants-Corrective spectacles are prescribed or given free for
BPL.
58. NEW INITIATIVES OF THE PROGRAM
Provision of free glasses in Presbyopia patients .
Provision of spectacles for school children by conducting Eye Testing
Fortnight every year in the month of June.
Provision of Multipurpose District Mobile Ophthalmic units(MDMOUs) in
all districts all over the country.
59. References
Parsons diseases of eye 22nd edition.
Khurana comprehensive ophthalmology AK Khurana 6th edition.
National programme for control of blindness guidelines.
Textbook of ophthalmology HV Nema 6th eidition.
