Juniper
Publishers- JOJ Ophthalmology
Mini Review
Considerable efforts in many developing countries,
through blindness prevention programs, the global number of blind and
visually disabled seems to be growing, mainly as an effect of population
increase and aging. The population of south East Asia is about 593
million, since the main cause of blindness is cataract and only in this
region 283 million people are effected by cataract, 73 million by
glaucoma, 52 million by age related macular degeneration, 30 million by
corneal opacity and 28 million by diabetic retinopathy. More than 75% of
blindness is preventable since the most important factor to understand
is that around same number of the blind people could see again if they
had eye care facilities in their related areas or regions.
Cataract, childhood blindness, refractive error and
low vision, glaucoma, and diabetic retinopathy are the leading causes of
blindness. On average throughout south east Asia there is one
ophthalmologist for around 200,000 people, and one mid level eye care
personnel for around half a million of the population. Most of the eye
care personnel are located in large cities and populated towns; on the
contrary, around 75% of the population lives in rural areas, thus making
access to eye health services is a major challenge.
Road blocks like surgical cost, lack of family
support, and failure to understand the need for surgery and other
social, infrastructural, and geographic factors, such as availability of
ophthalmologists in rural regions particularly and difficulties in
accessing eye-care centers with patients having to travel too far.
Quality of cataract surgery is also remains a concern, with poor
outcomes reaching 40% in some places. In fact, many ophthalmologists do
not perform surgery or may be inadequately trained. Cataract, therefore,
continues to be a challenge to handle with the need to plan a
comprehensive strategy addressing issues related to availability,
affordability, accessibility, and acceptability of eye-care services,
and improving outcome of cataract surgery in low- and middle-income
countries.
Globally, women as compared with men had a larger
percentage of blindness caused by cataract. Worldwide, 35.5% of
blindness among women was caused by cataract versus 30.1% of blindness
among men. It is estimated that blindness and severe impairment from
cataract could be reduced by approximately 11% in the low- and
middle-income countries if women were to receive cataract surgery at the
same rate. Additional focus is needed to bring cataract surgical
services to women mainly in low- and middle-income south east Asian
countries.
It has been estimated very carefully 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
blind-ness 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.
Blindness is significantly affects not only the
immediate family but by enlarge the whole community. The blindness
restricts mobility and requires some assistance for everyday work and
task. Consequently, blindness affects the community on a practical
level, as children cannot attend school when they become caretakers for
blind adults. Thus, countless children are denied the opportunity to
receive a basic education, when a sighted adult becomes the caretaker
for a blind individual, he or she must stop working partially or
complete. This leads to longterm economic and educational repercussions.
Consequently the family earning become reduced which put the family in
further poverty, frustration, depression and health issues.
To reduce or avoid the blindness in south east Asia
an effective ophthalmic services, like cataract surgery, the screening
for, and treatment of, diabetic retinopathy. The eye care centres having
facilities of high quality, efficient and low-cost cataract surgery is
the need of the time. The WHO and world health organizations should have
more focus on developing countries or region like south east Asia. The
effective eye care services require more coordinated and integrated
planning, modules and efforts of services from the primary, secondary
and tertiary levels. The need of outreach eye care services for rural
areas under able supervision could bring tremendous results.
The eye care organizations are putting substantial
efforts to build more hospitals and equip them, but right dedicated
volunteers, ophthalmologists team and processes need to place according
to the need and demand of area or region to ensure targeted
outcome..More over significantly enhancement in resource base,
infrastructure, equipment, eye specialists and other ophthalmic workers
are needed to emplace along with equal emphasis to build and emplace
task management teams to build the right processes and the
organizational capability for maximal cost-effective resource
utilization. Patient access, affordability and availability of surgical
consumables and pharmaceuticals are all part of task management teams.
Focused, clear and transparent strategies are
required to reduce global burden of blindness which require a global
vision and local implementation. These strategies share a public health
focus and community awareness blindness and eye care.
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