1. WORLD SIGHT DAY Dr. Madhuri. Dixit. M.S.(Ophth) M.S.(Ophth) Managing Trustee Vivekanand Nertalaya. Belgaum.

2. W S D World Sight Day (WSD) is an annual day of awareness held on the second Thursday of October, to focus global attention on blindness and vision impairment.

3. The global day for awareness of blindness and vision impairment

4. W H Y W S D Raise public awareness of blindness & vision impairment as major international public health issues Influence Governments/Ministers of Health to participate in and designate funds for national blindness prevention programmes Educate target audiences about blindness prevention, about VISION 2020 and its activities, and to generate support for VISION 2020 programme activities

5. What is VISION 2020 VISION 2020 : the Right to Sight VISION 2020 Working together to eliminate avoidable blindness

7. VISION 2020 Partnerships W H O Technical Assistance Capacity Building National Partners - National Vision 2020 Plans Sustainable program delivery

8. What is Avoidable Blindness Avoidable blindness is defined as blindness which could be either treated or prevented by known, cost-effective means.

9. Global Avoidable Blindness 37 million

10. INDIAN SENARIO India has HIGHEST number of blind globaly-12 MILLION Every year 2 MILLIONS are added 62% are from CATARACT NPCB from 1976 supported by World bank

11. Very Rich Levels of rising “overnutrition” World class academies and institutes. World class health care facilities and booming health tourism Women with education, power and influence A third of the world’s poor, nearly 400million living on less than $1/day 46% of children malnourished Highest number of illiterate people in the world The infant mortality rate of 57/1000 live births. Sex ratio of 933 females/1000 males Source: 1) Sample Registration System 2003- Annual Report, Office of the Registrar General, India 2) census of India 2001 3) Department of International Development (DFID) India: a land of contrasts

12. Gender disparity are high in almost in every sector of health sector Prevalence of cataract more in females than males In addition, there exists spatial disparities between urban and rural areas, and across Sates Gender Disparity RAAB 2007: prevalence of blindness 9.2% in women and 6.6% in men (over 50) 5% lower rate of IOL implantation State to State Cataract Surgical Rate (CSR) varies from 500 to 6,000

13. INNOVATIVE INITIATIONS Vivekanand Netralaya.Belgaum. (Priyadarshini Eye Health Care &Reseach Foundation) Clear Mission for VISION- ”Comprehensive qwality eye care for poor & underpriviledged blind people, free of cost & training medical & paramedical peressonel for this noble cause.”

14. INNOVATIVE INITIATIONS Vivekanand Netralaya How we work? Focus is only on underpriveledged Reaching out to them in remote places Identifying cataract patients Trasporting them to base hospital Catract removal with IOL Implantation Transporting back to their villages Follow up

15. Vivekanand Netralaya Belgaum Total No. of Cataract operations 5070 99.99% with IOL More females than males

16. Pvt. Hosp. NGO Hosp Govt. Hosp. Eye Camp Blindness Scenario in India

17. Emerging priorities and patterns of eye diseases Cataract remains the leading cause of blindness despite impressive advancements in surgical services. Uncorrected Refractive Errors is now recognised as the second leading cause, followed by Glaucoma, cornea. Childhood Blindness is now gaining attention. Diabetic Retinopathy is now becoming a major problem. Despite an over increasing need, low vision services are dramatically lacking

18. Cataract First cause of blindness (~50%) –backlog: 20 million un-operated cases –only 10 million surgeries year major constraints : –coverage –access –quality Cataract operations/million population/year CSR

19. Cataract Surgical Rate in India 2001 - 20022003 - 2004 WHO 2004

20. SICS Ray of hope to combat avoidable blindness due to Cataract Easy Effective Economical

21. Childhood Blindness in India 320,000 children are blind (19% of the world’s blind children) 50% of these cases are treatable or preventable In addition, an estimated 9.2 million children are visually impaired Causes: Cataract, Ref Errors, Corneal ulcer/ opacity, ROP, Glaucoma Life expectancy of a blind child is assumed to be 48 years, resulting in a loss of 33 working years Burden of childhood blindness measured in blind-person years is next only to cataract. Loss estimated to India’s GNP is US$11.1 billion

22. Analysis of blindness profile in Blind School Treatable Treatable and Curable 62.5 % Not Treatable 37.5 % 37.5 % of 25 % i.e. 9 out of 100 cases untreatable

23. Corneal Blindness Scenario - India Backlog of corneal blind people :1.1 million Added every year :25,000 - 30,000 Corneas required / year : 75,000 - 1,00,000 Corneas collected / year :28,000 - 30,000 Cornea utilized for sight restoration:12,000 - 15,000 Collection vs. Utilization : 40-55%

24. Need for Eye Banking Non availability of grafts Lack of quality in preservation & assessment of cornea tissue Lack of trained human resources Lack of standardized protocols, accreditation & need for appropriate legislation Lack of awareness of eye donation (gap between pledge and actual donation)

25. Nearly 171 Million Worldwide have Diabetes Likely to double to nearly 366 million by 2030. Diabetes rising worldwide India China US Russia Germany Population [Million]

26. An estimated 200% increase in next two decades 5.5 % Diabetic prevalence Rate 1/3 to 1/5 of Diabetic patients have DR There may be approximately 11-20 million with diabetic retinopathy by 2025 75% diabetic for more than 20 years will develop some form of diabetic retinopathy If not contained, India may be home for the largest number of diabetic blind (Source: WHO) DR Scenario - India

27. Reasons for Rise in Diabetes Denial of diabetes and no regular treatment Limited awareness of diabetes and related eye disease Asymptomatic nature of DR gives patient no warning No routine eye examination as a health seeking behavior Misconceptions: Controlling blood sugar levels eliminates the risk of visual loss If I can see well, why seek medical help

28. Poverty Eye Care Delivery System Quality Equity Supply and Equipment National & sub national structures Urban - rural divide Life style Long life expectancy Human Resources: Under utilized HR: 12,000 ophthalmologist Of them 50% surgically inactive (Need of 25,000 by 2020) The ophthalmology population ratio Urban1:25,000 Rural 1:250,000 Lack of mid level personnel Current :24,000; need 75,000 Remoteness and lack of awareness & health promotion Gaps in Eye Care Program

30. Eye Health Promotion is the “key” to early detection. & Early Detection is the “key” to early intervention. & Early Intervention is the “key” to controlling avoidable blindness.

31. LET US ACT NOW One person goes blind every 5 seconds and One child goes blind every minute Without proper interventions 76 million people could be blind by year 2020

32. Through collaboration let us commit to bring light & smile to as many as blind fellow human beings

34. Together we can make a difference. Thank you for your kind attention