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Simple Definition:1. Inability of a person to count fingersfrom a distance of 6 meters or 20 feet Technical Definition: 1. Vision 6/60 or less with the best possible spectacle correction 2. Diminution of field vision to 20 degree or less in better eye
Brief introduction of NPCB- National Programme for Control ofBlindness was launched in the year1976 as a 100% Centrally Sponsoredscheme with the goal to reduce the prevalence of blindness from 1.4% to 0.3%.
Prevalence Rate of Blindness- As per Survey in 2001-02, prevalence of blindness is estimated to be 1.1%. Target for the 10th Plan is to reduceprevalence of blindness to 0.8% by2007 prevalence of Blindness is 1% (2006-07 Survey).
Main causes of Blindness are as follows: Corneal Blindness Refractive error Corneal Blindness Glaucoma Surgical Complication Posterior Capsular Opacification Posterior Segment Disorder Others
The objectives of the programme are: 1. To reduce the backlog of blindness through identification and treatment of blind.2. To develop Eye Care facilities in every district.3. To develop human resources for providing Eye Care Services. 4. To improve quality of service delivery. 5. To secure participation of Voluntary Organizations in eye care.
Organizational Structure : Foreffective coordination andconvergencefollowing structure is proposed atvarious levels under the scheme:(a) Centre Level(b) State Level(c) District Level
Activities- 1. Annual Eye check up of all incumbents of blind schools covering the visual acuity, fundus examinations and other appreciate advance test required to assess chances of visual restoration. 2. Eye check up of applicants who desire to seek admission in a blind school and issue of certificate of incurable blindness recommending admission to a blind school. No person would be admitted to blind school without this certificate. 3. Follow up of treated cases as per recommendation of ophthalmic board.4. Rehabilitation of incurable blind would be as per scheme of department of social welfare. 5. Low vision Aids to screen all school going children for refractive errors And provide spectacles free of cost. 6. Eye check up of the incumbents of blind schools including special Investigation. 7. 100 percent achievement of Cataract operation of which 90% will be IOL And 10% for simple cataract surgery 2009-10.
Strategies-The four pronged strategy of theProgramme is:1. Strengthening service delivery,2. Developing human resources for eyecare,3. Promoting outreach activities andpublic awareness, and4. Developing institutional capacity.
Revised strategies-1. To make the National Blindness Control Programme more comprehensive bystrengthening services for other causes of blindness like corneal blindness (requiringtransplantation), refractive errors in school going children, improving follow-upservices of cataract operated persons and treating other causes of blindness likeglaucoma;2. To shift from eye camp approach to a fixed facility surgical approach and fromconventional surgery to IOL implantation for better quality of post operation vision inoperation patients;3. To expand the World Bank project activities like constructions of dedicated eyeoperation theatres, eye wards at district level, training of eye surgeons, moderncataract surgery, and other eye surgery and supply of ophthalmic equipment, etc. tothe whole country.4. To strengthen participation of voluntary organizations in the programme and to ear-mark geographic areas to NGOs and govt. hospitals and improve the performance ofgovt. units like medical college, district hospitals, CHC, PHCs etc.5. To enhance the coverage of eye care services in tribal and other under served areasthrough identification of bilateral blind patients, preparation of villages wise blindregister and giving preference to bilateral blind patients for cataract surgery.
It is a global initiative to reduce avoidable (preventable and curable)blindness by the year 2020. India is also committed to this initiative.
The plan of action for the country hasbeen developed with following main features : Target diseases are cataract, refractive errors, childhood blindness, glaucoma, diabetic retinopathy. Human resource development as well as infrastructure and technology development atvarious levels of health system. The proposed four tier structure includes Centers of excellence (20), Training centers (200), service centers (2000), and vision centers (20,000).
Proposed Structure for Vision 2020: The Right to Sight- • Centers of excellence 20 • Professional leadership • Strategy development • Continued medical education(CME) • Laying of standards and quality assurance • Research Tertiary • Training centers 200 • Tertiary eye care including retinal surgery corneal transplantation, glaucoma surgery etc.; • Training and CME • Services centers 2000 • Cataract surgery • Other common eye surgeriesSecondary • Facilities for refraction • Referral services • Vision centers 20000 • Refraction and prescription of glasses • Primary eye care Primary • School eye screening programme • Screening and referral services
Summary-NPCB was launched in the year 1976 as a 100% Centrally Sponsoredscheme with the goal to reduce the prevalence of blindness from 1.4%to 0.3%. Main causes of the blindness are Cataract (62.6%) RefractiveError (19.70%) Corneal Blindness (0.90%), Glaucoma (5.80%), SurgicalComplication (1.20%) Posterior Capsular Opacification (0.90%) PosteriorSegment Disorder (4.70%), Others (4.19%). Main objectives of NPCBare(1) To reduce the backlog of blindness through identification andtreatment of blind and (2) To develop Eye Care facilities in every district.NPCB includes functioning at central, state, and district level. Strategiesof the programme are1.Strengthening service delivery,2. Developing human resources for eyecare,3. Promoting outreach activities and public awareness, and 4.Developing institutional capacity. To achieve these objectives Mission“Vision 2020: The Right to Sight “ is started.
Bibliography-Park.K, Textbook of Preventive and SocialMedicine, 2oth edition, Published by-M/sBanarsidas BhanotPage no. referred- 375-377Websites-www.npcb.inwww.doctorshangout.comwww.indiangovt.in/npcb