Reports define extent of vision loss, focus on access to eye care

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Sandra Block, OD, M Ed, MPH, speaking at the 2021 American Academy of Optometry Annual Meeting in Boston, discusses the movements that have identified the extent of visual impairment around the world.

Reviewed by Sandra S. Block, OD, M Ed, MPH

Several major movements have identified the extent of visual impairment around the world, according to Sandra Block, OD, M Ed, MPH, professor emeritus at the Illinois College of Optometry and president of Public Health Com at the World Council of Optometry.

According to Block, speaking at the 2021 American Academy of Optometry annual meeting in Boston, the first major report was written by the National Academies of Science, Engineering, and Medicine (NASEM) in 2016, which focused on the state of eye care and their needs.

Block noted that this report focused on the American population and highlighted the impact of vision and eye health problems on Americans. The report set out 9 recommendations and it was hoped that there would be a response to address the issues and recommendations identified.

WHO Global Report2 on vision (WRV) 2019

According to Block, WRV was the first comprehensive report to focus on the state of vision and eye health around the world. The report summarized the best available evidence on the global scale of eye disease and visual impairment, took stock of progress and remaining challenges facing the eye care sector, and outlined a framework for action. , that is, universal health care and integrated people. Centered Eye Care (IPCE), to meet the population’s eye care needs.

Billions of people around the world are affected by vision-threatening diseases such as myopia, diabetic retinopathy, glaucoma, trichiasis, and age-related macular degeneration (AMD). Diseases such as nearsightedness and its complications, glaucoma and AMD are expected to increase with aging and lifestyle changes.

There are other eye conditions that impact quality of life, but do not threaten sight. These include presbyopia, blepharitis, conjunctivitis, and dry eye, among other concerns outlined in the WRV.

Block pointed out that at least 2.2 billion people are visually impaired, about half of these cases could have been prevented, including corneal opacities, diabetic retinopathy, trachoma, glaucoma, cataracts and refractive errors. untreated and presbyopia.

Lack of access to eye care

The WRV has identified the lack of access to appropriate care as a major problem, noting in particular inequalities in rural and low-income areas, and among women, the elderly, indigenous peoples, ethnic minorities and People with Disabilities.

In light of this, WRV focused on 2 priority areas, namely advancing universal health coverage through eye care and implementing IPEC care.

The stated objectives are to provide quality eye care services according to the needs of the population, improve service coverage and reduce inequalities, ensure that the cost of priority eye care interventions is included in bundles of services covered by prepaid pooled funding, and to provide a bundle of quality, integrated people-centered health services.

Block also pointed out that at the heart of IPEC is a service managed and delivered in such a way that people receive a continuum of health interventions spanning promotion, prevention, treatment and rehabilitation spanning the spectrum. comprehensive eye conditions according to their needs. It is also coordinated between the different levels and sites of care within and beyond the health sector.

The specific parameters include eye care provided in specialized hospitals and clinics and integrated in hospital and outpatient settings in all medical specialties, in primary care, in home schools and in other community settings.

WRV, according to Block, also envisions eye care as an integral part of universal health coverage.

Eye care packages

WHO is overseeing the creation of eye care packages to define mechanisms for diagnosing and treating specific eye diseases and making recommendations for countries to incorporate into their health models.

The goal of eye care interventions is to develop an evidence-based set of priority eye care interventions, including the necessary resources, for use by countries to plan, budget, and integrate eye care interventions into all delivery platforms. Services. Seven areas of eye care development have been identified. They include pediatrics, the anterior segment and its appendages, cataracts, glaucoma, refractive error, vitreoretinal and visual rehabilitation.

World Health Assembly

The 74th WHO World Health Assembly in May 2021 approved a resolution to prevent visual impairment and blindness, increasing the effective coverage of uncorrected refractive errors by 40% and the effective coverage of eye surgery. cataract by 30% by 2030. The adoption of this proposal addresses the huge unmet need for eye care.

This is a major step in ensuring that member countries focus their attention on the enormous extent of preventable visual impairment and blindness, Block explained.

The United Nations (UN) adopted the following resolution in 2021: “An eye exam for a child can make the difference between inclusion and / or exclusion; a pair of glasses, the difference between having access to information and finding a livelihood and not. Corrective eye treatment, the difference between improved eyesight and complete loss of sight. The gift of sight for the 1.1 billion people living with preventable sight loss is within reach if we ensure that world leaders respect this time. “

All of these key actions bring together governments, donors and financial institutions, United Nations agencies and the private sector, civil society, academic and scientific communities to achieve vision care for all.

What this means for eye care, according to Block, is that eye health will be recognized as a global development issue.

“There will be a commitment to reach 1.1 billion people who have vision problems and do not have access to care,” she concluded. “Vision and eye health will be integrated into United Nations frameworks, as eye health has been shown to impact country performance. Finally, countries will be urged to link eye health to other development programs. “

Sandra Block, OD, M Ed, MPH

E: block@ico.edu

This article is adapted from Block’s presentation at the 2021 American Academy of Optometry Annual Meeting in Boston. She has no financial interest in this matter.

The references

1 National Academies of Science, Engineering and Medicine.
2016. Making eye health an imperative for the health of the population: Vision for tomorrow. Washington, DC: The National Academies Press. https://doi.org/10.17226/23471.

2 World Health Organization. World Vision Report. World Health Organization. 2019. https://apps.who.int/iris/handle/10665/328717. License: CC BY-NC-SA 3.0 IGO

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