The Acting Director of the Botswana Public Health (BPH) Dr. Haruna Jibril, has said an ophthalmic study conducted in Botswana amongst adults aged 50 years and above in 2006 revealed that 3.7 percent of the population was blind.
Jibril said that over 74 000 adults lost their sight through cataract, diabetic retinopathy (DR), corneal scars, trachoma and glaucoma.
Officially opening an Ophthalmic Professionals workshop held annually in Gaborone last week and attended by the Ministry of Health Head of Disease Control Division, UK-based Addenbroke’s Abroad Representatives, Vision 2020 Links Representatives, Vision Aid Overseas Representatives, Standard Charted Bank Representative, Botswana Association for the Blind and Partially Sighted Representative and Ophthalmic Professionals from Public and Private Sector, Jibril said a follow-up study conducted in 2009 conducted in Botswana on childhood blindness revealed that uncorrected refractive errors were the leading cause of blindness.
“The results of these studies are a challenge to us and we need to strengthen our efforts as we implement Vision 2020 strategies to improve the delivery of ophthalmic services in the country,” said Jibril. “Research is needed to improve the knowledge on causes of avoidable blindness to generate evidence on the effectiveness of interventions with regard to the unacceptable, human and economic consequences. Foremost, sightlessness and visual impairment have far reaching social, economic and developmental implications; not only for the individual, but for the families and communities as well. Secondly, when visual disability occurs in early childhood, it challenges children’s development, mobility, education, and social and employment opportunities.”
“The Theme: ‘The Integrated Eye Care Team- Working to Eliminate Avoidable Blindness’ underscores the need for collaboration and commitment on all involved in the services and care delivery chain.”
Current World Health Organization (WHO) estimates show that worldwide about 285 million people are visually impaired, due to eye diseases or uncorrected refractive errors; 39 million are blind and 246 million suffer from low vision, likely to increase to 76 million by 2020 without effective interventions. Every five seconds one person in the world goes blind, while every minute a child loses his sight. The major global causes of avoidable blindness include cataract, glaucoma, refractive errors, corneal scars, trachoma and onchocerciasis. The number of blind people is alarming, considering the fact that 80 percent of blindness is avoidable, he said.
Since the early 1970s, WHO has been collaborating with concerned governments and non-governmental organizations to come up with strategies to prevent blindness among world populations and launched a global initiative for the elimination of avoidable blindness by 2020.
The development of more available and sustainable comprehensive eye-care system accessible to communities and ensuring the best possible vision and quality of life, through implementation of the three core Vision 2020 National Programmes strategies encompassing Human Resource Development, Disease Control, Infrastructure and Appropriate Technology Development.
Notwithstanding, for the WHO/International Association for the Prevention of Blindness (IAPB) Vision 2020:”The Right to Sight Initiative” to work, Ophthalmic Professionals have to lead the way and others will follow, he said.
National Prevention of Blindness Coordinator, Alice Lehasa, said Glaucoma, which is the second cause of blindness and irreversible blindness in the world, poses one of the greatest challenges in Preventive Ophthalmology.
Glaucoma, which is a global public health problem and a worldwide challenge in eye care delivery and blindness prevention, is comprised of an optic neuropathy characterised by pathological cupping and optic atrophy visual field loss. At least half of all cases still go undetected, even in the most developed countries (W. Europe, N. America.
Glaucoma may be associated with an elevated intraocular pressure is a silent disease with very few symptoms, until in advanced stages. It causes loss of vision and is slowly progressive; one eye is usually more affected (sometimes blind) than the other and, as a result, most patients present late to the clinic, Lehasa said.
She added that Diabetic Retinopathy (DR); the 5th cause of global blindness affecting 1.8 million is increasing world wide. DR the primary cause of 5-10 percent of blindness in economically intermediate countries has been identified as the main cause of blindness in economically active age group in developed countries and is gaining predominance in developing countries.
The prevalence of blindness of DR is due to an increase in diabetes throughout the world, especially from the increasing incidence and prevalence of type 2 diabetes, due to ageing of the population plus change in lifestyle lead to obesity. Most of the increase is, however, in middle and low income countries.
DR, which has a prevalence of 3 percent per 30 000 people, can be screened by Ophthalmic medical officers, ophthalmic nurse or medical doctor. Screening for Type 1 Diabetes should be done at puberty and then annually, while that of Type 2 at diagnosis and then annually. Referral to ophthalmologist – if retinopathy is diagnosed, she said.
Lehasa commended the best presentations in Ophthalmic Medicine by teams based in Letlhakane, Kanye Seventh Day Adventist and Selebi Phikwe Hospitals as spearheading the prevention of blindness and visual impairment in the remote population settings.