3. Introduction

4. Current situation

6. Major causes of blindness

8. Vision and mission

9. Strategies

10. Appendices

11. References

C O N T E N T S

Copyright, The National Committee for Prevention of Blindness, Jan 2003Correspondence:Ahmed Abdulla Ahmed, M.D., M.P.H., FRCS (ED)P.O. Box 12, Ministry of HealthManama, Kingdom of BahrainTel: 255555, Fax: 276905, Mobile: 9459501E-mail: ahmedmd@batelco.com.bh

ISBN: 99901-18-06-X

he Kingdom of Bahrain joined the International Blindness

Prevention initiative, which aims to eliminate preventable

causes of blindness by the year 2020, and to achieve the global

initiative: "VISION 2020: "THE RIGHT to SIGHT." In July of

2001, a ministerial order was issued by the Ministry of Health to

form the National Committee for the Prevention of Blindness

(Appendix 6.1).

Subsequently, the Ministry of Health issued another order in

August of 2001, designating the members of the National

Committee for Preventing of Blindness (Appendix 6.2). This

committee consists of eleven members, who represent the public

and private sectors, ministries, societies, and related professional

bodies.

I N T R O D U C T I O N

T

3

It is estimated there are approximately 40 million blind people in the world, ofwhich 30 million are blind as a result of preventable conditions. Another 110 mil-lion are suffering from severe visual impairment. According to the data availablefor the Eastern Mediterranean region, there are at least 5.5 million blind people,and 17 million who are suffering from visual impairment.

Numerous studies relating to the problem of blindness, visual impairment, andtheir causes were conducted in Bahrain. A retrospective study was conducted todetermine the etiology and ocular conditions that lead to low vision and blindness.The desired data was collected from the available outpatient records. Among thepatients attending the outpatient eye clinics, 7.4% were found to be blind, and6.9% were visually impaired. The most common eye condition leading to lowvision and blindness was cataract, followed by glaucoma and corneal diseases1.

A community based field study was done jointly with IMPACT International groupand WHO, to identify the prevalence and causes of blindness and visual impair-ment in a sample of the Bahraini population.2

The prevalence of bilateral and monocular blindness and bilateral and monocularvisual impairment, and their causes were as follows:

T H E C U R R E N T S I T U A T I O N

4

Blindness and visual impairment present major problems that require great effortfor eliminating their causes. This includes early detection through communitybased programmes among high risk groups. Furthermore, there should be remedi-al programmes such as eyesight correction and regular follow- ups for cases at risk,such as diabetic patients.

Category Prevalence %Causes

BilateralBlindness

1.9%

211064

CataractGlaucoma

Corneal opacityRefractive error

MonocularBlindness

4.8%

14764

CataractGlaucoma

Diabetic retinopathyRefractive error

BilateralImpairment

4.0%

34943

Refractive errorsCataract

GlaucomaMacular degeneration

MonocularImpairment

2.9%

18942

Refractive errorsCataract

Diabetic retinopathyGlaucoma

5

1 - C A T A R A C T : Cataract is the major cause of blindness worldwide, accounting for half of thecases. Cataract is an aging process resulting in opacification of the lens of the eye,thus preventing the passage of light into the eye. Vision can be regained by sur-gical extraction of the opaque lens and intraocular lens implantation. One thou-sand cataract extraction operations are carried out in Bahrain annually. There areno extensive waiting lists, or large backlogs of cataract in Bahrain.2 - G L A U C O M A :Glaucoma is the second cause for blindness in Bahrain. Visual loss is due to dam-age to the optic nerve as a result of high eye pressure. The solution lies in earlydetection and treatment by medication or surgical intervention. 3 - D I A B E T I C R E T I N O P A T H Y : Diabetes is considered one of the major health problems in the EasternMediterranean countries. WHO estimate the prevalence to be between 4% to 10%of the region's population.≥ An estimated 20 million persons are diabetic in thisregion. Bahrain has somewhere between 26,000 to 65,000 diabetics. This diseasemay lead to blindness as a result of diabetic retinopathy. To avoid visual loss, peri-odic eye check-ups must be done to discover early cases and treat with laser if nec-essary.4 - E R R O R O F R E F R A C T I O N Error of Refraction is considered one of the main causes of eyesight deterioration.It is ranked first among causes of visual impairment with prevalence of 34%among the Bahraini population. The condition occurs when the optical element ofthe eye does not focus the image clearly on the retina. To correct eyesight, the eyemust be checked, and corrected by eyeglasses, contact lenses, or corneal correctivesurgery.

MAJOR CAUSES OF BLINDNESS

6

5 - E Y E T R A U M A :Eye Trauma is regarded as an important cause for blindness in Bahrain. A studywas conducted on cases of eye injuries that required hospital admission.4 A totalof 489 patients were evaluated, 90% of whom were males and 10% females.Children under 20 years of age constituted 41.3% of total cases, with malesaccounting for 85% and females 14.9%. Thirty-eight percent of all injuries wereoccupational in nature, particularly among industrial and construction workers.14.6% of all cases resulted in blindness or severe visual impairment, while 28.6%of cases with ruptured globes had a similar outcome. Adequate preventive meas-ures to minimize the risk of ocular injuries among the population at risk are war-ranted, and should address safety at home, the playground, and work environment. 6 - C H I L D H O O D B L I N D N E S S : An estimated 1.5 million children are blind in Asia and Africa. A study of child-hood blindness at Al-Noor Institute for the Blind in Bahrain showed the main caus-es of visual disability were due to hereditary diseases, accounting for 42% of thecases.5 These diseases include retinal dystrophy, glaucoma, cataract, intrauterineinfections, and retinopathy of prematurely. Consanguinity is an important risk fac-tor among these children. Some examples of prevention programs are preschooland school vision screening, early detection of retinopathy of prematurely, andgenetic counseling to prevent heredity diseases.7 - C O R N E A L D I S E A S E S :Corneal opacity results from inflammations, traumas, and different corneal dystro-phies, leading to blindness. A corneal transplant is usually required to regainvision. Around 50 such operations are done in Bahrain annually. Donor corneasare not available locally, and have to be imported from outside sources, such as theInternational Eye Bank.

7

V I S I O NElimination of preventable causes of blindness is everybody's responsibility.

M I S S I O NThe National Committee for Prevention of Blindness aims todecrease the percentage of blindness and visual impairment to thelowest level possible among all groups by determining the magni-tude of the problem, its causes, and takes the necessary actionstowards prevention.

V I S I O N A N D M I S S I O N

8

1- Compliment and extend the International Initiative for pre-vention of blindness, and co-coordinate activities betweenthe global, regional and local establishments.

2- Conduct awareness campaigns to inform and educate peopleabout blindness, visual impairment and means of preven-tion.

3- Procure funds for prevention programmes and supportactivities of the committee.

4- Strengthen existing prevention programmes and supportfuture programs.

5- Collect available data, statistics and information, andencourage research, studies, and surveys related to blind-ness.

6- Organize seminars, workshops and courses on prevention ofblindness.

7- Synergize and strengthen efforts by working with groupsand organizations with similar aims and goals of theCommittee.

S T R A T E G I E S

9

Ministerial Order No. (11) For the year 2001 issued by the Ministry of Health to for the National Committee for Blindness Preventing on July 9th, 2001.(See Appendix 1 in Arabic).

Ministerial Order No. (13) For the year 2001 naming the National Committee forPreventing of Blindness, in August 8th, 2001 (Appendix 2Arabic). This commit-tee consists of eleven members namely:-

C h a i r m a n :Dr. Ahmed Abdulla Ahmed

M e m b e r s :Mr. Jamal FakhroDr. Ebtisam Al-AlawiMr. Abbas HilalMr. Saeed MohammedDr. Nabeel Al-ShirawiDr. Salah AliDr. Ebtisam FakhroMr. Saeed Al MasMrs. Afaf Al-AsiriMrs. Fatima Murtadha.

A P P E N D I C E S

10

1. Ahmed A. and Selvyn D.: Causes of Low Vision and Blindness in Bahrain.Bahrain Medical Bulletin, vol 10, No. 3:142-144, 1988.

2- Ahmed Abdulla Ahmed, MD, MPH, FRCS (Ed) [1], Ebtisam Al-Alawi,FRCS, MRCOphth, DO [2], Bahaa El-Din Fateha, MD, DrPH [3] and AblaMehio Sibai, PhD [4] : Population-based Visual Disability and VisualImpairment Survey in Bahrain -- accepted for publication on the SaudiJournal of Ophthalmology.

3- Ahmed A.: Prevention of Blindness due to Diabetes in the Middle East,Editorial. Middle East Journal of Ophthalmology, vol 2, No. 2:68-69,1994.

4- Ahmed A., Al-Alawi E., Fateha B., Mahmood H., Selvyn D.: Eye Injury inBahrain: retrospective study of cases admitted to hospital 1988- 1992.Middle East Journal of Ophthalmology, vol.2, No. 3:182-189, 1994.

5- Al-Alawi E, Ahmed A, Fateha B: Causes of Visual Disability at the Al-Noor Institute for the Visually Impaired in Bahrain. Saudi Journal ofOphthalmology, vol.12, No. 2: 101 - 105, April - June, 1998.

R E F E R A N C E S

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