How do we help prevent Blindness

Some of the activities we (used to) do to prevent blindness:

• Retinopathy of Prematurity Screening and Treatment
• Vision screening in communities and schools
• Primary Eye Care training for Information, Education and Campaign
• Eye surgeries such as cataract, pterygium, glaucoma, squint, etc. with partners or we conduct outreaches in Geographically Isolated and Disadvantaged Area
• Partnerships and collaboration with other Civil Society Organizations and other groups.

Bakit ayaw magpa-opera ng katarata ang ibang pasyente?

Marami na kaming napuntahan at na screen para sa katarata.  Karamihan din sa kanila kahit sabihan mo na mabubulag na sila pag ayaw magpa-opera, ayaw pa rin talaga.  Bakit kaya hinihintay ng ibang tao na halos mabulag muna bago lumapit sa doktor?  Marami na kaming narinig na dahilan pero nung may nabasa akong artikulo sa Community Eye Health Journal naconfirm ko na halos kahit saang bahagi ng mundo pare-pareho ang rason ng mga tao.  Ilan sa mga dahilan ay ito:

1. Takot - may narinig na k'wento na si ganito ay naoperahan sa katarata at nabulag.  Inoperahan pero hindi rin makakita.  Nasira ang mata dahil sa operasyon.
2. Gastos (oras at pera) - marami sa aming mga nakilalang pasyente, ayaw maiwan ang mga alagang baboy, manok, atbp.  Kung minsan nga nasasagot ko pa na: "mas importante pala ang baboy kesa sa inyong paningin?"  Pero kung makita mo o nalaman mo na may mga taong ang pagkain na ihahain sa mesa ay nakadepende kung nagtrabaho ka ngayong araw o hindi, (isang kahig isang tuka) malamang maaawa ka na lang.  Isa pa sa malaking rason ay ang gastos sa pamasahe papunta sa doktor maliban sa bayad sa konsultasyon ng doktor dahil minsan mas mahal pa ang pamasahe sa konsultasyon lalo pa at  kailangan ng tagabantay o kaagapay ang pasyente.
3. Ugali at Paniniwala - may ugali ang ibang tao na kayaan na lang kasi matanda na o kaya paniniwala na bigay ito ng Diyos kaya tanggapin na lang.  O kaya minsan sasabihin ng kapamilya na wala namang silbi kaya hayaan na lang.
4. Hindi ko kailangan magpagamot, kaya ko ito - para sa ibang pasyente ayos lang sa kanila na hindi sila makakita kaya naman nila.  Nasanay na lang na malabo ang paningin at sayang lang ang pera na gagastusin.
5. Mahal magpaopera ng katarata - kung lumagpas na sa ikaapat ang rason ng pasyente, tiyak ito na yun.  May mga pasyente naman na gustong-gusto magpaopera hindi lang kaya ang mga gastusin.  Napakamahal naman kasi ang singil ng ibang ophthalmologist.  Mababa na ang Php20,000 sa isang mata.

Nagtataka ka pa ba kung bakit maraming nabubulag sa katarata o hinahayaan na lang ang sitwasyon na hindi makakita?  Ilan lamang ito sa mga rason.  Ano ang magandang gawin?  Suportahan sana ng lokal na gobyerno ang pangangailangang ganito.  May ibang LGUs na tumutulong magbigay ng pamasahe, pambili ng gamot, sasakyan papunta sa doktor, at minsan sagot nila ang counterpart ng pasyente lalo pa at walang PhilHealth.  Sana dumami pa sila.  Marami sa ating mga ophthalmologists ay willing tumulong at mag opera kahit libre pero marami din sa kanila sakim sa pera.  Kahit kita naman nila walang-wala talaga, pipilitin nilang mangutang para lang may ipambayad.  Hindi ko naman sinabing i-libre na lang pero sana may 'socialized payment' sila na papipilian sa kanilang pasyente depende sa kung ano ang kakayanan ng pamilya pagdating sa pinansiyal na estado.  Hindi p'wedeng 50k ang singil mo sa lahat ng pasyente.  Maging makatao ka.  Hindi pera ang sinumpaan mo sa iyong propesyon kundi ang tumulong, makatulong sa mga nangangailangan.

Statistics on Blindness and Visual Impairment

We're getting a few questions lately as to what is the current statistics on blindness and visual impairment in the Philippines and so we needed to recheck our data.  Below is what we found for both global and national with its respective links:

The 3^rd National Survey on Blindness in the Philippines of 2004 says prevalence of visual impairment among children (0 to 20 years old) is 0.43.  


(the dilemma in this survey is that children age range is up to 20 years old.  For PhilHealth, a dependent child is below 21, in the convention of the rights of the child - a child means every human being below the age of 18 years (http://www2.ohchr.org/english/law/crc.htm), quoting "Child and Youth Welfare Code": "It shall apply to persons below 21 years of age" P.D. #603, in Philippine Law, "Child" refers to a person under the age of eighteen (18) years - (http://www.lawphil.net/statutes/repacts/ra2006/ra_9344_2006.html) ) 


Isn't it even more confusing now? Let us wait for the result of the 4th National Survey on Blindness maybe then there will be an agreed definition as to what is the age range of a Filipino child.   

Worldwide, a person goes blind every 5 seconds and a child goes blind every minute, and the children most at risk are those 5 years old and below. 

An estimated 1.4 million children are blind worldwide and millions more are visually impaired.

In developing countries, like the Philippines, 60% of children will die within one year of becoming blind and the remainder will, on average, spend 40 years without sight. 

90% of blind children receive no schooling and the majority will not grow up to achieve their full potential. 

http://hubmob-rmc.hubpages.com/hub/Blindness-Visual-Impairment-and-Eye-Health

Prevalence of childhood blindness is almost 1% of the world population.  

Costs for childhood blindness are estimated between $6 billion and $27 billion. 

About 70% of childhood blindness is thought to be preventable. 

In developing countries, 60%-80% of blind children die within 1-2 years. 

Vision problems affect 1 in 20 preschoolers and 1 in 4 school-age children.

http://www.uniteforsight.org/eye_stats.php

The global prevalence of childhood blindness is thought to be around 0.07%, or approximately one tenth of the prevalence of blindness in adults (Rahi et al. Measuring the burden of childhood blindness. Br J Ophthalmol. 1999 Apr;83(4):387-8)

In developing countries, it is believed that 60-80% of children who become blind die within 1-2 years (Lewallen, S and Courtright, P.Blindness in Africa: present situation and future needs. Br J Ophthalmol. 2001 Aug;85(8):897-903)

the prevalence of bilateral blindness in developing countries in Asia ranges from 0.3% of 4.4% (Saw et al. Causes of blindness and low vision in rural Indonesia. Br J Ophthalmol. 2003 Sep;87(9):1075-8)

http://blind.org.ph/blind_phil.html

Perhaps up to one hundred children lose their sight every week in the Philippines. 

http://www.aao.org/eyecare/news/upload/Eye-Health-Fact-Sheet.pdf

Facts About Blindness and Eye Health

Worldwide

• Somewhere in the world, someone goes blind every five seconds.

• A child goes blind every minute.

• Eighty percent of all blindness is preventable or curable.

• It is estimated that at least 7 million people go blind every year.

• Worldwide some 180 million people are blind or visually disabled—the equivalent of two-thirds of the entire U.S. population.

• Rates of blindness will double by the year 2020 unless prevention efforts are intensified.

• People in developing countries represent 90 percent of the world’s blind population and are 10 times more likely to go blind than those in developed countries.

• Africa averages just one ophthalmologist for every 1.25 million people

Prevalence of Blindness and Vision Impairment in the Philippines

Hidden among the 94 million people (http://popcom.gov.ph/press_releases/popstat/index.html) in the 7,107 islands of the Philippines are an estimated half a million people who are blind and many more who are visually impaired.   

The 3^rd National Survey on Blindness in the Philippines of 2004 says prevalence of visual impairment among children (0 to 20 years old) is 0.43.  Further quote: “Some random surveys showed increasing dropout among students in public schools in the upper elementary grades and in high school.  This could be attributed to eye problems particularly refractive errors and the high cost of optical services by private optometrists that are not affordable by vast majority.” Almost half of these cases are either treatable or preventable.  The causes of childhood blindness in the Philippines are: 

1. refractive errors
2. cataract
3. phthisis bulbi
4. corneal opacity
5. retinopathy of prematurity
6. optic atrophy 
7. amblyopia / others
8. glaucoma and 
9. uveitis.     

Among adults the leading cause is still cataract.

Persons aged 0-19 years old are considered part of the pediatric age group of the Philippines.  Estimated population of those below twenty years old (<20) for 2011 is 44,483,911.

Prevalence of blindness is 0.06% (26,690) 

Prevalence of low vision is 0.09% (40,035)

Error of Refraction is 53% (21,218);

Cataract is 40.8% (16,334);

and all other blinding causes is 6.1% (2,442)

Total visual impairment is 0.15% = 66,725

"Gilbert and Foster in 1993 examined 256 children in schools for the blind in Thailand (1 school) and the Philippines (3 schools). In the total study, 15% of children were blind as a result of Retinopathy of Prematurity (ROP)." 

There are 1,573 ophthalmologists of which is 22 pediatric ophthalmologists in the country and 95% of them are in Metro Manila (capital city of the country).  

UNCORRECTED REFRACTIVE ERRORS

There is no reliable existing data for uncorrected refractive errors especially among the adults but for children it is 53% of the low vision prevalence. 

Daniel Etyale on worldwide distribution of visual refractive error said: "5-15% of children are considered to have uncorrected refractive errors.  Although Vision 2020 (the current W.H.O. global initiative) imposes a mandate to correct refractive errors, little infrastructure and few resources are available to accomplish the task of correcting refractive errors.  Etyale noted that while access to general medical services is possible for about 25% of populations in developing countries, access to medical eye care, including refraction, could be obtained by only about 10 percent."

Quoting Etyale, given that at least 5% of the population has uncorrected refractive errors that is equivalent to 2,224,195.

Although there are 10,226 optometrists in the country, uncorrected refractive errors is still a leading cause of visual impairment in children and adults as optical services is a highly competitive business and therefore access to services is not affordable to the vast majority.

Prevalence of Blindness and Vision Impairments:

given that the current projected population for 2011 is 96 million with population growth rate of 2.04% annually;

Projected Population 2011	Bilateral Blindness (0.58%)	Cataract blind (0.62)	New cataract cases (incidence) every year (0.20)	Low Vision and Error of Refraction (2%)	Total vision impairment (2.58%)
96,000,000	556,800	345,216	69,043	1,920,000	2,476,800