World Sight Day 2018: “EYE CARE EVERYWHERE”

World Sight Day (WSD) observed every second Thursday in October, is the most important day in the eye health calendar. It is observed internationally under the theme ‘Eye Care Everywhere’, this October 11, 2018.

The observance of this day serves to raise public awareness and focus attention on the fact that visual impairment is a very important public health problem worldwide with socioeconomic consequences.

If not addressed expeditiously, it is only going to get worse.

WSD is coordinated by the International Agency for the Prevention of Blindness (IAPB) under the Vision 2020 global initiative “The Right to Sight”

Visual impairment makes people poor, depressed, participate less in social activities and more likely to be physically unwell. The socioeconomic consequences affect the families and communities too.

The latest estimates in 2015 produced by the Vision Loss Expert Group and published in the Lancet are as follows: The world population was estimated in 2015 to be 37.3 billion with 253 million visually impaired; 55% of these were women; 90% lived in low and middle-income countries; More than 75% of the causes of visual impairment can be prevented.

In 25 years, 1990 to 2015 the prevalence of visual impairment decreased from 4.58% to 3.38%.

However, this progress is under threat of being reversed by the rapid increase in global population and aging. In 2050 the global population is estimated to be 9.7 billion with 703 million visually impaired. Hence the urgency to increase eye care services globally.

The most common causes of visual impairment in the world are uncorrected refractive errors (need for glasses) 49 %, cataract 25.8% , age-related macular degeneration 4.1%, glaucoma 2.8%; corneal opacity 1.7%, diabetic retinopathy 1.2%, Trachoma 0.8%, other 14.7%.

In Dominica, the most common causes of visual impairment are refractive errors, cataract, glaucoma, diabetic retinopathy and La Plaine retinal degeneration.

Visual impairment from cataract can be reversed with cost effective surgery. Dominicans access cataract surgery locally and overseas.

Over the last 13 years various eye missions by Cuba, People’s Republic of China, USA and Venezuela have performed cataract surgery for hundreds of Dominicans.

Glaucoma is detected mostly on routine eye examinations from the age of 35 especially persons with a family history of glaucoma.

Opportunistic screening for glaucoma is performed for all patients presenting for eye care. All glaucoma medication is now free for patients for 60 and older.

Visual impairment from diabetic retinopathy can be prevented by regular eye examinations or fundus photography for early detection and treatment.

Screening by fundus photography is available in all seven health districts. Laser photocoagulation is available at Princess Margaret Hospital.

Visual impairment due to refractive error is treated with glasses or contact lens. There is various trained personnel who provide refraction services both in the public and private health sector.

Over the last 22 years, VOSH has provided affordable glasses to Dominicans.

In addition, VOSH refers screened patients found to have other eye problems including cataract, glaucoma, and diabetic retinopathy.

Some patients with LaPlaine retinal degeneration can preserve their vision with laser treatment.

To eliminate the preventable cause of blindness in Dominica:
– Eye care is integrated into Primary Health Care. District eye clinics to resume.
– The National Strategic Eye Plan is integrated in the National Health Plan but it must be ratified by the Government.
– Data must be collected to provide evidence-based care. Therefore an information system for health must be implemented.
– There is treatment for the major causes of visual impairment through public education, preventive, curative and rehabilitative services. Rehabilitative services to be enhanced.
– These services are accessible to all Dominicans including vulnerable groups.
– Cost of services is not a barrier to access eye care in Dominica. However more specialized treatment has to be accessed overseas at a cost only a few can afford.
– More persons are being trained as ophthalmologists, optometrist and specialized nurses.

However, job opportunities in Dominica must be made available on completion of their studies.

Investing in ’Eye Care Everywhere’ to eliminate preventable visual impairment, represents good value for money and a powerful social equalizer.