2019年VISION 2020视觉.ppt
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1、Kovin Naidoo ICEE Africa Director AFCO Vice-President,Optometry as part of Vision 2020: global perspective,Global Initiative to Eliminate Avoidable Blindness by the Year 2020,World Health Organisation- IAPB,Present estimation: 45 million people blind + 135 million visually disabled,Present situation
2、,Best corrected VA,International classification ignores the burden of uncorrected refractive error,World Prevalence of Blindness,Prevalence of Blindness,90%+ live in underprivileged communities,The blindness rate in many developing countries, especially in Africa, is 7 times higher, at 1.4%, than in
3、 developed countries,Gender is another major issue,Global Distribution of Blindness by Cause,Cataract 42 %,Trachoma 15 %,Glaucoma 14%,Oncho. 1 %,Other 28 %,Macular degeneration,Diabetic retinopathy,+ Refractive errors (uncorrected),Present situation,80% of blindness is avoidable preventable or curab
4、le,Leading Causes of Preventable Blindness:,Cataract Trachoma Onchoceriasis Childhood Blindness Refractive Error & Low Vision,VISION 2020,Vision 2020 will strive to make refractive services and corrective spectacles affordable and available to the majority of the population through primary health ca
5、re facilities, vision screening in schools and low-cost production of spectacles. Similar strategies will be adopted to provide low vision services.,Global estimates,Magnitude of refractive errors not reliably known Large global variation in prevalence (by age, gender, and race) Estimated: 2.3 billi
6、on people have refractive error 1.8 billion have access to refractive services 500 million do not have access to services,Sth Africa 1.0% RE:10% Cook, 1992 (n=268),China 4.4% Due to RE:10% Shaozhen Li, 1999 (n=5342),Australia 0.15% Due to RE:25% Taylor, 1997 (n=3268),India 2.5% Due to RE:9.6% Dandon
7、a, 1998 (n=2522),Saudi Arabia 0.7% RE: 5.3% Al Faran, 1993 (n=2882),10%+ of World Blindness,Blindness Due To Uncorrected Refractive Errors (3/60),Difficulties with Current Data,Non-uniform definitions across studies Non-representative study populations (convenience rather than population-based) Diss
8、imilar demographics of study population (age and sex) Refraction procedures are different (with/without cycloplegia etc),Negrel, Ellwein, 2001,Uncorrected refractive error is the major cause of:,blindness following mass cataract surgery using standard power IOL,Myopia with Autorefraction: Country Co
9、mparison,Low Vision,35m people worldwide have irreversible vision loss and are in need of low vision care.,*WHO Global Initiative: Vision 2020, Feb 1999,VISION 2020 will enable access to visual devices & low vision care at affordable cost,Treatment: Low vision care & vision correction,components,Dis
10、ease control through service delivery Human resource development Infrastructure and technology,Collaborations,has created valuable and effective collaborations of organisations WCO until 2002 was not a part of the International Agency for the Prevention of Blindness,Optometry a late entrant,It is on
11、ly recently that uncorrected refractive error and even more recently low vision has achieved prominence Landmark population-based studies in adults, children and in post-cataract patients.,Optometry and Public Health,Mainly private practice Limited discourse about public sector initiatives Individua
12、l Optometrists and groupings efforts,Public Health Challenges,Integration of professions Expansion of the scope of Optometry Consolidation of the scope of Optometry Charity vs Public Health Health Policy Health Systems development and Management Health Promotion,Opportunity for Optometry,The realisa
13、tion of the impact of uncorrected refractive error and Low Vision has provided the opportunity for optometry to play a major part in alleviating vision loss for those most in need.,Refractive Error and Vision 2020,WHO established a Refractive Error Working Group (REWG), as The REWG is now developing
14、 international strategic plans and policies to eliminate uncorrected refractive error.,Definitions,Children: -Myopia: 0.5D -Hyperopia: 2D,Refractive error in Children,-Binocular vision 6/12 is considered significant -Should only occur when appropriate resources for follow-up refraction and delivery
15、of spectacles. -Visual acuity screening of children can be performed at community level by teachers, health care workers etc.,Refractive exams,Children: Exams should be carried out only by eyecare personnel(ECP) with the appropriate skills in objective and subjective refraction, ocular motility, bas
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