Scribd Logo
Upload

Welcome to Scribd!

  • 92 views

    Community Ophthalmology Int - L Class

    Uploaded by

    aa
    Community ophthalmology focuses on comprehensive eye health at the community level through promotion, prevention, treatment and rehabilitation efforts. The key aspects of community ophthalmology include promotive efforts like educating communities about eye health, and preventive efforts such as screening for glaucoma, refractive errors, and other common eye diseases. A document on community ophthalmology in Indonesia found that the prevalence of blindness was 1.5%, with over half of cases due to untreated cataract. It discussed strategies to address the backlog of cataract surgeries needed and reduce blindness, such as training community health workers and holding high volume cataract surgery camps. NGO partnerships were also emphasized as important for expanding eye care services and

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Community Ophthalmology Int - L Class

    Uploaded by

    aa
    92 views30 pages
    Community ophthalmology focuses on comprehensive eye health at the community level through promotion, prevention, treatment and rehabilitation efforts. The key aspects of community ophthalmology include promotive efforts like educating communities about eye health, and preventive efforts such as screening for glaucoma, refractive errors, and other common eye diseases. A document on community ophthalmology in Indonesia found that the prevalence of blindness was 1.5%, with over half of cases due to untreated cataract. It discussed strategies to address the backlog of cataract surgeries needed and reduce blindness, such as training community health workers and holding high volume cataract surgery camps. NGO partnerships were also emphasized as important for expanding eye care services and

    Original Description:

    kekom

    Original Title

    Community Ophthalmology Int_l Class

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Community ophthalmology focuses on comprehensive eye health at the community level through promotion, prevention, treatment and rehabilitation efforts. The key aspects of community ophthalmology include promotive efforts like educating communities about eye health, and preventive efforts such as screening for glaucoma, refractive errors, and other common eye diseases. A document on community ophthalmology in Indonesia found that the prevalence of blindness was 1.5%, with over half of cases due to untreated cataract. It discussed strategies to address the backlog of cataract surgeries needed and reduce blindness, such as training community health workers and holding high volume cataract surgery camps. NGO partnerships were also emphasized as important for expanding eye care services and

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    92 views30 pages

    Community Ophthalmology Int - L Class

    Uploaded by

    aa
    Community ophthalmology focuses on comprehensive eye health at the community level through promotion, prevention, treatment and rehabilitation efforts. The key aspects of community ophthalmology include promotive efforts like educating communities about eye health, and preventive efforts such as screening for glaucoma, refractive errors, and other common eye diseases. A document on community ophthalmology in Indonesia found that the prevalence of blindness was 1.5%, with over half of cases due to untreated cataract. It discussed strategies to address the backlog of cataract surgeries needed and reduce blindness, such as training community health workers and holding high volume cataract surgery camps. NGO partnerships were also emphasized as important for expanding eye care services and

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 30

    COMMUNITY

    OPHTHALMOLOGY
    Ahmad Ashraf

    Social
    ophthalmology
    =
    Community
    ophthalmology is one of ophthalmology subdivision
    that oriented to comprehensive health community
    (promotive,
    preventive,
    curative
    dan
    rehabilitative)with focus on promotive and
    preventive aspects
    Clinical Ophthalmology is a branch of medical
    science that focus to individually and oriented to
    secondary services and located in institution

    ophthalmology include :
    Promotive
    Target is community
    Preventive
    Promotive = Promotion is a process of study from,
    by and for community that is fixed with local social
    culture .

    Promotif = Promotion is a process study


    from, by and for community that fixed with
    local social culture
    Community = participated

    People can recognize, maintain, protect


    and improve eye health

    Preventive in community ophthalmology focus on:


    - Glaucoma
    - Refraction
    - Degenerative
    - Corneal disorder
    Preventive
    3 type :
    1.Primary
    prevent diseases
    2.Sekunder
    prevent loss of visual acuity
    3. Tertiary
    rehabilitation of visual
    acuity to blind person ex : cataract

    primary
    prevention
    prevention
    of
    diseases occurrence
    Examples :
    Vitamin A deficiency : good nutrition
    Trachoma: good sanitation
    varicella / mumps: imunization
    refractive errors : watching TV with minimal
    distance 5X TV diagonal. Reading distance 30
    cm with good enough light
    Glaucoma: above 40 yo, control IOP regularly

    Sondary prevention : prevent loss of vision from


    existing disease, example :
    Vitamin A deficiency : if there are symptoms of
    night blindness, vitamin A 2x per year and
    improve nutrient
    cataract : surgery if decrease vision
    Glaucoma : saving sight with surgery or
    regular check up
    Diabetic Retinopathy : saving sight with retinal
    laser

    Tertiary prevention : improve vision in blind


    person , example :
    cataract: surgery
    Corneal scar : keratoplasty
    Low vision person : low vision aid, example :
    loup, magnifier
    Blindness : condition of vision that 3/60 with best
    correction or visual field 10o from fixation point.

    How many people are blind :


    Almost 50 million persons are blind worldwide,
    where 1,5 million below 16 yo.
    Prevalence of blindness varied in many places
    In Indonesia prevalence of blindness about 1,5%

    Some terms
    UKM/PK : upaya kesehatan mata dan
    pencegahan kebutaan
    PKKP
    : penanggulangan kebutaan katarak
    paripurna
    Both are implemented integrated to all sector and
    active role from community are needed to realize
    eye health for all

    Magnitude of blindness in Indonesia:


    Based on sight survey 1993-1996 : prevalence of blindness
    1,5% 1,5% X 200 m = 3 million
    Causes of blindness :
    - 52% cataract : 52% X 3 jt = 1.560.000
    - 9,5% refractive error :
    9,5% X 3.000.000 = 285. 000
    - 13,4% glaucoma: 13,4%X3 jt = 402.000
    - 8,5% retinal disorder :
    8,5% X 3.000.000 = 255.000
    - 6,4% corneal disorder : 6,4%X3 jt= 192.000
    - 10,2% other diseases : 10,2%X3.000.000 = 306.000

    Cataract blindness in productive ages about + 1416% from all cataract = 249.000
    If average income Rp. 80.000,-/month, so
    economic loss because of cataract blindness in
    productive age about
    250.000 X 12 X Rp. 80.000,- = Rp. 240.000.000
    These not yet include economic loss due to
    cataract blindness because of family burden .
    Cataract incidence 0,1%
    0,1% X 200.000.000 = 200.000
    Cataract blindness : burden to family and local
    income due to decrease of productivity

    Eye Survey results :


    1982
    1,2% blind rate
    1993-1996
    1,5% (52% by cataract)
    8 province
    Why increase: 1,2%
    1,5% cause by:
    1. UHH: usia harapan hidup / life expectancy
    increase from 60 to 66 yo
    2. Degenerative diseases more than infectious
    disease
    3. Lack of eye health facility.

    Problem in community :
    1.
    2.

    Increasing Prevalence : 1,5%


    Man Power : lack of ophthalmologist , eye
    paramedic,
    3. Low Budget , community ability to pay also
    decrease
    4. Political will does not strong enough to take
    community participation

    THE MAIN EYE MORBIDITY PREVALENCI

    Refractive Error
    Pterygium
    Cataract
    Conjuntivitis
    Corneal Scar
    Glaucoma
    Blepharitis
    Retinopathy
    Hordeolum
    Strabismus

    22,1
    13,9
    7,3
    2,0
    1,4
    0,4
    0,3
    0,2
    0,3
    0,3

    BLINDNESS PREVALENCE AND CAUSES OF


    BLINDNESS OF BOTH EYE
    Lens

    0,78

    Glaucoma / N II

    0,20

    Refractive Error

    0,14

    Retina

    0,13

    Cornea

    0,10

    Others

    0,15

    Total blindness

    1,5

    Blind Rate: 1,5%


    Population 200.000.000
    Blind : 1,5% X 200.000.000 = 3.000.000
    by cataract: 0,78% x 200.000.000 = 1.560.000
    Number of surgery in Indonesia / year :
    + 60.000
    remain : 1.560.000-60.000= 1.500.000
    This number : BACK LOG

    Defenition Back Log: Number of cataract patients


    that not operated in 1 year
    Incidence: Number of new cases in 1 year: 1 o/oo
    So, every year new cases of cataract :
    1o/oo X 200.000.000 = 200.000/tahun

    Causes of Back Log:


    - Social economy
    - Lack of knowledge in community
    - Geography
    - Lack of eye specialist
    - Majority in rural area
    - Mainly facility located in urban area
    Strategic steps cataract management :
    - Social marketing
    - Operational preparation
    - Surgery
    - Follow up by ophthalmologist or GP

    Social marketing:
    Local population
    Map of area
    Determine target surgery
    Cooperation with health infrastructure
    Local government announcement
    Local NGO participation

    WHO , if prevalence of blindness :


    0,5%
    : clinical problem
    >0,5% - < 1%
    : community problem
    >1%
    :
    social
    problem
    influencing national health development
    specially eye health
    National program are :
    Decreasing blindness rate < 1% in 2003
    Decreasing eye morbidity
    Socialization eye services in community

    Blind criteria WHO:


    Visual acuity < 3/60 with maximal correction
    Ratio
    WHO

    : 1 ophthalmologist for 350.000


    population
    : 1 ophthalmologist for 250.000
    population

    Government strategies to solve high blindness rate


    with cooperation
    LSM (Lembaga Swadaya Masyarakat) / NGO local,
    national or international :
    Training UKM/PK for eye cadres for case finding of
    operable cataract
    Training for paramedic for cataract case finding and post
    operative management
    Training for General practitioners in PHC
    Training for teacher for early detection of refractive error
    Mass cataract surgery called SAFARI KATARAK with low
    cost or free of charge

    Glaucoma as second
    following cataract : 0,2%

    causes

    of

    blindness

    To decrease this number : intraocular pressure


    (IOP) regular check for patient 40 yo or above to
    detect :
    chronic simple glaucoma:
    Symptoms :
    Intraocular pressure > 20,6 mmHg
    visual field defect
    cupping of the disc

    Visual field :
    Medial
    : 50 o
    Superior : 60 o
    Inferior
    : 70 o
    Lateral
    : 90 o
    Visual category in opthalmology:
    > 6/18
    : normal
    6/60 - 6/16
    : visual impairment
    3/60 6/60
    : low vision
    < 3/60
    : blind

    Some NGO that in cooperation in cataract


    eradication program :
    yayasan Dharmais Perdami
    Lions Club
    Rotary Club
    Hellen Keller International
    Dark and Light International
    Christoffell Blinden Mission: CBM
    dll

    Infrastructure eye services :

    primary eye care : Puskesmas


    Secondary eye care : RS type C/B dan BKMM
    Tertiary eye care
    : RS type A
    subspesialistic services
    BKMM : Balai Kesehatan Mata Masyarakat
    secondary services provide by
    ophthalmology

    Important activities to decrease blindness :


    In all places there must be :
    1. Providing eye services
    2. Early Detection / screening and refractive error
    management
    3. In specific place :
    - Vitamin A supplement
    - Trachoma program with SAFE strategy
    (Surgery, antibiotic, Face washing,
    Environmental)

    Specialistic services:
    1. Diagnostic and management of glaucoma
    2. Diagnostic and management of retinopathy
    3. Specialist center for childhood blindness

    Thank you

    You might also like