UNIVERSITY OF GONDAR COLLEGE OF MEDCENE

AND HEALTH SCINCE DEPARTMENT OF OPTOMETRY

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Community Eye Health Presentation On Vision 2020- The

Right To Sight
Instructor Dawit Zenebe (BSc. Optom, MPH)
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Goal: The elimination of avoidable blindness by 2020,

in order to give all people in the world, the right to sight
 Session Outline
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Magnitude of blindness
Introduction
Partnerships
VISION 2020 Advocacy With Governments
 Strategies of vision 2020
Five key areas for action
Achievements
 Session objectives
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At the end of this session the participants
will be able to
Describe Magnitude of blindness in the
world
Mention Partners of VISION 2020
Describe Strategies of vision 2020
Mention Five key areas and Achievements
of vision 2020
 Facts
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• An estimated 45 million people worldwide are blind.
• Every year, an additional 1-2 million persons go blind.
• More than two-thirds of this blindness is treatable and
preventable.
• A majority of the blind live in the poorest section of the
developing world.
• Without proper interventions the number of blind will
increase to 75 million by 2020.
• Restoration of sight is one of the most cost-effective
interventions in health care.
Causes of Global Blindness 1995
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45 million

Cataract Trachoma Diabetic AMD and

Refractive Vit A Def Retinopathy other
Errors Glaucoma diseases
Oncho

60% 15% 15% 10%

 Introduction
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• The name is suggestive both of the goal, the

prevention of avoidable vision loss and
blindness by the year 2020 and the notion of
good vision, 20/20 (6/6) vision as the target.
 Introduction…
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• Launched 1999
• Joint programme of IAPB and World Health
Organization (WHO)
• Facilitating development & implementation of
national eye care plans
• Collaboration between private organisations &
public (government) agencies
 Partnerships
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• the World Health Organization (WHO) and the

International Agency for the Prevention of
Blindness have developed a global initiative for
the elimination of avoidable blindness by the
year 2020; "Vision 2020: the right to sight".
 Partnerships…
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WHO
Technical Capacity
Assistance Building

National Partners - National Vision 2020 Plans

Sustainable program delivery
Partnerships…

Established 20 years ago, Under the VISION 2020 Seeing is Believing 

the MECTIZAN Donation programme Carl Zeiss will programme has contributed
Program is the single be major supporter for the substantially to the global
largest, longest standing establishment of five VISION 2020 initiative,
public/private partnership training centres within the combining awareness-
of its kind and is widely next five years. The funds creating, volunteering as
regarded as one of the will be used for training well as millions of dollars in
most successful public- staff and equipping the fundraising support. 
private health centre.
collaborations in the
world.
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VISION 2020 Advocacy With Governments
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• VISION 2020 workshops – reaching 150

countries
• National prevention of blindness
committees established in 118 countries
• National eye care plans in 104 countries
 Five key areas for action
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 Cataract
 Trachoma
 Onchocerciasis
 Childhood blindness
 Refractive error and low vision
 Objectives and action
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1. Strengthen advocacy to increase Member States’ political,
financial and technical commitment in order to eliminate
avoidable blindness and visual impairment.
2. Develop and strengthen national policies, plans and
programmers for eye health and prevention of blindness
and visual impairment.
3. Increase and expand research for the prevention of
blindness and visual impairment.
4. Improve coordination between partnerships and
stakeholders at national and international levels for the
prevention of blindness and visual impairment.
5. Monitor progress in elimination of avoidable blindness at national,
regional and global levels.
 Strategies of vision 2020
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1. Strengthen advocacy
2. Disease Control Programmers
3. Human Resource Development
4. Strengthen the existing eye care
infrastructure
5. Use of appropriate and affordable
technology
6. Mobilizing the resources
 1. Strengthen advocacy
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Public awareness about eye care

Introduction of topic about eye care in school
curriculum
To increase the involvement of local
community and NGO on eye care
Strengthen the hospital program for the eye
donation
 2. Disease Control Programmers
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A. Cataract
B. Trachoma
C. Childhood blindness
D. Refractive error and low vision
E. Onchocerciasis
F. Glaucoma
G. Diabetic retinopathy
 A. Cataract
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Objective
 Increase the quality and the quantity of cataract
surgery
Strategy
 To increase the cataract surgery rate 6000 by 2020

 IOL surgery for >85% by the year 2005 and for all
by the year 2010
 YAG capsulotomy serves for all district hospital by
the year 2010
Cataract…

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 B. Trachoma
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Magnitude of the problem

590 million people at risk from blinding trachoma
150 million people have active trachoma
10.6 million people have trichiasis
5.9 million people blind from trachoma
15% of global blindness: 2nd cause of blindness

“a forgotten disease of forgotten people”

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Trachoma Control Strategy

SAFE Strategy - It stands for:
Surgery – Trichiasis surgery
Antibiotics – Tetracycline ointment, Systemic
tetracycline or Doxycycline
 It may be given on a community or individual basis

Face washing – regular face washing to keep the eyes

and face clear of discharge, health education
Environmental change–provide adequate water supply,
improve community sanitation (building and using VIP
latrines and proper waste disposal); exclude cows and
goat from the home
C. Causes of Childhood Blindness

Retina
Causes of childhood blindness

Corneal scar

Whole globe
Lens

Optic nerve
Glaucoma

Other

Uvea

0 100,000 200,000 300,000 400,000

Numbers of blind children

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Causes of Childhood Blindness…

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Causes of Childhood Blindness…

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prevention of child hood blindness
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• To identify areas where childhood blindness
from preventable disease is common and to
encourage preventive measures, for example:
(a) Measles immunization;
(b) Vitamin A supplementation;
(c) Nutrition education;
(d) Avoidance of harmful traditional practices;
(e) Monitoring of use of oxygen in newborns.
prevention of child hood blindness
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• To provide specialist training and services for the

management of surgically remediable visual loss
in children from:
(a) Congenital cataract;
(b) Congenital glaucoma;
(c) Corneal scar;
(d) Retinopathy of prematurity.
D. Refractive Error and Low Vision
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Create awareness and demand for refractive
services through community-based services/primary
eye care and school screening.
Develop accessible refractive services for individuals
identified with significant refractive errors.
Training in refraction and dispensing for
paramedical eye workers if ophthalmologists and/or
refractionists are not available in sufficient number.
Ensure that optical services provide affordable
spectacles for individuals with significant refractive
errors.
Refractive Error and Low Vision
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Develop and make available low vision services
and optical devices for all those in need, including
children in blind-school or integrated education.
Certain low vision devices can be manufactured
locally, or purchased externally in bulk supplies to
reduce costs.
Include the provision of comprehensive low vision
care as an integral part of national programmes for
the prevention of blindness, or rehabilitative
services for the visually disabled.
 E. Glaucoma
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Opportunistic screening at eye care institutions

should be done in all person above the age of
35 years, those with diabetes mellitus and those
with family history of glaucoma
Community based referral by multi purpose
workers of all person diminution of vision,
coloured halos, raped change of glasses , ocular
pain and family history of glaucoma
Opportunistic screening at eye camps in all
patients above the age of 35


www.health.gov.au/internet/eyehealth 200931
Disease control program

Disease Cataract Intensified surgical intervention

Control
Onchocerciasis
Programmes vermectin distribution, vector control
Trachoma SAFE strategy

Childhood Vitamin A, immunazation

Blindness
Refractive Error Refraction center in all PHC BY 2010,low vision
Center in 30 center
Implementing specific
Diabetic Crate awareness, leaser rx in 30
programmes to center
control the major
Retinopathy
Glaucoma Screening
causes of blindness.

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 3.Human Resource Development
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Create one ophthalmologist post and facility per 250

000 population through government and/or private
Sector with equal distribution for urban and rural
populations.
Where there are insufficient ophthalmologists, train
OMAs and ophthalmic nurses for secondary eye
care.
All medical graduates to be trained in basic eye care.
Human Resource Development…
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Train sufficient and appropriate staff for
refraction of underserved populations.
Provide training in basic principles of
management for medical/paramedical staff.
Develop manpower for equipment
maintenance/repair, low-cost spectacle
production and eye drop preparation.
 4. Infrastructure Development
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Development of district-level eye care services,
with primary eye care integrated into the PHC
system for a population of between 0.5 and 2
million people.
To provide practitioners, hospitals and clinics with
information on good-quality and affordable
appropriate technology.
To provide appropriate donated equipment to
countries which cannot afford its purchase.
 Infrastructure Development
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To assist users to evaluate, select and purchase
appropriate equipment using methods which will
help to prolong its useful life.
To introduce new technologies such as computers
and computer networks to improve management
efficiency and information exchange.
Conduct feasibility studies on new technologies to
ensure cost-effectiveness.
 Guiding Principles
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summarized in the acronym ISEE:
• Integrated into existing health care systems
Sustainable in terms of money and other resources
Equitable care and services available to all, not
just the wealthy
Excellence – a high standard of care throughout
 Achievements
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Thanks to VISION 2020 advocacy, all 193 WHO

member states are formally committed to investing in
eye care
Two World Health Assembly resolutions have urged
WHO member states to develop and implement VISION
2020 national plans, and WHO to provide technical
assistance
A WHO Action Plan for Prevention of Blindness and
Visual Impairment has now been prepared and was
generally adopted at the 2009 World Health Assembly 
 Achievements
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135 countries have participated in a VISION 2020
workshop
107 countries have formed national VISION 2020
committees
91 countries have drafted national eye care plans
To date, 15 million fewer people are blind
compared with projections made when the
initiative was launched *
 Achievements
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Cataract is included in most national plans for the
prevention of blindness, and cataract surgical rates are
increasing in many countries.
 Cost-effective surgical techniques have been
developed and tested and are being improved
continuously (e.g. small-incision cataract surgery and
use of good-quality, low-cost intraocular lenses).
 Achievements
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The VISION 2020 global initiative intensively
promotes awareness of the extent of uncorrected
refractive errors and the means for correcting them.
Uncorrected refractive errors are increasingly being
addressed in national plans for the prevention of
blindness, and low-cost, good-quality spectacles are
becoming available.
 Achievements
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vitamin A deficiency: There are concerted global efforts
to control vitamin A deficiency in children and women
of child-bearing age.
Measles: Measles immunization coverage continues to
improve, resulting in a lower incidence of measles and
measles-related deaths. In 2004, there were 454 000
deaths from measles, a reduction of 48% from 1999
 Achievements
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The Measles Initiative, a partnership between the American Red
Cross, the United States Centers for Disease Control and
Prevention, the United Nations Foundation, UNICEF and WHO,
is now focusing on 47 countries, mainly in sub-Saharan Africa
where 98% of deaths occur, with the goal of reducing deaths
from measles by 90% by 2010 from the estimates for 2000.
The WHO Region of the Americas has eliminated measles, and
three other regions have set elimination targets. Reducing the
prevalence of measles will also reduce the number of children
with measles-related corneal ulceration and scarring.
 Achievements
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Retinopathy of prematurity: Programmes for detecting and
treating severe retinopathy in premature infants at risk are
expanding throughout Latin America and eastern Europe and are
being established in urban areas in China, India and other Asian
countries.
Child eye-care centers: Training in pediatric ophthalmology is
becoming more prevalent, and tertiary level child eye-care
centers are being set up in low-income countries.
Consumables for children: Low-vision devices suitable for
children as well as other consumables are available through
resource centres in Hong Kong, China, and Durban, South
Africa.
 Achievements
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At national level, political support for trachoma control has
increased continually since 1997, the year the WHO Alliance
for the Global Elimination of Blinding Trachoma (GET 2020)
was created; intersector collaboration is growing, and use of
the SAFE strategy for eliminating the disease is increasing.
GET 2020 is active at the global level. It is a public–private
partnership, bringing together WHO, national coordinators,
nongovernmental organizations, donors and international
experts, with support from the pharmaceutical industry.
 Achievements
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At the closure of the Onchocerciasis Control
Programme in 2002, 40 million people in 11 countries
had been saved from infection and eye lesions, 600 000
cases of blindness had been prevented, and 25 million
hectares of abandoned arable land had been reclaimed
for settlement and agricultural production, with an
economic rate of return of 20%he disease is increasing
 Summery
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 The global initiative known as ‘VISION 2020: the Right to
Sight’ is an established partnership between the World Health
Organization (WHO) and the International Agency for the
Prevention of Blindness (IAPB).
 It was launched in 1999
 The guiding principles are summarized in the acronym ISEE:
 The ultimate goal of the initiative is to integrate a sustainable,
comprehensive, high-quality, equitable eye- care system into
strengthened national health-care systems.
 Reference
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 World Health Organization, Prevention of Blindness Programme
(WHO/PBD), 2005.
 Fifty-sixth World Health Assembly resolution WHA56.26,
elimination of avoidable blindness
• http://www.vision2020.org/main.cfm
• http://www.iapb.org/
• http://www.who.int/blindness/partnerships/vision2020/e
n
ANY
QUESTIONS?
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