Preventing Blindness in the country

R R Sharma
A Survey namely National Blindness and Visual Impairment in India (2015-19) was conducted under the aegis of National program for control of blindness and visual impairment, Director General of Health Services, Ministry of Health and family welfare.
Survey aimed to provide the evidence about the present status of blindness and visual impairment in India.
It brought many interesting and important facts and figures to fore. Out of 93108 enumerated individuals in age group above fifty years in thirty one districts, estimated prevalence of blindness was 1.99%. Maximum prevalence of blindness was found in the category of above eighty years which descends as we go down the ladder of age.
Education being a very potent tool for social economic progress in a developing country like ours also comes into play in deciding the figures of blindness and visual impairment. Blindness was found to be higher among illiterates as compared to literate population. More than 150 million population of the country requires reading glasses but don’t have access to them.
Cornea is an outer most transparent layer of an eyeball that covers the iris and pupil and admits light to the interior. It may get damaged because of malnutrition, chemical injury, accidents, surgery etc. It is pragmatic to state that not all the cases and types of blindness and visual impairment are treatable or curable, but for that matter large number of cases are treatable. Corneal opacity or corneal blindness is another major reason of blindness in India. And this is curable.Nearly two to twelve lakh people of the country suffer from low or acute corneal blindness. All they need is a generous willing eye donor and institutional paraphernalia ranging from eye banks, optometrists and hospitals.
Corneal blindness is treated by replacing damaged cornea by a healthy donated human cornea. Ideal time to donate is within six to eight hours of death. After removal, eyes are analysed, processed at the eye bank for the final transplant. Almost every healthy individual can donate eyes. Process merely takes fifteen to twenty minutes. And the myth of disfigurement of the face is farce. Corneal transplant is not new, first one was performed way back in 19th century.
Donated eyes are in acute shortage. More than eleven lakh blind population of our country is waiting for corneal transplantation.Nearly 10 million people die every year due to various reasons in India but only 25000 i.e twenty five thousand only donate their eyes. This causes great scarcity of cornea among needy patients. It accentuates into huge socioeconomic burden on the individual, family and country. People with corrected cataract, spectacles can also be donors.
Being a flagship programme for blind populationNPCB( National program for control of blindness) in India was launched in 1976 with goal of reducing prevalence of blindness to 0.3% by 2020. Stacking the efforts on the shelves of hope it moved with the aim of “Eye Health For All” by comprehensive and holistically universal eye care services and quality, effective service delivery.
NPCB upgraded and strengthened RIOs (Regional institutes of ophthalmology) and also partners like medical colleges, district hospitals, sub district hospital, vision centres and NGO eye care hospitals. On awareness front it scored high and laid stress on preventive care, expanding research on prevention along with incrementing participation of voluntary organisations. Free spectacles being provided to old Persons suffering from presbyopia. It reached to hilly areas by opening tele ophthalmology centres there. And did fairly well in creating a network of eye banks and eye donation centres linked with medical colleges and RIOs for timely collection and use of donated eyes in transparent manner.
Albeit the welfare programmes and schemes bang their strident in alleviating the poor blind rural population, but there is always a scope of improvement and better inclusion. The research study by AICB (All India Confederation of the Blind) revealed that only 3% of the total beneficiaries are visually impaired when it comes to get loans from NHFDC (National Handicapped Finance and Development Corporation). Many times the glitches remain in utilising the loans issued by NHFDC for the stated purpose. More vocational training is required to convert the pool of blind and visually impaired people into national assets.
H. Keller put it right that there is no better way to thank God for your sight than by giving a helping hand to someone in the dark. Camba (Cornea Andhat Mukt Bharat Abhiyaan) is a project of Saksham ( Samdrishti, Shamita Vikas and Anusundhan Mandal) and it’s primary objective is blindness free Bharat. As a social organisation it has got a unique distinction to cover 678 districts, motivating people to take pledges for eye donation, preventing blindness by fighting at multilevel.
CAMBA succeeded in getting more than 1.5 lakh eyes donated which is a rare success for any NGO. Also it managed above three lakh pledges taken by people pan India. From preparing database of needy corneal blind people to creating functional network between donor, eye bank and recipient, CAMBA pushes through multifronts.
History is replete with examples of such men and women of iron who left an undeniable consequential mark through their lived lives that blindness or visual impairment is not an actual handicap, but the parched will to contribute and succeed in life surely is. Galileo Galileo(1564-1642), exponent of astronomy suffered loss of sight and moved towards complete blindness in later part of his career, notwithstanding his name is synonym to scientific revolution and was first to discover four moons of planet Jupiter. Similarly it was blindness of Louis Braille which led him to with invention of Braille Writing, sans which no other blind individual could have read a poem or been able to comprehend important written message.
India having largest number of totally or extremely blind population i.e 15 million indubitably with it’s inclusive participative welfare schemes, empowering programmes and active participation of NGOs is moving in right direction to achieve the goal of “Right to sight for all”.
We need more optometrists, nearly 50,000, whereas there are only 8,000. One cannot gauge the pressure on optometrist catering to health needs of such a vast population. Mostly ophthalmologists are burdened with general eye check-up of patients which hamper their efforts and focus to conduct blindness preventing surgeries.Developed countries have a two pronged strategy in which ophthalmologist focus on surgeries and optometrists hark upon primary eye care refractive errors like presbyopia, contact lenses and low vision aids. We need to emulate this strategy to perfection to keep a tab on avoidable blindness.
Faculty enrichment, increased seats in MD ophthalmology in medical colleges, increased private sector participation in health field, and better institutional and infrastructural framework will help in tiding our way towards better health care services.
To win the battle against avoidable blindness lock stock and barrel, we need anchoring role to be played by civil society, NGOs, other non state actors and community participation as well. More and more people should come up for eye donation. Even if a person did not take pledge for eye donation in his lifetime, his immediate family can come forward for donation after his death. Eye donation comes under the ambit of Human Organ Transplantation act. Eye-banks are important pillars of eye care and treatment. Central Government supports eye banking system through recurring grants for operational costs and non recurring for infrastructural costs. To realise Vision 2020: Right to sight India, we need to increase the current number of eye banks from 110 to 200 and to raise nearly 1000 eye donation centres. What could be a bigger donation than an organ donation. Being a vital donation, eye donation can change lives of many individuals and their families.
Our Prime Minister has rightly said ” when an organ is transplanted in another human body, not only does the organ get a new life but also the body”. It would be apt for the author to conclude with the statement “Jeetay Rakatdaan, Marne Ke Baad Netradaan”.
(The author is currently working as a Police Officer)