Eyeworld Asia-Pacific

DEC 2016

EyeWorld Asia Pacific is the news and feature magazine of APACRS, KSCRS, and COS. EyeWorld Asia-Pacific serves as the premier publication for anterior segment surgeons in the Asia-Pacific region.

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December 2016 EWAP NEWS & OPINION 65 Categories of blindness Source: János Németh, MD New plan to reduce global visual impairment by 25% within 5 years by Stefanie Petrou Binder, MD EyeWorld Contributing Writer Global action plan targets avoidable blindness in Europe and around the world v isual impairment and blindness are still significant global health issues; however, an initiative is putting steps in place to root out avoidable blindness on a worldwide scale. Universal Eye Health: A global action plan 2014–2019 (www. who.int/blindness/actionplan) was endorsed by the World Health Assembly in 2013 to reduce the global prevalence of avoidable visual impairment by 25% by 2019, and provide universal access to comprehensive eyecare services for the visually impaired. EyeWorld spoke to János Németh, MD, professor, Department of Ophthalmology, Semmelweis University, Faculty of Medicine, Budapest, Hungary, and chair of the International Agency for the Prevention of Blindness (IAPB) Europe, who organized the first European regional global action plan (GAP) meeting in 2015, about the European survey outcomes to date. Global statistics The World Health Organization (WHO) estimates that 285 million people suffered from visual impairments in 2010, which included 39 million cases of blindness. Experts think that 80% of blindness can be avoided through preventive measures, diagnosis, and timely treatment. Study estimates 1 have shown that 42% of global visual impairment results from uncorrected refractive errors and 33% from cataract, with glaucoma (2%), corneal opacities (1%), diabetic retinopathy (1%), childhood blindness (1%), AMD (1%), trachoma (1%), and other causes (18%) making up the remainder. Furthermore, more than half of global blindness is caused by cataract (51%) alone. Other causes are glaucoma (8%), diabetic retinopathy (1%), AMD (5%), uncorrected refractive error (3%), trachoma (3%), childhood blindness (4%), corneal opacities (4%), and others (21%). "The high prevalence of visual impairment and blindness on a worldwide scale shows the importance of developing a global action plan in which trained surgeons and staff help treat the avoidable causes of visual impairment, like cataracts and refractive errors," Dr. Németh said. "Although most of the blind and visually impaired live in developing or low-income countries, we should not forget that blindness is an important health issue in Europe as well. Diabetic retinopathy, although seen to represent only 1% of visual impairment in 2010, should be highlighted because due to our aging population, the number of diabetic patients will increase in the next 10 to 20 years." GAP GAP focuses on three main objectives: evidence-based advocacy, a health system-based approach for strengthening comprehensive eyecare, and a multisectoral engagement approach fostering effective partnerships. Dr. Németh explained, "Each of the three objectives has specific actions and a set of measurable indicators to chart progress. Data collection in Europe is an important source of information that will be used for planning purposes and advocacy. GAP aims to generate evidence on the magnitude and causes of visual impairment and use it to advocate increased commitment from countries. It will develop integrated national eye health policies, plans and programs for enhancing universal eye health and strengthen eye health through multisectoral engagement and building of effective partnerships." The global action plan measures progress at the national level using three main indicators: data reflecting the prevalence and causes of visual impairment; information on the number and types of eyecare personnel, such as ophthalmologists, optometrists, and allied ophthalmic personnel (AOP); and the nature of local cataract surgical service delivery, including the cataract surgical rate and the extent of cataract surgical coverage. Regional initiatives Dr. Németh organized the first European regional GAP meeting in June 2015 in Vienna, Austria, with the IAPB European Region and in cooperation with the European Society of Ophthalmology (SOE), the International Council of Ophthalmology (ICO), and WHO. The IAPB "Europe Towards Universal Eye Health" GAP meeting also included 21 presidents and representatives from national ophthalmologic societies. "The meeting allowed the 54.6% 21.2% 24.2% Treatable Preventable Non-avoidable Avoidable continued on page 66

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