Prevention of Blindness and Eye Care

Below are the PAHO/WHO Oficial Mandates and Strategies pertaining to the Prevention of Blindness and Eye Care Program:

CD53/11. Plan of Action on the Prevention of Avoidable Blindness and Visual Impairment (2014-2019). 53rd Directing Council. 2014.

cd53-11-ocular-health

CD53/11. Plan of Action on the Prevention of Avoidable Blindness and Visual Impairment (2014-2019).

Available in Spanish, French and Portuguese.

CD49/19. Plan of Action on the Prevention of Avoidable Blindness and Visual Impairment (2008-2012). 49th Directing Council. 2009.

cd49-19-ocular-healthCD49/19. Plan of Action on the Prevention of Avoidable Blindness and Visual Impairment (2008-2012).

Available in Spanish and Portuguese

Strategic Plan for Vision 2020: The Right to Sight. Caribbean Region. 2002.

pob-vision-plan-caribbean

Strategic Plan for Vision 2020: The Right to Sight. Caribbean Region.

Prevention of Avoidable Blindness and Visual Impairment. WHA59.25. 59th World Health Assembly. 2006.

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Prevention of Avoidable Blindness and Visual Impairment. WHA59.25.


Below are the publications and resources pertaining to the Prevention of Blindness and Eye Care Program:

[Spanish] Guía de Atencion Básica en Baja Visión para Oftalmologos Generales

pob-guia-oftalmologos

Guia de Atencion Basica en Baja Vision para Oftalmologos Generales

"El objetivo de esta guía es mostrar los lineamientos básicos en el manejo de la baja visión, sin pretender constituir un curso completo de capacitación."

Eye Diseases in People ages 40-84. The Barbados Eye Studies: A Summary Report. 2006.

pob-barbados-studies

Eye Diseases in People ages 40-84. The Barbados Eye Studies: A Summary Report.

"Analyses of the Barbados Studies and long-term follow-up data are providing information on the risk and progression of all major blinding eye diseases; data essential to develop sound prevention and health delivery policies."

[Spanish] Plan Estrategico Nacional de Salud Ocular- Formato.

pob-guia-plan-estrategico

Plan Estrategico Nacional de Salud Ocular

El formato para hacer un Plan Nacional de Salud Ocular en la Región de las Américas.

Prevention of Deafness

WHO: Make Listening Safe. 2015.

make-listening-safe-pic

Make Listening Safe: Brochure

Available in Spanish.

"The World Health Organization launched the Make Listening Safe initiave in 2015 with the aim to reduce the risk of hearing loss posed by unsafe exposure to sounds in recreational settings."

WHO Programme for Prevention of Deafness and Hearing Loss; An Outline.

POB-who-deafness-outline

WHO Programme for Prevention of Deafness and Hearing Loss: An Outline.

"Hearing loss is a barrier to communication and language development and one of the leading causes of morbidity. In this outline, WHO has identifies strategic areas of work for 2018-2021 for the Prevention of Deafness and Hearing Loss."


Comprehensive low vision care

Despite major advances in eye care there is a significant number of persons of all age groups who cannot have their sight fully restored. The majority of these have some residual vision that can be enhanced or made more useable and utilized for tasks that require vision. Benefits of Low Vision Care reduces the functional impact of vision loss, facilitates child education and development, maintains independence, maintains productive activity, enhances quality of life, improves life satisfaction.

It is estimated that for every million population there are 17.000 people with low vision, one third of this would have an important functional improvement with the low vision care. These numbers are rapidly increasing due to aging of the populations in both developed and more importantly in developing countries and the increasing "epidemic" of diabetes related vision loss.

About 900 children per million populations require low vision care, 106 early intervention and 230 require educational support. An important cause is the increasing of retinopathy of prematurity in Latin America.

What needs to be done?

  • Increase access and demand to comprehensive low vision services to people with visual impairment.
  • Develop national policies on comprehensive low vision care.

Blindness from diabetic retinopathy

The prevalence of diabetes among adults in Latin America and the Caribbean varies among countries. It is estimated that approximately 50% of diabetics are unaware they have the condition. More than 75% of patients who have had diabetes mellitus for more than 20 years will have some form of diabetic retinopathy. After 15 years of diabetes, approximately 2% of people become blind, and about 10% develop severe visual handicap.

The prevalence of Diabetes mellitus affecting persons 40-84 of African descent in Barbados is high, with 18% of the population giving a diabetes history predominantly of older-onset. In the Barbados Eye Study 30% of persons with diabetes had diabetic retinopathy and 1% had proliferative diabetic retinopathy.

 Evidence-based treatment is available to reduce significantly the risks for blindness and for moderate vision loss. Clinical studies spanning more than 30 years have shown that appropriate treatment can reduce the risks by more than 90%.

What needs to be done?

  • Perform situation analysis of management of diabetic retinopathy in the Region as base for planning and advocacy.
  • Integrate the prevention of blindness strategies in the national diabetes programs, and ensure that they are incorporated into non- communicable chronic diseases programs.

Blindness in premature babies

In Latin America and the Caribbean an estimated 42,000 babies with birth weight of less than 1,500 gm. require screening for R Retinopathy of the premature babies and 4.300 need treatment every year, untreated 50% of these babies will become blind.

Prevention of blindness due to ROP is planned in three levels.

Primary prevention: reduce the incidence of ROP through improved pre and neonatal care. This includes good antenatal care, good obstetric care, and meticulous neonatal care, particularly with respect to oxygenation - vital role of nurses. Follow up of preterm babies, screening babies at risk - neonatologists or neonatal nurses should identify babies to be examined.

Secondary prevention: early identification of severe cases of ROP by regular examination by a skilled ophthalmologist of premature babies in neonatal care and timely treatment of those with "high risk" ROP

Tertiary prevention: restore useful vision in children with retinal complications through vitreoretinal surgery (stage 4 ROP, not for stage 5) and or offer rehabilitation.

What needs to be done?

  • Improve coverage and quality of Retinopathy of Prematurity (ROP) Programs.
  • Improve quality of information on neonatal care.
  • Increase public awareness and education in ROP and other prematurity health.

Uncorrected refractive errors in school children

Good vision is vitally important in education, screening at school age is recommended. Studies on the prevalence of refractive errors in school age children (5-15 years of age) show that the magnitude of the problem varies among ethnic groups. A study in Chile revealed that more than 7% of children could benefit from the provision of proper spectacles.

The incidence of myopia is higher in the 11-15 age groups; this is the highest priority although in countries where there is evidence that younger children have a high prevalence of refractive errors and resources are available these children should be screened.

What needs to be done?

  • Elaborate regional principles in refractive errors programs.
  • Develop and follow national refractive errors programs