Vision 2020 – The right to sight

  • ‘Vision 2020 – The right to sight’ is a global initiative by the WHO launched in 1999.
  • WHO together with the ‘Task Force of International Non Governmental Organisations’ aims to reduce global burden of blindness, and to eliminate preventable blindness by the year 2020
  • The various NGO’s involved in this initiative are:
    • International Agency for Prevention of Blindness
    • Helen Keller International
    • Al Noor Foundation
    • ORBIS International
    • Sight Savers International
    • International Federation of Ophthalmological Societies
    • Lions Club International Foundation
    • Cristopher Blindness Mission
    • The Carter Centre
    • Operation Eye Sight Universal
  • The project is executed in four ‘5 year plans’ starting from the year 2000

Strategic approach:

  • The strategies incorporated into Vision 2020 are:
    • Disease prevention and control
    • Training of eye health professionals
    • Strengthening of existing eye care infrastructure
    • Use of appropriate and affordable technology
    • Mobilisation of resources

Disease prevention and control

  • WHO has identified 5 conditions responsible for major part of the global burden of blindness. They are:
    • Cataract
    • Childhood blindness
    • Refractory errors
    • Trachoma
    • Onchocerciasis

Cataract

  • Cataract is the single largest cause of preventable blindness in the world
  • An estimated 19 million people are blind as a result of curable cataract
  • Vision 2020 aims to reduce blindness due to cataract to zero by the year 2020
  • Increasing the Cataract Surgery Rate (CSR) is focussed
  • Importance is given for:
    • Ensuring high success rate in cataract surgeries
    • Make cararact surgeries affordable to the general public
    • Overcome any barriers that come in the way towards attaining these goals

Childhood blindness

  • It is estimated that about 1.5 million children (0-15 years of age) around the world are blind
  • The main causes of childhood blindness are:
    • Vitamin A deficiency
    • Measles
    • Retinopathy of prematurity
    • Congenital cataract
    • Conjunctivitis
    • Ophthalmia neonatorum
  • The major strategies in control of childhood blindness are:
    • Prevention of blindness
      • Vitamin A supplementation
      • Measles vaccination
      • Monitoring of oxygen administration in neonates
      • Health education and screening programs in schools
    • Surgical treatment for:
      • Cataract
      • Retinopathy of prematurity
      • Glaucoma

Trachoma

  • Trachoma is caused by Chlamydia trachomatis
  • An estimated 6 million people are blind due to trachoma complications
  • WHO has advised the SAFE strategy for prventing blindness due to trachoma
    • Surgery to correct lid deformity and prevent blindness
    • Antibiotics for treatment
    • Facial hygiene
    • Environmental change with access to clean water, sanitation and health eduation

Refractory errors

  • The aim is to eliminate impaired vision and blindness due to refractory error
  • An estimated 35 million people in the world require low vision care
  • The steps to be taken are:
    • Screening for refractory errors those can be improved with spectacles or low vision aids
    • Refraction services for those with significant refractory errors
    • Optical services to provide spectacles at an affordable rate
    • Low vision services – provide low vision aids

Onchocerciasis

  • Onchocerciasis is caused by onchocerca volvulus
  • It is also called river blindness
  • It is prevalent in some African countries
  • An estimated 17 million people are affected with onchocerciasis
  • Aim is to eliminate blindness due to onchocerciasis by 2020
  • The strategy is to provide community directed treatment with annual doses of ivermectin

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