VISION 2020 Nina Holst, Betanien Hospital, Skien.

Bergen 15. June 2015

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Every second one person in our world goes blind!

Every minute a child goes blind!

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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

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HISTORY OF VISION 2020 / 1950

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

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TRACHOMA Repetitive infections with

chlamydia Trachomatis (childhood, adolescens)

Conjunctival scarring

Entropium – corneal scarring

BLINDNESS

Poor hygiene, sanitation, water supply

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HISTORY OF VISION 2020 / 1972 - 1978

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

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HISTORY OF VISION 2020 / 1987/93

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.

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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

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Causes of childhood blindness

High income countries

CNS disorders

Retinal conditions

Middle income countries

Retinal conditions, mainly hereditary, retinal dystrophies, ROP

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Causes of childhood blindness cont.

Low income countries

Corneal scarring (Vitamin A deficiency, measles,ophthalmia neonatorum, harmful traditional practices)

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HISTORY OF VISION 2020 / 1975

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Onchocerciasis – river blindnessParasite transmitted by blackflies.

Flies abounding in running water (riverside)

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Onchocerca volvulus cycle in man.

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Onchocerciasis –distribution

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Onchocerciasis - treatment

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Onchocerciasis -treatment1987 MSD committed to donation of Mectizan® (Ivermectin)

“for as long as necessary for the control of onchocerciasis”

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HISTORY OF VISION 2020 / 1993

Global database on blindness and visual impairment was developed.

1990 – 38 mill blind, 110 mill visually impaired

1996 – 45 mill blind, 135 mill visually impaired

2020 - double ???!!! Graying population

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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

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Three main Objectives.

1. Identify the causes and the solutions

2. Train and mobilize the necessary resources

3. Facilitate, planning and development of three core strategies in VISION 2020 training program

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Three core strategies

1. Disease control

2. Human resource development

3. Infrastructure and appropriate technology development

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VISION 2020 committees and workshops

Meet the local needs

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HISTORY OF VISION 2020 /2004

Am J Ophthalm 2003 Apr; 135(4):471 -6

The magnitude and cost of global blindness, an increasing problem that can be alleviated.

Frick KD, Foster A.

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Human consequence

Economic impact

102 000 000 000 $

No intervention:

2020 – 76 mill blind

Successful VISION 2020:

2020 – 24 mill blind

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Avoiding 429 mill blind-person-years

DALY,s.Poverty

Aging

Family

Education

QALY,s

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Proportion of cases of blindness due to each major cause.( Foster A., Gilberrt C., Johnsen G., CEHJ Vol 21 No 67 2008)

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CataractCa 40 % of world blindnessaging population both developed and developing countries

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Prevention??Risk factors:

Smoking

UV-radiation

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Cataract

SURGERYHigh volumeHigh qualityLow costSustainable programs

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Refractive errors and low vision

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

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Diabetic retinopathy

Priority disease

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Glaucoma

Priority disease

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Age related macular degeneration AMDPriority disease

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Global Action Plan 2014 - 2019

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.

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London School of Hygiene and Tropical Medicine

Bloomsbury

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

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Ophthalmologists per million population

(Resnikoff et al, Br j Ophthalmol 2012)

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Would you consider working with EHCS in a developing country?

25-2

9 yr

s (n

=8)

30-3

4 yr

s (n

=27)

35-3

9 yr

s (n

=41)

40-4

4 yr

s (n

=43)

45-4

9 yr

s (n

=29)

50-5

4 yr

s (n

=34)

55-5

9 yr

s (n

=28)

60-6

4 yr

s (n

=27)

65-7

0 yr

s (n

=31)

>70 y

rs (n

=31)

Total

(n=29

9)0%

10%20%30%40%50%60%70%80%90%

100%

do not knowNoYes

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How to increase interest for Eye Health care Services in developing countries in The Norwegian Ophthalmological society

InformationOrganizingEconomyLeave

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Eye care for allSuggestion of

activities

Thursday 8 October

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Thank you!

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