Table.

Main cause of Bilateral Blindness

Table. Main causes of Low Vision

 Low vision – moderate + severe vision impairmen

Nearing 2020: Prevention of Blindness
Opthalmology LEADING CAUSES OF BURDEN OF DISEASE, WORLD
YL7: 08.17  DM and refractive error is rising

Dr. Maria Victoria A. Rondaris Figure. Vasbdla

23 November 2017 | 9:30 AM – 10:30 AM
IMPACT OF MYOPIA IN A DEVELOPING WORLD
GROUP 9: Arancon, Espiritu, Filart, Geron, Go, M., Javier, Lazatin, Magno,
Nerva, Roderos
 Increasing prevalence of high myopia by 2040, 2050

OUTLINE DIABETIC RETINOPATHY

OUTLINE ............................................................................................................... 1  Leading cause of vision loss in the working age group (20-
I. OUTLINE ........................................................................................................... 1 65 years old)
II. VISION 2020: THE RIGHT TO SIGHT ....................................................... 1 o China, India, Indonesia, and Bangladesh alone
AIM OF VISION 2020 .................................................................................... 1
MOST VISION LOSS IS UNNECESSARY .................................................... 1
represent 45% of the global burden
PHILIPPINE NATIONAL BLINDNESS SURVEY ........................................... 1 o The highest prevalence of diabetes is found in the
LEADING CAUSES OF BURDEN OF DISEASE, WORLD .......................... 1 Eastern Mediterranean, close to 14%
IMPACT OF MYOPIA IN A DEVELOPING WORLD ..................................... 1 o In Africa, 2/3 of people with DM remain undiagnosed
DIABETIC RETINOPATHY.............................................................................. 1
DISTRIBUTION BY GEOGRAPHY ................................................................. 1
DISTRIBUTION BY AGE ................................................................................ 1
DISTRIBUTION BY GEOGRAPHY
DISTRIBUTION BY GENDER ........................................................................ 1  SEA region without India is the 3rd highest
VISION 2020 STRATEGY .............................................................................. 1 o China and India were separated due to population
OPHTHALMOLOGISTS PER REGION, PHILIPPINES 2016 ...................... 1
INDICATORS ................................................................................................... 2
MORBIDITY AND QUALITY OF LIFE ........................................................... 2 DISTRIBUTION BY AGE
DALYS GLOBALLY........................................................................................... 2  82% of all people who are visually impaired are age 50 and
THE HIGH COST OF LOW VISION .............................................................. 2
HEALTH SYSTEM STATISTICS ..................................................................... 2 older.
CHALLENGES .................................................................................................. 2
DOH AO 173 S 2004 ..................................................................................... 2 DISTRIBUTION BY GENDER
INTERVENTIONS AND STRATEGIES TO IMPLEMENT THE PROGRAM. 2
VISION 2020 STARTEGIES IN THE PHILIPPINES ................................... 2  2/3 of visually impaired and blind people are women and
FINANCING THRU PHILHEALTH .................................................................. 2 girls
OTHER LAWS: PHILIPPINE DISABILITY LAWS ........................................ 2 o Longer life expectancy
IMPLEMENTATION MECHANISM ................................................................. 3 o Lack of access to services in poorer societies with highly
PRIORITY ACTIONS ....................................................................................... 3
IMPORTANT NOTES ............................................................................................ 3
paternal cultures
REVIEW CENTER ................................................................................................. 3  In some countries, the woman/mother is the last
FREEDOM SPACE ................................................................................................ 3 priority in health care
REFERENCES ........................................................................................................ 3  This happens in countries like Africa

I. OUTLINE VISION 2020 STRATEGY

 Epidemiology of blindness and vision impairment in the  Community participation
world and Philippines o Cost effective disease control interventions
 Impact of vision loss  Cataract surgery is the best
 National program on prevention of blindness  Provision of spectacles
o Human resource development
 Ophthalmology training
II. VISION 2020: THE RIGHT TO SIGHT  Attempt to bring in training for ophthalmic nursing
 Mission: eliminate avoidable blindness by 2020 o Infrastructure development
 The specialist should be complimented with all his
AIM OF VISION 2020 “toys”
 2015-2019
 Development of a sustainable comprehensice healthcare
o 25% reduction in prevalence of vision impairment by
system to ensure the best possible vision for all people and
2019
thereby improve quality of life
 Develop full potential to those with unavoidable blindness OPHTHALMOLOGISTS PER REGION, PHILIPPINES 2016
MOST VISION LOSS IS UNNECESSARY  Our problem is not a lack of doctors but rather
maldistribution
 Cataract is still the most common cause of vision o A vast majority of doctors are concentrated in NCR
loss/impairment o This is because this region has the tools necessary for
the practice of ophthalmology
PHILIPPINE NATIONAL BLINDNESS SURVEY o Regions near metro manila also have more doctors than
the rest
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  0.75 government nurses per 10,000 population
INDICATORS  1.74 midwives per 10,000 population
 Cataract surgical rate  7.6 ratio of government nurses/midwives to physicians
o Performance indicator  1:519 – 1: 4,000 ratio of hospital bed to population
o Number of surgeries performed per million per year  1:25,000 – 1:800,000 ratio of Eye MDs to 2015 population
o Must include all sectors: private, public, NGOs
 Cataract surgical coverage CHALLENGES
o Impact indicator  Low awareness at government level
o Proportion of operable cataract cases operated in time o There are provinces that would rather deal with other
o CSC for people, CSC for eyes health programs
o Monitors care coverage, access to care by elderly  Lack of political will (“NGO business”)
o Ideal CSC is 85%  Poor integration into health systems
o The challenge is to integrate the eye health program into
III. THE IMPACT OF VISION LOSS PWD programs
 In some countries vision loss is not a priority because it is o Integrate into the age 5 and below health programs
not fatal o Integrate into immunization program
 Medical specialty
MORBIDITY AND QUALITY OF LIFE  Chronic eye conditions increasing
 Premature death (2.4x higher risk) o Because eye conditions are also connected to chronic
 Depression diseases such as DM, cancer, stroke
 Falls and fractures
 Ease of daily living ahead DOH AO 173 S 2004
 Social and religious interaction halved  National Blindness Prevention Program
 Earlier entry to institutionalized care  Sometime in 2013, they revised the guidelines because
nothing was happening
DALYS GLOBALLY o Nothing was happening because there was no
 Disability adjusted life years – the sum of years of potential coordination of efforts
life lost due to premature mortality and the years of o NGOs lorded over, leaving out the other stakeholders
productive life lost due to disability
o Cancer (5.1%) INTERVENTIONS AND STRATEGIES TO IMPLEMENT THE
o Harmful use of alcohol (4.5%) PROGRAM
o Respiratory disease (3.9%)  Advocacy and health education
o Tobacco use (3.7%)  Capacity building – national and local
o Visual impairment (3%)  Information management
o Physical inactivity (2.1%)  Networking, partnership building and resource mobilization
o Unhealthy diet (1-2%)  Supervision, monitoring, and evaluation
 Research and development
THE HIGH COST OF LOW VISION o There are no good researches on eye under the DOH
 In developing countries, people suffer from oderate to  Service delivery
severe visual impairment, 2x as many as those who have o Has to be functional
significant hearing impairment
VISION 2020 STARTEGIES IN THE PHILIPPINES
IV. THE PHILIPPINE PREVENTION OF BLINDNESS  Ensure cataract surgery is appropriate, available,
PROGRAM (PBP) accessible, and affordable to everyone
 Started with Ramon Magsaysay  Reduce prevalence of cataract, blinding errors or refraction,
o 1954: 40,000 blind Filipinos (could have been prevented) and vitamin A deficiency through enhanced services
o August was declared as sight saving month  Pooling of resources of government and non-government
agencies to address problems of cataract, EOR, Vitamin A
National sight plan for the Philippines deficiency
 1974, revised in 1979
 Council on Blindness Inc. FINANCING THRU PHILHEALTH
o Dr. Salvador Salceda: President  Philhealth Law mandates PHIC membership for all Filipinos
o Dr. Alejandro de Leon: executive Director  Lowest quintile, 5.2 million families 26 million) identified by
 Prevention of Blindness 1990 Master Plan (DOH) National Household Targeting System DSWD enrolled
(4Ps) and paid by national government
 1997: Philippines an original signatory of the Vision 2020  Second lowest quintile national-local government sharing
Program launched in Geneva 4.1 million families (20.5 million individuals)
 1998: National Committee for Sight Preservation (NCSP)  No balance billing
formed to coordinate implementation of the Vision 2020  Point of care
Program in the Philippines  Mandatory philhealth for all senior citizens
 50 patients limit per month for every eye doctor
HEALTH SYSTEM STATISTICS
 1.93 baranggay health stations (BHS) per 10,000 population OTHER LAWS: PHILIPPINE DISABILITY LAWS
 24 baranggay health workers per 10,000 population  RA 7277
 0.45 BHS per baranggay
 0.3 government physicians per 10,000 population
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08.17: Prevention of Blindness
 o An act providing for the rehabilitation, self- development  Conducting researches on the outcomes and efficacy of
and self-reliance of disabled persons and their preventive eye health
integration into the mainstream of society and for other
purposes (Magna Carta of Disability, July 20, 2006) IMPORTANT NOTES
 RA 9442 amends the previous (July 24, 2006) Feel free to add anything pertinent to the lesson here. It can be
 RA 10754 an act expanding the benefits and privileges of mnemonics, additional references, or the like. The group
persons with disability (March 23, 2016) assigned is required to put important notes that the batch must
know regarding the trans
IMPLEMENTATION MECHANISM
 National Government REVIEW CENTER
o DOH, NEDA: Develop macro plan and policy directions
for health facility development, functionality and 1. The questions?
sustainability in line with the Philippine Development a) Helvetica c) Four choices
Plan 2016-2022. b) Size 9 d) This is a table with no
o DOH, DBM, NEDA: Ensure that Congress provides borders
necessary augmentation of investments for health
facility development of national government agencies 2. Question
and LGU’s a) c)
o DOH, CHED, DICT: Coordinate to provide technical b) d)
advisory, human resource, capability building, and
information technology solutions 3. Question
 Local Government a) c)
o Shall ensure that adequate human resources for health b) d)
shall be provided for the functionality of health facilities
o Shall ensure the necessary budget for miscellaneous 4. Question
and other operating expenses of health facilities a) c)
 Private Sector b) d)
o Supplement 60% of projected general hospital bed gaps
through establishment of new, and expansion of 5. Question
existing hospitals a) c)
o Shall be mandated to support functioning of the Service b) d)
Delivery Networks (SDN)
Answers: a,b,c,d,e
PRIORITY ACTIONS
 Integrating vision screening and other preventive eye health FREEDOM SPACE
intervention into public health practices for all ages Watch the intro video on avoidable blindness here:
 Creating education and awareness programs that include https://www.youtube.com/watch?v=CpNqMaBy0fw
vision loss prevention, detection, and treatment regimens
 Reimbursing both treatments and preventive eye health REFERENCES
intervention to ensure positive impact on system wide costs
and support for future innovation Guyton, AC, & Hall, JE. (2006). Textbook of Medical
 Developing and utilizing tele health mechanisms to provide Physiology. (11th ed). Philadelphia, PA: Elsevier Saunders.
greater access to screening and treatment regardless of
geographical location Guyton, AC, & Hall, JE. (2006). Textbook of Medical
 Advocating for vision loss to become widely recognized as Physiology. (11th ed). Philadelphia, PA: Elsevier Saunders.
preventable health condition
Guyton, AC, & Hall, JE. (2006). Textbook of Medical
Physiology. (11th ed). Philadelphia, PA: Elsevier Saunders.

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