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7/30/2019 Blindness Awareness Month 2013
http://slidepdf.com/reader/full/blindness-awareness-month-2013 1/4
www.eyecarecaribbean.com
1
Focus on Dominica - Dr. Hazel Shillingford Ricketts (Consultant Ophthalmologist)
The month of May has been designated as “Blindness Awareness Month”.
This means that during the month of May there will be a number of programmes geared towards
informing the general public about blindness.
The Dominica
Association of
Persons with
Disabilities must be
congratulated for
their efforts in
putting together a
programmes under
the theme:“Preventing blindness and assisting those whose sight
cannot be restored”.
Their goal is to create a more enabling and
accessible environment for persons with impaired
vision.
The term blind means the loss of sight. However for
the purpose of standardizing the level of loss of
vision referred to as blindness, it is defined as the
best-corrected visual acuity (that is with corrective
lenses) of less than 20/400 or a visual field of less
than 10 degrees (The normal being 180 degrees
horizontally), in the better eye.
Visual Impairment refers to the level of best-
corrected visual acuity of 20/70 to 20/200 or a
visual field of less than 20 degrees in the better eye.
(WHO classification)
The Snellen Fraction used to designate the level of
vision (example 20/400) means that this person can
only see letters at 20 feet which a person with
normal 20/20 vision can see 400 feet away.
There are about 285 million people around the
world who are blind or visually impaired. InDominica it is estimated that there about 700
persons who are blind and 2100 visually impaired.
There are many causes of blindness. Most of the
causes of blindness
can be treated to
restore vision or
prevent loss of
vision. However
there are some
causes of blindness
that cannot be
treated. About 80%
of blindness can be prevented. The majority of
people who are blind are older than 50 years. 90%
of the those who are blind in the world live in
developing countries and most live in poverty.
Blindness Awareness Month
Dr. Hazel Shillingford-Ricketts
7/30/2019 Blindness Awareness Month 2013
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www.eyecarecaribbean.com
2
The number of persons who are blind continues to rise as the world’s population is
increasing, people live longer and the prevalence of Diabetes Mellitus is increasing. This is a
serious public health issue. It is a serious socioeconomic concern not only for the individual
but for their family, their country and the world. Measures must be put in place to address
this rowin roblem.
Vision 2020: ‘The Right to Sight’ is a global initiative of the World Health
Organization and The International Agency for the Prevention of Blindness to
eliminate preventable causes of blindness by the year 2020.
In 2000, the Caribbean Vision 2020 Programme was launched and the strategy
is to eliminate blindness caused by Cataracts, Glaucoma, Diabetic Retinopathy,
Childhood Blindness and Refractive Errors (need for glasses). The programme
is geared at mobilizing resources to provide more services to reduce this
growing public health issue of blindness.There are a number of measures
already in place across every sector which helps to prevent blindness in" " " " " Dominica. Eye care delivered by the Ophthalmological Team is integrated in
" " " " " Primary Health Care throughout the island making eyecare available,
" " " " " affordable and accessible.
Important causes of blindness in children are Measles, Rubella and Vitamin A
Deficiency. Immunization and a diet rich in vitamin A has eliminated those
causes of childhood blindness. Clean water to bathe and keep the face clean
prevents blindness from a bacterial eye infection called trachoma still prevalent
in Africa and some other developing countries.Premature babies are at risk of blindness from Retinopathy of Prematurity.
Screening of premature babies to detect and treat this condition to prevent
blindness is ongoing.School Health Programme conducted by the Family Nurse
Practitioners for 5 and 11 year olds detects children with vision problems. They
are referred to the Ophthalmologist for further evaluation and treatment.
In the working age population, Diabetic Retinopathy is the leading cause of
blindness. This affects the productive sector of our country. It is important that
the risk factors of obesity, lack of exercise and proper nutrition are addressed to
reduce the number of people developing diabetes which now affects about 18%
of our population.
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Those diagnosed with Diabetes have to control their Blood Sugar, Blood
Pressure and Cholesterol to reduce the risk of developing Diabetic
Retinopathy. In addition,Diabetics must have regular eye examinations to
detect the eye complications early. Early detection and treatment can prevent
blindness. There is a screening fundus photography programme for Diabetics
in the Primary Health Sector. Laser treatment is available for treating DiabeticRetinopathy.
Cataract
Cataract is the leading cause of
blindness in the world. It is
responsible for over half of the
causes of blindness. If everyone
live long enough they will
develop Cataracts, as aging is the
most common risk factor.
However blindness from Cataract
can be reversed with a day
surgery under local anesthetic. It
is one of the most cost effective
surgical interventions.
Glaucoma
Glaucoma is the most dreaded
cause of blindness. It is the
leading cause of irreversible
blindness. Regular eye
examination from the age of 40 is
a good practice to detect if one has
Glaucoma especially if they have
a family member with it. The risk
increases as one gets older. It
cannot be cured but it can be
controlled by lowering the
intraocular pressure with
eyedrops, laser and surgery. It is a
silent thief of sight as it causes nosymptoms until it is in the
advanced stage. Glaucoma
medications are subsidized in the
public health sector. Despite
treatment, some people still
become blind from Glaucoma but
most preserve their sight.
Refractive Error
Refractive Errors - the need for
glasses, are a significant cause of
functional blindness and visual
impairment. Some people cannot
afford to buy glasses which are
medical devices to correct poor
vision. The Rotary Club and the
VOSH team provide low cost
glasses to the public during their
Annual Eye Screening Programme
The VAT (Value Added Tax) on
eyewear increases the cost
especially for those with high
prescriptions. Considerationshould be given to removing VAT
on corrective eyewear.
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In addition to the Vision 2020 list of eye diseases discussed above, a degenerative retinal condition in older
persons on the east coast of Dominica is a significant cause of irreversible blindness. Albinism is an
irreversible cause of visual impairment.
People with Down Syndrome have a greater prevalence of high Refractive Errors and Keratoconus making
some of them either functionally blind or visually impaired. They should have regular eye examinations and
provided with corrective glasses. There are also children who suffered birth asphyxia or who have congenitalabnormalities of the optic nerve and brain who are irreversibly blind.
There are many other causes of blindness.
In addition to prevention of blindness, the needs of those whose vision cannot be
restored must be addressed. Persons who are blind or visually impaired are entitled to
basic services and opportunities wherever they live, and there is a great need to increase
understanding of the needs of blind and visually impaired persons.
Blind Awareness Month 2013, provides an opportunity to address the rights and needs
of the blind, and so, the agenda for the month’s programme are directed at creating a
more enabling and accessible environment for persons with blindness and impaired
vision.
The Dominica Association of Persons with Disability has organized workshops, media
and video programmes, educational tips, and school presentations.
Being blind does not mean one is helpless, can’t learn, can’t work, can’t
love and have children, does not have talent or potential.
I urge persons who are blind or visually impaired to make use of theopportunities to rehabilitate themselves to continue living fulfilling lives at
home, at school, at work and socially.
Being aware of how to assist blind or visually impaired persons will be
empower them to become independent. Therefore, the general public
especially the cooperate community, service providers, schools, social
groups, caregivers and family members of the blind are urged to support
and participate in the activities organized for Blindness Awareness Month.
Thanks to the Dominica Association for Persons with disability and others
in the community for their ongoing efforts in assisting blind and visually impaired persons.
Contributed by Dr. Hazel Shillingford Ricketts M.B.B.S. (U.W.I); F.R.C.S. (C)