Objectives:I. Caring for the blindII. Epidemiology trends and healthcare implicationIII. Microeconomics and other social parameters as they affect the eye care in daily routine

Primary Eye Care OD-104

Sahibzada Hakim Anjum NadeemDepartmental Coordinator,Department of Optometry and Vision Sciences CEO Anjum Eye Care & Optical CompanyOptometrist, Al-Khair Eye Hospital LahoreCo-Incharge OTTC, Optician, Refractionist, COAVSPhone:03344496480, Email: shanjum92@gmail.com

Caring for the blind

Blindness• Blindness is the inability to see.

According to WHO ‘ blindness is the visual field of around 5 degrees.• Visual acuity less than 3/60 by

Snellen’s chart.• Inability to count fingers in daylight at

a distance of 3 meters.”

Causes Of BlindnessThe cause of the blindness includes:1. Cataract2. Diabetic retinopathy3. Corneal opacity4. Macular degeneration5. Vitamin A deficiency 6. Posterior Segment Pathology etc.

Blindness

Blindness is both avoidable and unavoidable.I.Avoidable blindness: It includes all those causes which when corrected will not lead to blindness such as correcting refractive error,catarct,trachoma.II.Unavoidable blindness: It includes thoses causes that cannot be prevented

even with the help of treatment or other correction such as retinitis pigmentosa, macular degeneration etc.

Low visionAccording to WHO, a person with low vision is the one who has the impairment of visual functioning even after standard refractive correction and has a visual acuity of less than 6/18 to light perception or a visual field less then 10 degrees and who is potentionally able to use this vision for the planning and execution of the tasks.

Causes of low vision

• Diabetic retinopathy• Refractive errors• Cataract• Age related macular degeneration• Glaucoma• Retinitis pigmentosa• Corneal opacities• Trachoma etc.

Care guidelines for the blind• Keep all areas well illuminated.Many

visually impaired people do have some working vision, especially if there is enough light.• Keep walk ways clear.• Keep the floor clear of clothing,furniture

and other items that a visually impaired person may trip over.

• Do not move furniture.People with visual impairements map out their environment so that they can move around safely.• Keep things organized .keep things in

their place also prevents accidents.• Keep drawers and cabinets closed. A

partially open cabinet or drawer creates a dangerous obstacles.

• Mark stairs and doors with contrasting colors of the person have some working vision, the colors will make the outlines of the stair or a door easier to see.

• Announce your arrival and departure as you enter a room ,let the person know you are there; when you leave ,say you are going.

• Announce your presence if you are already in the room when the blind person enters.

• Let the person initiate touch if he wants you to somewhere .• Walk one step ahead when leading.

Specialized services for blind and visually impaired

• Talking products : talking calculators ,clocks , watches etc.

• Come and go safely with a long cane or dong guide.

• Use computers with speech synthesizers or large-print displays.

• Take care of their homes and personals needs using specially designed techniques.

Epidemiology trends and healthcare implication

Primary health care

Healthcare that is provided by health care professionals in the first contact of a patient with the health care system.

Epidemiology

Epidemiology is the study of the distribution and determinants of health related states or events (including disease),and the application of this study to the control of diseases and other health problems.

• Epidemiology is the science of the study of patterns ,causes and effects of the health and disease conditions in defined populations.• It is corner stone of the public health

and informs policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive medicine.

Epidemiologist• Epidemiologists help with the study design ,

collection and statistical analysis of data , and interpretation and dissemination of results (including peer review and occasional systematic review).

• Epidemiologist has helped to develop methodology used in clinical research, public health studies and, to a lesser extent, basic research in the biological science.

Methods for epidemiological investigation

• Various methods can be used to carry out epidemiological investigation.• Descriptive studies can be used to

study distribution.• Analytical studies are used to study

determinants.

Major areas of epidemiological study include disease etiology, outbreak investigation ,disease surveillance and screening,biomonitoring ,and comparison of treatment effects such as in clinical trials.

The bureau of epidemiology• The bureau of epidemiology conducts study-

based programs which protects the public’s health and reduce the burden from disease and conditions of public health significance –whether infectious or of the environmental origin.

• The epidemiologist and toxicologist within the bureau share a commitment to using the best scientific data available to shape prevention , intervention and disease control activities, and improve health and safety of floridians and visitors.

Steps• Investigate and develops disease prevention

and control measures for infectious and non infectious disease outbreaks.

• Conducts surveillance(population based monitoring )on more than 100 reportable diseases and conditions of public health importance for the purpose of rapid case finding and implementation of control measures to prevent secondary cases of illness.

• Conduct surveillance on occupationally related illness and injuries and develops strategies to improve worker safety.

• Maintain data system used to conduct analyses and disseminate data on environmental hazards and health effects that may be related to the exposures.

• Publishes periodic reports based on infectious and non infectious disease and other health related data,data trends and implications for public health.

• Maintain and develops reportable disease surveillance software (Merlin) for the storage, transmission, and analysis of reportable disease case reports.• Provide education, information and

training to healthcare facilities, individuals ,business and general public on disease control and environment issues that impact health.

Steps• Provide statewide toxicology consultation.• Provides environment health risk.

assessment around hazardous waste sites.• Provides technical support on indoor air

quality concerns.• Collects , analyzes and disseminates data

on the occurrence of birth defects.• Diseases should be reported to your local

country health department.

Population based health management

Epidemiological practice and the results of epidemiological analysis make a significant contribution to emerging population-based health management frameworks.

Population based health management encompasses the ability to:

• Assess the health states and health needs of a target population.

• Implement and evaluate interventions that are designed to improve the health of that population.

• Efficiently and effectively provide care for members of that population in a way that is consistent with the community’s cultural,policy and health resource values.

Pakistan health care• As far as Pakistan health care is concerned ,it is

believed to be one of the best compared to the health care system of Pakistan that was adopted after the partition , the health care provision has come a long way.

• Today ,proper national health care is provided by both the private and public sector Pakistan Ministry of health plays an important role so far as Pakistan health care is concerned.

Microeconomics and other social parameters as they affect

the eye care in daily routine

Socioeconomics

Socioeconomics(also known as socio-economics or social economics) is the social science that studies how econmics acitivity affects social processes.in general it analyzes how societies progress , sytagnate,or regress because of their local or regional economy,or the global economy.

Microeconomics• Microeconomics (from greek prefix mikro-

meaning “small and economics) is a branch of economics that studies the behavior of individual households and firms in making decisions on the allocation of limited resources.• It applies to markets where goods or services

are bought and sold. Microeconomics examines how these decisions and behaviors affect the supply and demand for goods and services.

Eye illness

a. Impaired vision b. Low visionc. Blind d. injured

Work Injury

• The impact of an occupational illness or injury on an injured worker can be severe.• Almost two-thirds of respondents lost

their health insurance after diagnosis with a work-related illness or injury, most for more than a year.

• Injured workers often face an array of difficulties following a diagnosis of a work related injury or illness. Workers with acute injuries or illness and uncomplicated treatment and recovery may move through the experience smoothly and with out much impact on their lives.

Workers with chronic illnesses

Workers with chronic illnesses or injuries including eye, require expensive or complicated medical treatment and result in long or even permanent stretches out of work almost invariably face a very different reality.

Eye injury

• Each day, an estimated 2,000 workers suffer eye injury on the job, which not only robs many of them of their sight ,but also costs employers and insurance companies millions of dollars a year.

• The impact of an occupational illness or injury on an injured worker can be severe.

What contributes to eye injuries at work?

• Not wearing eye protection. Nearly three out of every five workers injured were not wearing eye protection at the time of the accident.

• Wearing the wrong kind of eye protection.• The workers most likely wear eye glasses with no

side shields, through injuries.• Among employees wearing full cup or flat foldSide shields occurred, as well.

Why is eye safety important?

• OSHA regulations require that employers provide a safe work environment , which includes supplying the appropriate personal protective eye wear.

• For workers, eye injuries may lead to pain and discomfort, medical cost ,lost work time,lost wages,and even permanent disability.

• For employers ,eye injuries may impact productivity, worker morale, and compensation costs.• An eye injury at work may severely

impact daily living family interactions.• Recreational activities ,and one’s

enjoyment of life.

The barriers faced by injured workers• The nature of the barriers faced by injured

workers accessing medical care for their illness/injury.

• The use and perceived utility of legal resources in the pursuit of workers.

• Compensation benefits.• The overall impact of the illness /injury on

worker’s lives.

Eye injury prevention• Employers are required to conduct an eye hazard

assessment and use engineering controls to remove or minimize hazards where possible.

• Employers are required to provide properly fitting protective eye wear appropriate protective eyewear is not available or is missing ,notify your supervisor.

• When protective eyewear is a part of your job, make a habit of wearing it and encourage your coworkers to use it too. Protective eyewear is an important tool of your trade.