Prevention of blindness in China's current situation report

 Of: Professor Zhao Jialiang Beijing Union Medical College Hospital Department of Ophthalmology Professor
blindness prevention work is both part of public health is an important part of ophthalmology. In our ongoing prevention of blindness in large-scale work 20 years later in the General Assembly for the first time the International Association for the Prevention of Blindness was held in China before the understanding of global blindness prevention work status and progress, review the work of prevention of blindness in our history, summed up the achievements in the prevention of blindness and problems, clear the future the goal of further improving the work of the prevention of blindness is very useful.
a World Health Organization on the prevention of blindness work
new goal as soon as possible to reduce the global number of blind people, the World Health Organization (World Health Organization, WHO) and some international, non-governmental and private organizations, in the February 17, 1999 in Geneva, jointly launched . World Health Organization Director-General Brundtland pointed out that the blind in our member countries has become a serious public health, social and economic problems of developing countries the situation is more serious; reduce the global number of blind people the only way to worldwide meaningful partnership of cooperation. the prevention of blindness work carried out for half a century, international efforts have made great end, but due to world population growth and aging, the world is still a significant increase in the number of blind people. If this trend continues, by 2020 blind-fold the number will increase by 1. At present the population of visual impairment is estimated to 100 million 8000 million. which 4 0000000-4 500 million are blind. blind refers not to walk alone because of visual impairment, usually require professional and (or) social support. vision loss not only to patients and their families suffer, but also to bring a lot of problems their countries. In developing countries, more serious problems, because the whole world blind each have 9 of 10 distributed in these countries . According to incomplete statistics, there are about 60% of the blind live in sub-Saharan region of Africa, China and India.
worldwide cause of blindness: cataract 46.0%, 12.5% of trachoma, river blindness 0.6%, respectively, kinds of causes of blindness in children accounted for 3.3%. others such as glaucoma, diabetic retinopathy and trauma accounted for 37.5%. on these blinding factor, if given enough attention to early and appropriate treatment, some of the blind can be prevented or controlled by, such as trachoma and river blindness; some blind patients can restore vision after treatment, such as cataract. According to WHO estimates that 80% of the blind can be avoided.
blindness prevention and eye care in the cooperation of the international, non-governmental and private organizations to strengthen cooperation, working together, can get past actions of individual organizations alone can not be achieved. The new global action are: (1) 2020 avoidable blindness cure before the common goal of all partners will work together. joint promotional activities will help increase global awareness for the blind, to mobilize additional resources to combat avoidable blindness. (2) international and national prevention of blindness has been made valuable experience working on the basis of partnership to address eye health issues.
strengthen existing eye care facilities and institutions; (4) the use of appropriate and affordable technologies; (5) to mobilize and develop resources to combat the blind.
year plan to implement. The first one five-year plan will begin in 2000. The remaining three programs were started in 2005,2010 and 2015. At present the main preparation stage of publicity, development of regional planning and development resources. ; the first step is to carry out global campaigns to raise people and Government of understanding the social impact of blindness and to mobilize commitment to eradicate avoidable blindness of its long-term political and professional obligations.
chosen to implement the 2020 childhood blindness, refractive errors and low vision. The reason why that choice is based on their proportion of the number of blind and control them the feasibility and affordability. Other diseases such as glaucoma and diabetes retinopathy is not yet meet these criteria. but with the 000 million people become blind due to cataracts, so be the first to consider the treatment of eye disease. generally considered not prevent cataracts, but surgery can restore sight to the blind to close most of the normal range of vision.
per million population each year as did the amount of cataract surgery rate of cataract surgery (cataract surgical rate, CSR), is that the level of eye care in different parts of a useful measure of one. now between countries and even within a country very different CSR, the United States 5 000 / million, and the whole of Africa is 200 / million.
in developing countries, even if there are facilities for cataract surgery, but because of the economic and cultural barriers, so that blind people can not accept some of cataract surgery. In addition, the operation efficiency is Low is one of the reasons. implementation of the 1 200 ?? cases; in 2010 will reach 2000 ?? cases; to the final goal in 2020 was 3 years, 2 million cases of surgery.
in the treatment of cataract, to restore vision and quality of life to obtain a high success rate; (2) to provide affordable and accessible services, especially in underserved populations; (3) to take measures to improve the utilization of surgical equipment. The strategy including coordination of work, training personnel and strengthening management, monitoring and evaluation of service quality.
2. Trachoma: Trachoma occurs mainly in Africa, but the Eastern Mediterranean, Southeast Asia and Western Pacific regions were more common. trachomatis is the most common and preventable cause of blindness, estimated that about 560 million people Erzhi impairment of vision or blindness. another 1 million 4 6 million cases of active trachoma in need of treatment. Trachoma is the world's lack of housing, water and sanitation and other basic needs of health The common areas of socio-economic underdevelopment.
developed for the international trachoma as control strategies, and applications in epidemic areas. It is expected that through the implementation of control strategies SAFE 2020, on a global scale may be one of the radical as a cause of blindness in trachoma.
through the 2000 to 2010 will complete five million cases of trichiasis surgical correction. In addition, at least during this period for 6 0,000,000 cases of active trachoma.
3. River blindness: river blindness is endemic in 30 countries in Africa, but a few areas in Latin America and Yemen also occurred. It is estimated that 1 800 million people infected with river blindness, in which 30 people have been blind. If the current control measures for river blindness-endemic countries in the successful implementation, is expected in 2010 Creek Blind will be able to control. The recent introduction of ivermectin (ivermectin) treatment of annual dose directly in the community, river blindness, there is hope in Africa and Latin America, a country cure for this disease cause of blindness.
4. childhood blindness: the main due to vitamin A deficiency, measles, neonatal conjunctivitis, congenital cataract and retinopathy caused by immature children. due to low weight and increase the survival rate of very low birth weight infants, especially in developed countries, is an immature child retinopathy obvious problems. For the same reason, in developing countries, particularly in urban areas, retinopathy of premature children is also becoming a serious problem.
other causes of blindness of children with congenital or hereditary eye disease, the current difficult to prevent. causes of blindness in children in different countries vary, with the time of the occurrence of blind children will change.