NPCB.pptx

National Programme for Control of Blindness

1. NPCB : NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS PREPARED & PRESENTED BY – AL AMIN ARPITA CHAKRABORTY BHITALI BARMAN BISWAJIT KASHYAP

2. CONTENT Blindness Global burden of blindness Introduction of NPCB Objectives Strategies Organization structures Activities of NPCB New initiatives Vision 2020 Universal eye health

3. BLINDNESS • Defination :- ̴ According to WHO, Blindness is defined as the visual acuity less than 3/60 in the better eye with best correction or a visual field of less than 10 ⁰ from the point of fixation in each eye. • Causes of blindness :- The most common causes of global blindness are- Cataract & Refractive error- 60% of total curable blindness and is treatable . blindness Glaucoma & DR- 15% of total blindness which is partly preventable although very preventable difficult. blindness Trachoma & Vitamin A deficiency & Onchocerciasis - 15% of total & can be prevented. ARMD & Other disease- 10% of total blindness & no preventive measures found yet.

4. • Symptoms of blindness:- ̴ If you’re completely blind, you see nothing. But in some cases of partial blindness, you might experience the following symptoms: 1) Cloudy vision 2) An inability to see shapes 3) Seeing only shadows 4) Poor night vision 5) Tunnel vision

5. Types of blindness 1)Economic blindness : In ability of a person to count fingers from a distance of 6 meter or 20 feet 2)Social blindness: Vision 3/60 or diminution of field of vision 10 degree 3)Manifest blindness: Vision 1/60 to just perception of light 4)Absolute blindness 5)Curable blindness 6)Preventable blindness 7)Avoidable blindness

6. GLOBAL BURDEN OF BLINDNESS As per WHO statistics- ̴ The leading causes of vision impairment & blindness are uncorrected refractive errors & cataracts. globally, at least 2.2 billion people have a near or distance vision impairment. In at least 1 billion of these cases, vision impairment could have been prevented or has yet to be addressed. ̴ 82% of people living with blindness are aged 50 & above. ̴ 85-95% of all visual impairment can be prevented or cured. ̴̴ Prevalance is highest in Africa(2%) followed by Asia(1.2%) and Latin America(1%).

7. National burden:- Out of 39 million people across globe who are blind, India has 8 million blind persons. As per 2006-07 survey the prevalance of blindness was 1%. Prevalence of blindness- 1) >50 years was 8.5% 2) childhood blindness is 0.8/1000 3) children 5-15 yrs the visual impairment is 6.4%.

8. INTRODUCTION OF NPCB NPCB or National Programme for Control of Blindness, was launched in 1976 with a goal to reduce the prevelance of blindness from 1.4% to 0.30% by the year 2020 It was the single largest national health programme with an outreach in more than 640 districts in India and is a unique example of a successful public - private partnership

9. GOALS To reduce the prevalence of blindness from 1.49%(1986-89) to < 0.3% by 2020. To establish an infrastructure efficiency to current cases of blindness each year to prevent future backlog.

10. OBJECTIVES To reduce the backlog of Avoidable blindness through identification and treatment of the blind. To develop comprehensive eye care facilities in every district. Strenghtening and upgradation of RIOS to become center of excellence in various subspecialities of ophthalmology. To develop human resources for providing eye care resources and increase & research for prevention of blindness and visual impairment. To enhance community awareness of eye care. To secure participation of voluntary organization and private practitioner in eye care.

11. STRATEGIES Based upon the findings of the survey conducted during 1998 to 1999 & 1999 to 2000 :- Improved follow up services of cataract operated persons & treating other causes of blindness like glaucoma. Active screening of population above 50 years of age & school children for identification and treatment of refractive errors. Coverage of underserved areas for Eye care through Public- Private Partnership. To shift from eye camp to approach to find facility and form conventional surgery to IOL implantation for better post operative vision. To strenghten participation of voluntary organisation in the programme and improve performance of govt. units. Emphasis on Diabetic Retinopathy , Glaucoma, Corneal transplantation, Vitreo retinal surgeries, Childhood Blindness, ROP.

12. ORGANIZATIONAL STRUCTURE Administration:- Central ------ Oph . Section, DGHS, MOHFW State ------ State ophthalmic cell, Directorate of health services, State health societies. District ----- District blindness control societies.

13. DISTRICT BLINDNESS CONTROL SOCIETY Located in Patiyala emphasises on implementation of NPCB takes place through the district blindness for control society. The main objectives of DBCS is to achieve maximum reduction in avoidable blindness in the district through optimal utilization of avoidable blindness within the district.

14. SERVICE DELIVERY & REFERRAL SYSTEM Tertiary level ------- Apex, Regional institutes, Medical colleges Secondary level ----- District hospital & NGO Eye hospital Primary level ---- Sub-district level hospitals/CHC Mobile ophthalmic units Upgraded PHCs Link workers/Panchayats

15. ACTIVITIES OF NPCB Cataract operations Involvement of NGOs Civil works Commodity Assistant IEC activities Management Information System Monitoring and Evaluation School Eye Screening Programme Collection and utilization of doneted Eyes Control of Vitamin A deficiency

16. NEW INITIATIVE To reduce the backlog of blindness through identification and treatment of blind at primary, secondary and tertiary level based on assessment of the overall burden of visual impairment in the country. Provision of free glasses in presbyopic patients. Provision of spectacles for school children by conducting Eye Testing Fortnight every year in the month of June. To promote Eye donation and to urge the eye banks to perform better in the forthcoming years. Provision of Multipurpose District Mobile Ophthalmic Units (MDMOUs) in all districts all over the country.

17. VISION 2020: THE RIGHT TO SIGHT Launched on 1998 by WHO & the International Agency for the Prevention of Blindness(IAPB) , a global initiative to reduce avoidable(preventable and curable) blindness by the year 2020. Target Diseases- 1) Cataract 2) Refractive errors 3) Childhood blindness ( vitami n A ) 4) Corneal blindness ( trachoma,onchocerciasis ) 5) Glaucoma 6) Diabetic retinopathy

18. PLAN OF ACTION FOR INDIA: Proposed structure Center of Centers of Excellence(20) Excellence(20) Training Training Centers(200) Centers(200) Services centers Service Centers(2000) (2000) Primary level vision Vision Centers(20000) Centers(20000)

19. SERVICES AT EACH CENTRE PRIMARY LEVEL: VISION CENTERS 20,000 Screening and referral services School eye screening programme Center of Primary eye care excellence(20) Refraction and prescription of Training glasses centers(200) Service centers (2000) Primary level vision centers(20000)

20. SECONDARY LEVEL: SERVICE CENTER 2000 Cataract surgery. Center of Other common eye surgeries. Excellence(20) Facilities for refraction . Training Referral services. centers(200) Service centers (2000) Primary level vision . centers (20000)

21. TERTIARY LEVEL: Training centers 200 • Tertiary eye care: Retinal surgery Center of Corneal transplantation excellence(20) Glaucoma surgery Training • Training and CME. Centers(200) Center of excellence 20: Service centers • Professional leadership (2000) • Strategy development Primary level vision • CME Centers(20000) • Laying of standards and quality assurance • Research .

22. UNIVERSAL EYE HEALTH A global action plan was unanimously adopted by the 194 member states at the world health assembly, the decision making body of the WHO. This plan was named as “Towards Universal Eye Health: Action Plan 2014-2019”. In principle, Universal Eye Health involves the following- Offering comprehensive eye care services (for eye health promotion, prevention, treatment and rehabilition ). Intregrating eye health into the wider health system providing access to everyone, including the poor, minorities and the disabled. Ensuring that the services should be free for the poorest – whether by means of fee waivers or national health insurance.

23. SUMMARY: Blindness is a great public health problem NPCB started in 1976 mainly to achieve goal reduction in prevalence of blindness from Activities carried out to achieve goals through cataract surgeries , NGOs, screening of school children, eye camps, IEC for eye donation, MDMOUs etc. In preventing Preventable Blindness, and treating Curable Blindness. Vision 2020 the Right to Sight will be achieved by the help of 3 levels of eye care.