1. Nina Holst, Betanien Hospital, Skien. Bergen 15. June 2015
VISION 2020
Nina Holst, Betanien Hospital, Skien.
Bergen 15. June 2015

3. Every second one person in our world goes blind!
Every minute a child goes blind!

4. Facts about global blindness
A total of 40 million people are blind
Another 150 million people are victims of severe disability
90 % of the worlds blind live in developing countries
80 % of this blindness is avoidable ; preventable or treatable

5. HISTORY OF VISION 2020 /
WHO early efforts on blinding prevention programmes
Prevention and treatment of Trachoma
Assess the magnitude of the problem
Institute control activities
Research of treatment options

6. TRACHOMA
Repetitive infections with chlamydia Trachomatis (childhood, adolescens)
Conjunctival scarring
Entropium – corneal scarring
BLINDNESS
Poor hygiene, sanitation, water supply

7. HISTORY OF VISION 2020 /
The earliest epidemiological data of Global blindness PROBLEM: different methods SOLUTION: standardized guidelines Later on WHO produced standardized protocols for grading systems in surveys of Trachoma and Childhood blindness

8. HISTORY OF VISION 2020 / /93
Thylefors B et al. A simplified system for assessment of trachoma and its complications. Bulletin of the World Health Organization, 1987, 65 (4): 477–483. Gilbert C et al. Childhood blindness: a new form for recording causes of visual loss in children. Bulletin of the World Health Organization, 1993, 71: 485–489.

9. Childhood blindness
A group of diseases occurring in childhood, result in blindness or severe visual impairement
Wide variety from region to region
Determination of socio-economic development
Access of Eye Health Care Services

10. Causes of childhood blindness
High income countries
CNS disorders
Retinal conditions
Middle income countries
Retinal conditions, mainly hereditary, retinal dystrophies, ROP

11. Causes of childhood blindness cont.
Low income countries
Corneal scarring (Vitamin A deficiency, measles,ophthalmia neonatorum, harmful traditional practices)

13. HISTORY OF VISION 2020 /

14. Onchocerciasis – river blindness
Parasite transmitted by blackflies.
Flies abounding in running water (riverside)

15. Onchocerca volvulus cycle in man.

16. Onchocerciasis –distribution

17. Onchocerciasis - treatment

18. Onchocerciasis -treatment
1987 MSD committed to donation of Mectizan® (Ivermectin)
“for as long as necessary for the control of onchocerciasis”

19. HISTORY OF VISION 2020 /
Global database on blindness and visual impairment was developed – 38 mill blind, 110 mill visually impaired 1996 – 45 mill blind, 135 mill visually impaired double ???!!! Graying population

20. The VISION 2020: The right to sight is the global initiative for the elimination of avoidable blindness launched by Gro Harlem Brundtland, WHO general director in February 1999

21. Three main Objectives. Identify the causes and the solutions
Train and mobilize the necessary resources
Facilitate, planning and development of three core strategies in VISION training program

22. Three core strategies Disease control Human resource development
Infrastructure and appropriate technology development

23. VISION 2020 committees and workshops
Meet the local needs

25. HISTORY OF VISION 2020 /2004
Am J Ophthalm 2003 Apr; 135(4): The magnitude and cost of global blindness, an increasing problem that can be alleviated. Frick KD, Foster A.

26. Human consequence Economic impact 102 000 000 000 $ No intervention:
2020 – 76 mill blind
Successful VISION 2020:
2020 – 24 mill blind

27. Avoiding 429 mill blind-person-years
DALY,s.Poverty
Aging
Family
Education
QALY,s

28. Proportion of cases of blindness due to each major cause. ( Foster A
Proportion of cases of blindness due to each major cause. ( Foster A., Gilberrt C., Johnsen G., CEHJ Vol 21 No )

29. Cataract Ca 40 % of world blindness aging population
both developed and developing countries

30. Prevention??
Risk factors:
Smoking
UV-radiation

31. Cataract SURGERY High volume High quality Low cost
Sustainable programs

32. Refractive errors and low vision
Include myopia and hyperopia with or without astigmatism
Recent studies have confirmed a large burden of uncorrected refractive errors
> 100 mill people with low vision, ¼ will benefit from low vision services

33. Diabetic retinopathy
Priority disease

34. Glaucoma
Priority disease

35. Age related macular degeneration AMD
Priority disease

36. Global Action Plan
A world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential and where there is universal access to comprehensive eye care services.

37. London School of Hygiene and Tropical Medicine Bloomsbury

38. Norwegian Ophthalmologists -a resource in VISION 2020 right to sight initiative

39. Ophthalmologists per million population
(Resnikoff et al, Br j Ophthalmol 2012)

40. Would you consider working with EHCS in a developing country?

41. Information Organizing Economy Leave
How to increase interest for Eye Health care Services in developing countries in The Norwegian Ophthalmological society
Information
Organizing
Economy
Leave

42. Suggestion of activities
Eye care for all
Suggestion of activities
Thursday 8 October

43. Thank you!