Preservation and Restoration of Vision:

Initiatives and Resources

On this page:

• The devastating impact of loss of vision
  
  
• ICO dedicated to preservation of vision
  
  
• Resources and connections on the Eye Site

Preservation of vision headlines:

• LAICO’s EYEXCEL Course to Develop Capacity in Eye Care Organizations
  
  
• Please Help Us Estimate the Number of Ophthalmologists
  
  
• The Need for Management Capacity to Achieve VISION 2020 in Sub-Saharan Africa
  
  
• VISION 2020: The Next Decade
  
  
• Australia’s Advocacy Success
  
  
• VISION 2020 Symposia at WOC 2010
  
  
• Enhancing Eye Care in Africa
  
  
• Progress in the Fight Against Trachoma
  
  
• ICO Bahrain Declaration on Trachoma and Trichiasis Surgery
  
  
• WHO Reports 153 million have uncorrected refractive errors
  
  
• Jackson Lecture quantifies the benefits of eye care
  
  
• Advocacy presentations and tips
  
  
• Data on countries with few ophthalmologists
  

(Also see: More News of preservation of vision)

The devastating impact of loss of vision

Every five seconds, one person in the world goes blind.

A child goes blind every minute.

There are 37 million people who are blind in the world.

There are 124 million more with significant loss of vision.

75 % blindness is avoidable: either preventable or treatable.

Yet the World Health Organization (WHO) estimates that the number of blind and visually impaired will double by 2020 unless concerted action is taken.

Ninety percent of the world's blind people live in developing countries, including close to seven million each in India and China and more than 19 million in other countries.

ICO dedicated to preservation of vision

The International Council of Ophthalmology (ICO) is a professional organization of ophthalmologists that is dedicated to preserving and restoring vision for all people worldwide.

Also see: ICO Commitments

Resources and connections on the ICO Eye Site

To help ophthalmologists, ophthalmologic societies and others contribute to the preservation and restoration of vision, the ICO's Eye Site offers:

• information on existing preservation of vision initiatives, including:
• International Ophthalmology's Vision for the Future
  
  
• VISION 2020: The Right to Sight
  
  
• Research Agenda for Global Blindness Prevention
  
  
• WHO and Non-Governmental Development Organizations (NGOs)
  
  
• ICO preservation of vision programs and initiatives
  
  
• Other initiatives
  
  
• suggestions on how ophthalmologic societies and individual ophthalmologists can participate and contribute
  
  
• data on loss of vision and incidence and prevalence of eye conditions
  
  
• publications and other resources available on prevention of blindness
  
  
• information on ophthalmic education, ICO educational initiatives and programs and other educational meetings and tools for ophthalmologists.

LAICO’s EYEXCEL Course to Develop Capacity in Eye Care Organizations

August 11–14, 2010, Lions Aravind Institute of Community Ophthalmology (LAICO) “EYEXCEL - Expanding Global Eye Care Workforce through Excellence in Training” course in collaboration with the ICO. This four-day training program aims to develop the capacity for in eye care organizations to deliver quality training programs on a regular basis.

This course is for institutions currently offering or planning to offer training courses. Registrants should be a team of two representing each institution, to ensure that ideas generated in the training workshop will be established in the institution. The application deadline is July 15, 2010. For more information, download the EYEXCEL course brochure, archive.icoph.org/pdf/Final Eyexcel.pdf.

Please Help Us Estimate the Number of Ophthalmologists

Last year, the World Health Assembly endorsed the World Health Organization’s Action Plan for the Prevention of Blindness and Visual Impairment. To support implementation of the Action Plan, the ICO is working to obtain the best possible data on the number of ophthalmologists in practice and in training in each country.

We would deeply appreciate your help to obtain this data so that we can all advocate effectively for improving eye care.

ICO Director for Advocacy, Serge Resnikoff, MD, PhD, has sent a questionnaire to national ophthalmologic society presidents (and individuals in countries without societies) asking them to estimate the numbers of practicing ophthalmologists and trainees.

Please be sure your society responds to this survey by April 10, 2010. If your society did not receive it, please send a message to leader@icoph.org, and we will send a survey to you.

The Need for Management Capacity to Achieve VISION 2020 in Sub-Saharan Africa

The Kilimanjaro Centre for Community Ophthalmology, with their colleagues Amir Bedri, Ciku Mathenge, Gerald Msukwa, and others have been working to build management capacity to achieve VISION 2020 in Africa, with support from groups such as the Fred Hollows Foundations, International Eye Foundation, LAICO, and IAPB. In tackling the topic of management capacity in Africa, they share their “lessons learned” in an article by Susan Lewallen and Amir Bedri Kello in the December 2009 issue of PLoS Medicine.

To read the article click here. For more information on the Kilimanjaro Centre for Community Ophthalmology (KCCO), see www.kcco.net.

VISION 2020: The Next Decade

The American Academy of Ophthalmology’s International Forum held at October’s (2009) Joint Meeting brought world ophthalmologists together to address the progress of VISION 2020 and the challenges that still lie ahead.

Hugh Taylor, MD, opened the discussion with VISION 2020: Where Are We Now, One Decade Later?, archive.icoph.org/ppt/V2020WhereAreWeNow.ppt. (PPT–379 KB). He noted that the key to success is, and will continue to be, effective collaboration and partnerships.

Ivo Kocur, MD, presented a summary of the Action Plan for the Prevention of Avoidable Blindness and Visual Impairment and the steps leading to its adoption by the WHA: archive.icoph.org/ppt/IvoKocurWHOIntForum.ppt. (PPT–9.6 MB)

Panelists Abdulaziz AlRajhi, MD, Ramachandra Pararajasegaram, MBBS, Louis D. Pizzarello, MD, and Victoria M. Sheffield, MD, described some measures of VISION 2020 success thus far: eye health on local government agendas, increased priority for prevention of visual loss within the WHO and the cooperation of non-governmental organizations.

Australia’s Advocacy Success

Australia has been a model for effective pursuit of VISION 2020 goals, with the Government having committed over $100 million to improve eye care in Australia, and recently allocating $45 million to improving eye care in Asian and Pacific countries.

A key to Australia’s success has been the formation of VISION 2020 Australia and definition in 2005 of the National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss, which outlines five areas for action: 1. Reduce risks, 2. Increase early detection, 3. Improve access to eye care services, 4. Improve the systems and quality of care, and 5. Improve the evidence base.

Australia’s National Framework is available at:
www.health.gov.au/internet/main/publishing.nsf/Content/ageing-eyehealth-framework-toc.htm.

Australian ophthalmologists and their College have played a leading role in working with the Australian government. Significant economic investment and effective coordination between organizations are also important components of this successful model.

Visit the VISION 2020 Australia Web site to download over 70 advocacy resources:
www.vision2020australia.org.au/resources.cfm.

VISION 2020 Symposia at WOC 2010

The World Ophthalmology Congress in Berlin will be an opportune time to discuss VISION 2020 and advocacy topics among the world’s ophthalmologists.

A sample list of VISION 2020 Symposia topics:

• Vision 2020: 10 Years on, 10 Years to Go
• Africa: Can We Succeed in the Greatest Challenge to Blindness Prevention?
• Beyond Vertical Programs: Challenges and Success in Building Comprehensive Eye Care Within a Health Care System
• Brain Drain: Challenges and Solutions
• Refractive Error from School Age through Presbyopia: Combating the World’s Leading Cause of Visual Disability
• The Economics of Blindness: What Does Lost Vision Cost, How Much Can Prevention Save?

For more details on these and other subjects, download the WOC 2010 preliminary program:
www.woc2010.org/uploads/media/WOC2010_Pre_Program_e21209_01.pdf.

Enhancing Eye Care in Africa

At the recent ICO Board Meeting in San Francisco (October 2009), Dr. Daniel Etya’ale presented his perspective on eye care in Africa: Enhancing Eye Care in Africa: Needs, Challenges, Opportunities, and Suggestions for a Radical Shift of Paradigm. To overcome the significant challenges of this region, he suggested a multi-pronged approach consisting of:

• Human resource development
  
  
• Essential equipment and supplies
  
  
• Disease control expansion and up-scaling
  
  
• Advocacy, targeted for and within Africa
  
  
• Evaluation, monitoring, documenting and reporting.

“We need to make an underlying paradigm shift from prevention of blindness to eye health, from disease control to prevention, from selective to comprehensive eye care, and other new approaches,” Dr. Etya’ale said. A copy of his presentation is available for download at: archive.icoph.org/ppt/EyeCareAfricaOct09.ppt.

The Africa Ophthalmology Forum (AOF), formerly the ICO/MEACO Advisory Leadership Group, is moving to unite ophthalmologists across Sub-Saharan Africa to identify potential future ophthalmologic leaders in the region and help them acquire knowledge, skills and experience. AOF Chair Kunle Hassan, MD reported that the AOF is currently establishing officers, geographic area leaders and key committees to bring local leadership to the prevention of visual loss efforts in the region.

Progress in the Fight Against Trachoma

Significant progress in the fight against Trachoma is shown in a recent WHO report, Trachoma: Global Magnitude of a Preventable Cause of Blindness, published in the British Journal of Ophthalmology.

Now 40.6 million people are estimated to be suffering from active trachoma, down from an estimated 84 million in 2003. Success in implementing the SAFE control strategy, more accurate data, and socio-economic development are among the reasons for the improvement. The full article is available at: bjo.bmj.com/content/93/5/563.full.

The Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020), met recently in Geneva and to track progress and plan for the future. The group reviewed the progress of some 45 countries with endemic Trachoma including three countries - Ghana, Morocco and Oman - whose recent campaigns now seem to have successfully eliminated Trachoma. The ICO Bahrain Declaration on Trachoma and Trichiasis Surgery was also adopted at the meeting.

The ICO Declaration, archive.icoph.org/pdf/icotrichiasis.pdf (PDF - 644 KB), reaffirms the importance of trichiasis surgery to treat Trachoma. Also available is the ICO International Clinical Guideline on Trachoma: archive.icoph.org/pdf/ICOTrachoma.pdf (100 KB).

ICO Bahrain Declaration on Trachoma and Trichiasis Surgery

The International Council of Ophthalmology announces the ICO Bahrain Declaration on Trachoma and Trichiasis Surgery: archive.icoph.org/pdf/icotrichiasis.pdf (PDF - 644 KB).

With this declaration, the ICO aims to reaffirm the importance of trichiasis surgery to treat trachoma and to encourage ophthalmologists around the world to ensure the quality of trichiasis surgery through appropriate training and supervision.

As part of the global effort to eliminate blinding trachoma by the year 2020, governments and NGOs have ramped up their trachoma activities significantly over the last few years. Many programs have trained medical officers and medical assistants to do the bulk of this surgery. Reports of variations in the outcome of this surgery continue to emerge and it is important to assure surgery is done to an appropriate standard.

The ICO Bahrain Declaration on Trachoma and Trichiasis Surgery was proposed by the ICO at the MEACO Congress in Bahrain in March (2009), was officially adopted by the ICO Board of Trustees, and has been endorsed by the International Association for the Prevention of Blindness (IAPB) Board of Trustees.

The ICO International Clinical Guideline on Trachoma is available on the ICO website: icoph.org/guide/trachoma.html. The trachoma guideline can also be downloaded as a PDF file (100 KB).

WHO reports 153 million have uncorrected refractive errors

On World Sight Day 2006, the World Health Organization (WHO) released new estimates that 153 million people around the world have uncorrected refractive errors. That includes at least 13 million children (age 5 to 15) and 45 million working age adults (age 16 to 49).

WHO estimates that 90 percent of those with uncorrected refractive errors live in low- and middle-income countries, where they lack access to eye testing, glasses and contact lens, with severe personal, social and economic consequences.

“Now that we know the extent of the problem of uncorrected refractive errors, especially in low and middle income countries, we must re-double our efforts to ensure that every person who needs help is able to receive it,” said Serge Resnikoff, MD, Coordinator of WHO’s Chronic Disease Prevention and Management unit.

Adding these new figures to the previous WHO estimate of 161 million people who suffer from significant vision loss as a result of disease, WHO now estimates that 314 million people around the world are visually impaired.

For more, see the WHO news release on uncorrected refractive error.

Jackson Lecture quantifies the benefits of eye care

At the 2006 joint American Academy of Ophthalmology/Asia Pacific Academy of Ophthalmology meeting, Dr. Hugh Taylor presented a compelling description of both the far-reaching impact that vision loss can have within a country and the impressive economic benefits of prevention and eye care.

In his delivery of the prestigious Jackson Memorial Lecture, former ICO Director for Advocacy (now ICO Treasurer) Hugh Taylor, MD, spoke on “Eye Care: Dollars and Sense,” a persuasive argument for increasing funding for eye care. Among his findings were:

• Vision loss ranks seventh as a cause of loss of well-being
  
  
• Slowing the progression of macular degeneration by just 10 percent would save an average of $250 million a year in Australia for the next 20 years
  
  
• For each dollar spent on prevention of vision loss and eye care, there is a five dollar return to the community.

You can read the Jackson Lecture in the January issue of the American Journal of Ophthalmology if you are subscribed or view it on the American Academy Web site.

Data on countries with few ophthalmologists

In February 2006, Jacob Pe’er, MD, Chair of the ICO Committee on Countries with Minimal Ophthalmic Presence, presented to the Advisory Committee to the Council data on countries with few ophthalmologists compared to the population.

The data indicate, Dr. Pe’er reported, that there are 32 countries that have two or fewer ophthalmologists, less than one ophthalmologist per million population or no ophthalmologic organization. Of those countries, 20 are in Africa, eight in the Western Pacific, two in Southeast Asia and two in the Eastern Mediterranean.

The Committee identified three critical needs in those 32 countries:

1. training of ophthalmologists
2. training of paramedical staff
3. technology and infrastructure necessary to provide eye care.

The Advisory Committee discussed what could be done that would help the most in those countries, and members stressed the value of working in cooperation with Non-Governmental Development Organizations (NGOs) and the VISION 2020 global initiative.

The Committee will evaluate options and report back with recommendations.

Next: More News of preservation of vision.

Also see: International ophthalmology's Vision for the Future