‘Pakistan among countries with highest cataract surgical rate’

Islamabad :With cataract being the largest cause of blindness worldwide, Pakistan is among few countries, where patients of the medical condition that causes blurred vision have the best access to surgery in the world, say experts.

According to them, Pakistan is among 12 countries with the highest cataract surgical rate, which is the number of cataract operations performed per million people in one year and is used as a proxy indicator of access to cataract services in a country.

The experts, who gathered in a Mir Khalilur Rehman Memorial Society seminar on ‘eye health in Pakistan’ at a hotel here on Saturday, called for better government support and cooperation to prevent and control blindness in the country, especially the one caused by diabetes.

Prof Asad Aslam Khan, the national coordinator of the National Programme for Prevention and Control of Blindness, told participants that the country’s eye care programme was a journey of four decades.

He said from 1947 to 1979, the country didn’t have any forum to work against preventable and curable blindness and it was only in 1980 when the president appointed the national eye camp committee, while the health ministry notified the first national committee on prevention of blindness in 1990-91 that was restructured as the national steering committee on prevention of blindness in 1994.

Prof Asad said the year 2008 witnessed the formation of the national committee for eye health (NCEH) for integrated eye care in the country as required by the WHO, World Health Assembly and International Agency for Prevention of Blindness.

He said the committee went all-out against avoidable blindness and visual impairment in the country with the help of international and national partners, including WHO, Sightsavers (UK), CBM (Germany), Fred Hollows Foundation (Australia), Brien Holden Vision Institute (Australia), Standard Chartered Bank, Layton Rahmatullah Benevolent Trust, Al-Ibrahim Eye Hospital and Al-Shifa Trust Eye Hospital.

“From 1947 to 1980, eye healthcare was managed by individuals, while from 1980 to date, eye care services have been planned from the platform of NCEH,” he said.

The programme coordinator said the first national blindness survey was carried out by the NECH in 1989 putting the sightlessness prevalence at 1.78 per cent, while the second such exercise occurred in 2002-04 showing the 0.9 per cent blindness incidence.

He said the third national blindness survey was under way.

Prof Asad said the 2002–04 survey blamed cataract for 51.5 per cent blindness cases, corneal opacity 11.8 per cent, uncorrected aphakia 8.6 per cent, glaucoma 7.1 per cent and posterior capsule opacificiation 3.6 per cent, refractive error 2.7 per cent and diabetic retinopathy 0.2 per cent and declared 80 of blindness avoidable.

He said after developing and successfully executing four five-year plans for prevention of blindness, the NCEH was in the process of developing the fifth one by hiring a consultant.

The programme coordinator said the committee’s terms of references included evidence generation, human resource development, the establishment and strengthening of institutions for promotion of eye health, district-based eye care services and disease control projects, integration of PEC into primary health care, public awareness, and inclusive eye care in the country.

“We’ve to our credit the reduction of blindness incidence in the country from 1.78 per cent in 1989-90 to 0.9 per cent in 2002-04 and as the fresh survey is under way, the incident is likely to see further decline,” he said.

Prof Asad also said the committee strengthened the primary eye care component of PHC on public private partnership, developed and incorporated the PEC Module lady health workers curriculum, and trained the countrywide LHWs in PEC.

He said during the last two decades, the NCEH had got eye units upgraded or established in the country’s 27 teaching hospitals, more than 120 district headquarters hospitals and over 100 tehsil headquarters hospitals.

The programme coordinator said the country had more than 800 optometrists, 50 orthoptists, 50 investigative oculists, 1,200 ophthalmic technicians, 34 vitreoretinal specialists, 24 pediatric ophthalmologists, 92 community ophthalmologists and more than 100 ophthalmic nurses.

He added that the committee’s efforts had led to the increase in the cataract surgical output from 280,000 in 2004 to 1,143,786 in 2018.

Prof Asad said after the upgradation of eye care facilities at tertiary care hospitals through the provision of the latest equipment and human resource, patients from attached areas of teaching hospitals didn’t have to travel to big cities for treatment, while those with diseases of vitreoretina and pediatric ophthalmology were being handled at 16 centres across the country.

About the impact of disease control projects, he said cataract surgeries were being done either free of charge or at a very affordable cost at district and tehsil headquarters levels; trachoma was near eradication; children were being screened by teachers for eye ailments; diabetes-related blindness was prevented due to early screening; blindness caused by glaucoma was being prevented by early detection and screening, and patients with low vision were being provided with low vision devices at district level.

He said the NCEH had planned to free the country from trachoma by 2021, incorporate ICEH across the country, introduce cataract support programme and diabetes-related blindness control programme, establish low-vision clinics at DHQ hospitals and community screening clinics for eye diseases at RHCs, and develop and implement eye health management information systems across the country.

The programmed coordinator pushed the national health services ministry for resolving the azithromycin issue with the WHO for trachoma treatment, allocating funds for prevention of blindness from retinopathy of prematurity, supporting programme for the prevention of diabetes-related blindness and glaucoma, and establishing an independent optometry council.

Dr Zafar Mirza, special assistant to the prime minister on national health services, attributed the cataract surgical rate of 5203 per million population in Pakistan to the public-private partnership and credited the federal government, provincial health departments, World Health Organisation, and international and national NGOs for it.

Assuring the NCEH of the health ministry’s patronisation in future as well, he called for the provision of insurance cards to all the people with total and severe visual impairment.

from The News International - Islamabad https://ift.tt/2MiNlqK