Health Days 2015

 

What is the initiative of the “Vision 2020: the Right to Sight” about?

“Vision 2020: the Right to Sight” is a global initiative launched by the International Agency for the Prevention of Blindness (IAPB) in collaboration with the World Health Organization (WHO). It aims at developing the programs and plans for eliminating the avoidable blindness by 2020. Many governmental institutions participate in such initiative including the Ministry of Health (MOH), governmental and non-governmental associations for ophthalmology, blindness elimination and rehabilitating the weak-sighted. 

 

• Geographically-speaking, the spread of visual impairment worldwide is uneven.
• 90% of the weak-sighted people live in low-income or medium-income states.
• The number of visually impaired cases is estimated at over 285 million people in 2010.
• Of which 39 million are blind.
• And 246 million are weak-sighted.
• The Mediterranean East region, including the Gulf States, and the Kingdom, accounts for 12.5% of the blindness rate worldwide.
• 80% of the vision impairment cases are avoidable, and can be prevented or treated.
• The cataract, inflicting 51% people worldwide with blindness (19.7 million cases), is among the principal causes of blindness.
• Cataract surgery and redressing the refractive errors top the medical interventions conducive to make a success.
• Uncorrected the refractive errors, 43%, is among the causes resulting in avoidable blindness.
• Over 120 million people suffer from weak-sightedness resulting from the uncorrected refractive errors: short-sightedness (myopia), long-sightedness (hyperopia) or astigmatism. All these people can nearly restore their vision with eye glasses, contact lens or surgical intervention.
• It is estimated that, in the next few years, the number of the blind at the age of 50 and over will increase in the regions affiliated to the WHO, namely in China, India, Southeast Asia and Mediterranean East region, unless the necessary procedures of prevention and treatment are taken for fighting the principal causes of the vision impairment.
• Causes of weak-sightedness and blindness resulting from aging are increasing due to uncontrollable diabetic level.
• Blindness cases, caused by the infectious diseases, such as onchocerciasis and  trachoma causing blindness, in the countries affected are gradually eliminated thanks to establishing effective, innovative partnerships between the governmental and private sectors.
• Over decades, the WHO, in collaboration with its member states and international partners, continues its work towards eliminating the main causes of the avoidable blindness through providing the technical assistance, detection, and coordination services.
• Over 1.4 million children are afflicted with blindness. Among the principal causes of child blindness are cataract, retinopathy of prematurity, and vitamin A deficiency. And, half of children blindness cases can be avoided or treated. There is a global program, designed as a result of the existing partnership between the WHO and Lions Clubs International (LCI), implemented in 30 countries, providing the children with eye care services.
• Every five seconds, someone is afflicted with blindness worldwide.
• And every minute, a child is afflicted with blindness.
• It is estimated that seven million people are afflicted with blindness annually.
• As close as half million children lose their sight every year. Most of them die before completing a year as a result of blindness-associated diseases; most of them are inherited.
• Globally, approximately two thirds of the visually impaired worldwide are females, 60%.
• Still, females outlive males; this in turn renders them more vulnerable to the cataract and weak-sightedness.
• Females get less treatment opportunities
• The loss of the world economic product, due to the productivity shortage resulting from the visual impairment and blindness, will surpass trillion Saudi Riyals every year by 2020.

• Idea of the World Sight Day Theme:
• The idea behind the World Sight Day revolves around the Braille writing system. It is a globally approved method for teaching the blind. Braille writing system depends on a cell made up of six main dots: three on the right, and three on the left. These six dots constitute all the letters to become words. Each Braille-based letter is formed through the embossing of some dots in the cell made up of six dots unlike the others, in turn, constituting a letter to enable the blind to read through touching.
• The dots in the theme of the World Sight day stand for three Letters: W/S/D, the initials of the World Sight Day in Braille writing system.

• Personal hygiene helps protect the eye from several diseases.
• Avoid the use of stagnant water or water from streams or rivers to wash the face, as they contain many germs that may cause inflammation of the eye.
• Those who wear contact lenses should keep them clean and disinfect thoroughly, as contamination can lead to serious eye infections.
• In case a foreign body entered your eye, avoid rubbing it. Wash it gently to expel the foreign body; rubbing your eye may cause scratches or tears in the outer surface of the eye.
• If you have eye redness or any other complaint, you should consult an oculist, and refrain from using medicines without prescription, or drops found at home; as each medicine is of special combination and special use. Some drops and ointments contain materials that may harm the eye when used under certain circumstances. 
• You have to get rid of all old used eye drops and ointments that may already be expired or can bring germs to the eyes and cause inflammation in them.
• Ladies are not advised to use kohl (eye darkening powder) sold in markets in from of powder or stone grinding at home, as researches proved that most of these products are contaminated with different kind of bacteria and contain high concentration of lead. They can be replaced with cosmetics in form of pens, preferably with a lid.
• It is not preferable for ladies to share a kohl pen.
• Because the kohl contains high concentration of lead, it should not be used on children eyes to prevent the possibility of poisoning.
• Sun glasses protect the eyes from strong sun rays, and also provide protection against sand and dust.
• Beware of looking directly at the sun, even if it eclipses, or very strong light such as welding light, as they may cause damage to some parts of the retina.
• To prevent infection transmission from a person to another, each person should have his own face towel, which should not be used by others.
• Eye drops containing cortisone compounds or its byproducts should not be used unless supervised by a doctor, because using them, for a prolonged time without a medical supervision, may cause some complications in the eye, and could be dangerous sometimes.
• Exposure to welding glare may cause serious damage to the cornea (outer layer of the eye), and consequently a severe pain in the eye. It is advisable to use goggles to protect the eyes from the welding glare and any foreign body and in case of any welding-caused damage a doctor should be consulted immediately. Avoid use of local anesthetic drops, which may cause serious damage to the eye if used repeatedly.
• Some common diseases such as high blood pressure, diabetes, and others may cause some changes inside the eye; therefore it is advised to see a doctor for early diagnosis of such changes to get the necessary treatment.
• If the eye suffered burns or exposed to incendiary chemicals, it should be immediately washed with a copious amount of water and the patient should see an ophthalmologist as soon as possible.
• The first cause of vision loss in one eye is accidents and eye injuries, mostly in children while playing, therefore they should be put under supervision and prevented from playing with sharp-edged objects and other dangerous toys such as guns, throwing stones or fireworks.
• Many chemical materials and cosmetics may leave an adverse effect on vision; alkaline and acid materials may cause dangerous burns. Also, alcohol and some aromatic compounds may cause damage to the cells of the retina or optic nerve fibers. Incidence of poisoning with methyl alcohol occurs through skin absorption, and there are cases of people who lost their sight as a result. Also, drinking small amounts of methyl alcohol causes complete loss of vision; so methyl alcohol swallowing incidents must be treated through gastric lavage at hospital's emergency department.
• All medicines and incendiary chemicals should be kept in well-sealed bottles and out of reach of children.
• Pregnant women should avoid contact with cats; to prevent infection in case the cats are infected with diseases, such as Toxoplasmosis, which leads to transmission of the disease to the fetus, causing significant damage to the retina or other parts of the eye such as the lens.
• Meat should be well cooked; fruits and vegetables should be washed carefully as a precaution to prevent infection with Toxoplasma microbe, which may cause serious infection to the eyes.
• Some eye diseases like glaucoma or high pressure inside the eye may not cause any symptoms or pain in the eye in its early stages. Such diseases can be detected only upon eyes examination by an ophthalmologist; therefore it is advised to examine the eyes once a year especially for those who are over forty and with a history of the disease in the family for early detection and treatment of the disease and prevention of blindness.
• Periodic examination of the eyes is the way to detect any eye diseases and preserve vision.
• In the event you show any of glaucoma or eye high pressure symptoms, such as visual field loss, blurry vision, seeing colored halo around the lights, big cornea size, or cornea color change in children in cases of congenital glaucoma, you have to swiftly see the eye doctor to early diagnose and treat it.
• In case of developing glaucoma, it is advised to avoid intermarriage, or not getting married to a close relative so as not to increase the likelihood of your children inheriting the disease.
• It is important for the glaucoma patient to take the medicines regularly according to the instructions of the eye doctor, since careless irregular administration leads to raising the eye pressure again, and damaging more tissues of the optic nerve.
• Glaucoma patients should not neglect taking the medicines even if the vision condition has not improved; for the medicine principal goal is to preserve the vision and not to improve its level.
• Glaucoma patient is advised to see the eye doctor in the event that any side effects resulting from taking the medicine should appear, or the vision ability should recede.
• It is important to inform any other doctor, apart from the eye doctor, about the eye medicines used by the patient, and any other diseases he suffers from, especially heart and lung diseases.
• Once the glaucoma medicines run out before your appointment with the doctor, it is recommended not to wait till the next visit; rather, you should see the doctor immediately or hurry up to the emergency section of any hospital. 
• Glaucoma is an eye disease resulting from high pressure inside the eye, leading to damage in the optic nerve, which is gradually followed by partial loss of optical vision field, and if not treated, the optic nerve will be damaged completely; thus eyes lose vision.
• Glaucoma is publicly known as Blue Water. The name comes from the meaning of glaucoma in the Greek language, which means blue falls; because the patient sometimes sees blue halos around the light source, giving the impression that the water inside the eyes is blue. Also, the color of the infected eye with very high pressure at birth is called "congenital or hereditary blue water", which is of dark blue color.
• Glaucoma is considered the third major cause of blindness in Saudi Arabia and the region; it is very dangerous because it leads to permanent vision loss if not detected and treated early. When the pressure increases in the eye more than usual, all eye internal tissues and blood veins of optic nerve and some tiers of retina will be affected and the optic nerve tissues get progressively damaged. Unfortunately, this damage is incurable, and thus comes the importance of early diagnosis and treatment continuously in order to not raise the pressure over its natural rate and the optic nerve remains in good condition.
• In case there are persons with congenital high eye pressure in the family, medical advice should be sought before marriage between relatives. And all family members with history of the disease should examine the eye pressure at least once a year.
• Cataract or White Water is the cloudiness of the eye lens, which is completely transparent in normal conditions. It is not water or a liquid inside the eye as widely believed, but is the case when the lens loses its natural transparency, causing blurred vision.  
• Cataract is the main cause of blindness in the world and is a major cause of blindness among the elderly in Saudi Arabia. It is when some changes occur in the lens protein fibers in people over the age of fifty, causing the loss of lens transparency and the lack of clarity of vision.
• It is advised to vaccinate children against German measles. Pregnant women should avoid contact with persons with infectious diseases, so as to protect their babies against congenital cataract.
• It is not necessary to wait until cataract patient's lens condensed completely or loses his vision in order to have a surgery, as previously thought; surgery could be performed as soon as the cataract is diagnosed and when the sight deteriorates to the level that he cannot perform his normal activities.
• Idleness of the eye (Amblyopia) occurs when the vision acuity in one eye is less than the other, without presence of any apparent physical reason, such as when the child develops hyperopia or myopia the eye. Idleness also occurs when there is organic disease in the eye, like congenital cloudiness in the lens (cataract) or due to an injury in the eye. One of the complications of such case is formation of cloud in the corneal or cataract that obscures the vision of that eye, leading to visual idleness if the eye is not treated fast enough.
• Idleness of the eye occurs when having one of the heterotropia cases, when the eye sends unclear or double image to the brain, which rejects the image and ignores it, and then the child stops using that eye unconsciously. The idleness of the eye develops until the weak-sighted child stops using that eye for life, if the case remained untreated. Visual idleness is attributed to the lack of cells that receive light in the visual center of the brain during first years of the child’s life. Remember that idleness of the eye cannot be cured after the age of seven, which means that the vision in this eye remains weak for life.
• Since heterotropia is the cause of idleness of the eye, the focus is to treat the idleness at first place, and then comes the role of surgery to correct the heterotropia (squint).
• Diabetes is a chronic disease that raises levels of sugar in the blood causing its failure to reach the body’s cells. Diabetes causes many complications in many parts of the body, including the eye.
• The retinopathy caused by diabetes is considered one of the main reasons of blindness in modern time.
• All diabetics are at risk of retinopathy; the longer the duration of the disease, the more the rate of developing retinopathy increases. Those who control diabetes and keep up with treatment to have a normal level of blood sugar will have fewer complications compared to those, who are not dealing well with the disease and treatment.
   
   
  
   The image as seen by glaucoma patients

• Lack of clarity of vision or  blurry vision
• Seeing glare around the bright lights at night
• Frequent need for changing the eye glasses

Treatment of Cataract: In most cases, treating the cataract requires a simple procedure meant for replacing the clouded lenses by artificial ones. 

Glaucoma or Blue Water: Glaucoma is the raising of the eye pressure, and it is the second blindness cause in the Kingdom.

• Those over the age of 40 or those with glaucoma-related medical family history should examine their eyes annually to help detect glaucoma earlier and avoid vision loss as a result, Allah forbid. It is not recommended to use any drops without prescription since some drops contain cortisone that leads to the raising of the eye pressure, and partial or permanent vision loss. It is advised to see eye doctor when noticing: 
• Any sudden change in vision
• Noticing colored haloes around the lights
• Redness with pain in the eye

 Idle eye (Amblyopia):

• Idleness of the eye occurs when the vision acuity differs from one eye to another, and either eye becomes weaker or idler than the other. Eye idleness in children happens in the following cases:
• Difference of the hyperopia  or myopia level between the two eyes
• Heterotropia cases
• Physical cause such as injury in the cornea or cataract in either eye

Treatment:

• Covering the sound eye with the aim of activating the idle eye, and thus, improving its vision level 
  Diabetic Retinopathy: It is a change in the retina. It occurs the more the diabetes goes, and when the diabetic does not control sugar level.  

• See the eye doctor periodically and annually for examining the retina.
• Maintain the diabetes level by following the doctor's instructions.
• Contact Lenses: To maintain the health of your eyes, visit the optician for taking the correct measurements for the medical or colored contact lenses. Also, you should mind the use and care instructions; in order to avoid eye ulcer that may cause blindness, Allah forbid.

 

 To contact the National Prevention of Blindness Committee (NPBC):

• Website: http://www.npbc.org.sa
• Phone: 011 466 1058
• Fax: 011 466 1049
• Email: info@npbc.org.sa