Visual impairment affects a startling 285 million people worldwide; 39 million of them are blind with a further 246 million suffering from low vision. The even more startling fact is that 80 per cent of visual impairment is curable. So what exactly is causing this problem and how can it be prevented or cured?
The World Health Organization says “visual impairment is unequally distributed across countries, age groups and genders”, with poverty being a key factor. Inadequate nutrition and sanitation contribute to ill-health in general, with war in some geographical areas forcing people to be constantly on the move making it harder for governments, NGOs and healthcare providers to reach them. And with 90 per cent of the visually impaired living in developing countries it is a vicious cycle; poor eyesight and blindness further prevent the social and economic development of some of the world’s most disadvantaged people. The main types of curable visual impairment are common refractive errors like myopia, when the eyeball is too long or the cornea is too curved causing objects in the distance to look blurred, hyperopia – the opposite; close objects are out of focus, and astigmatism – where the irregular shape of the cornea affects focus so that vision is blurred at any distance.
Cataracts, a clouding of the eye lens caused by a build-up of protein, and glaucoma, a damaged optic nerve, are also major causes of visual impairment. And that’s not all. Trachoma – a painful condition caused by repeated bacterial infections of the eye – is prevalent in areas of extreme poverty and poor sanitation, while river blindness is a disease caused by a parasitic worm that is transmitted to humans through the bites of infected black flies. But a great deal can be done about the most common causes of visual impairment, which has decreased significantly since the early 1990s primarily as a result of concerted public action.
VISION 2020 is a global initiative for the elimination of avoidable blindness and is a joint programme between the World Health Organization and the International Agency for the Prevention of Blindness with an international membership of NGOs and professional associations.
Noor Dubai in the UAE is one such philanthropic organisation. The foundation has been providing mobile eye camps as part of its outreach programme since it began in 2008, explains CEO Dr Manal Taryam, providing 14 camps in nine different countries to date.
“The selection of countries is based on the need and statistics provided by the Ministry of Health and the World Health Organization,” explains Dr Taryam. She emphasises the issue of poverty as a major cause of blindness: “People with refractive errors need simple glasses to be able to see but can’t afford them. Glasses cost US$4. Cataract surgery is a straightforward procedure that is performed under local anaesthesia and takes from 10 to 12 minutes,” she adds.
A simple cataract surgery costs the foundation an average of US$8 per eye and besides surgery, Noor Dubai distributes medication and glasses to those in need. “Each camp lasts for approximately 10 days, and includes initial screening, surgery and post-operative check-up. For two weeks after every camp, members of the medical team will visit again to make sure that all operated cases are doing well and there are no complications.”
There is no cure for glaucoma and once sight has been lost it will not return, but much can be done to prevent this from happening; regular screening will identify the problem and treatment may include medication and/or surgery. Along with the use of insecticides to kill black fly and the provision of medication, raising awareness has made a great impact in the fight against the infectious diseases that threaten sight and lead to blindness.
With women and girls accounting for nearly two-thirds of visually impaired people worldwide, educating women is vital in the fight against global blindness. Due to poverty and cultural beliefs, priority for healthcare access is initially provided to men and in many places, men have twice the access to eye care as women.
Social and economic factors in poor and rural areas can limit women’s access to eye healthcare, despite often having more responsibility for home and children. In addition, women suffer from the highest rates of illiteracy and are therefore harder to reach; they may also have less access to the family financial resources to pay for treatment.
Noor Dubai runs training programmes for ophthalmologists and healthcare providers in managing trachoma and river blindness. Dr Taryam describes how “the programme also includes educating volunteers, teachers and women’s groups on how to prevent the spread of the trachoma infection”.
The publication released by VISION 2020 states that there are 15 million fewer blind people than the projection when the initiative began, proving that the prognosis is anything but gloomy. This ongoing success is a direct result of the work of the WHO, the Agency for Prevention of Blindness, participating governments and philanthropic organisations like Noor Dubai, that work together to win the visual impairment battle.