A meeting implemented with the technical and financial support of

Caribbean Council For The Blind & Visually Impaired - Blackburn Building - Holberton - Antgua-Barbuda - W.I
Tel: 1 268 736 7401 - 4 e-mail: v2020@eyecarecaribbean.com www.eyecarecaribbean.com

Preventng blindness and visual impairment; While restoring sight and creatng opportunites for persons
whose sight cannot be restored
Report on the
2013 Annual Meeting of
Vision 2020 Committees -
Representatives for the Caribbean
2

The 2013 Caribbean Regional V2020 Commitees Meetng
was held at the Pegasus Hotel, Kingston, Jamaica on 3
rd
and
4
th
December. The proceedings were chaired by Arvel Grant,
Chief Executve Ofcer of CCB-Eye Care Caribbean.
The meetng provided a platorm for sharing, learning and
networking between V2020 Commitees and persons
involved in eye health and paid partcular atenton to
Diabetc Retnopathy one of the most prevalent causes of blindness in the Caribbean. The
meetng also provided an opportunity for delegates to become familiar with the World Health
Organizatons global eye health acton plan 20142019 Towards Universal Eye Health - htp://
www.who.int/blindness/actonplan/en/
Partcipants included delegates from 12 Caribbean countries (Antgua and Barbuda, Barbados,
Belize, Dominica, Guyana, Hait, Jamaica, St. Kits and Nevis, St. Lucia, St. Vincent and the
Grenadines, Suriname and Trinidad and Tobago), who were joined by representatves from the
following organisatons:
Internatonal Agency for the Preventon of Blindness (IAPB)
Pan-American Health Organisaton (PAHO)
The Caribbean Council for the BlindEye Care Caribbean
Sightsavers
Orbis Internatonal
The Sussex Eye Hospital, UK
The Queen Elizabeth Diamond Jubilee Trust
Brien Holden Vision Insttute
The Meetng was implemented with the technical and fnancial support of the Caribbean Council
for the Blind (CCB), The European Union (EU), Pan American Health Organizaton (PAHO) and
Sightsavers.
MEETING HIGHLIGHTS
Keynote Address:
In his keynote address, the Chief Medical
Ofcer in the Jamaica Ministry of Health, Dr
Kevin Harvey, said that the Jamaican
Government is commited to the eliminaton
of avoidable blindness by the year 2020,
through delivery of the highest quality of
health care to its citzens.

Dr Harvey stated that the Government is
pleased to have partnered with Vision 2020
through the Southern Regional Health
Authority to service a catchment of over
600,000 persons by delivering quality eye
care in that region.
Dr. Kevin Harvey, Chief Medical Ofcer, Jamaica
Ministry of Health delivers the keynote address
3

The Status of V2020: The Right to Sight in the Caribbean
Towards Universal Eye Health
Dr Louis Pizzarello, Chair of the North American Region of the
Internatonal Agency for the Preventon of Blindness (IAPB),
discussed IAPBs World Sight Day 2013 Report, also notng that
in May 2013 Towards Universal Eye Health: A Global Acton
Plan 2014-2019 was adopted by Member States of the World
Health Assembly. By doing so 194 countries acknowledged the
importance of Universal Eye Health and have commited to
reducing the prevalence of avoidable visual impairment and
securing access to rehabilitaton services for the visually
impaired. Dr Pizzarello reminded partcipants that there are
currently 285 million people with visual impairment around the
world, with 4 out of every 5 cases avoidable.

Dr. Juan Carlos Silva, Regional Advisor - Visual Health PAHO, reminded
partcipants of the objectves of the Strategic Framework for V2020: The Right to
Sight (Caribbean Region) and also went into greater detail on the contents of
the Global Acton Plan (2014 2019), advising partcipants on actons that can
be taken to help achieve its objectves.
Philip Hand, Sightsavers Programme
Manager (Caribbean) discussed the
impact of the European Union funded
project Delivering V2020 in the
Caribbean in the eye health related
areas of organisatonal development,
human resource and infrastructure
development and public awareness.

In additon to
developing
eye health
facilites in
Antgua,
Guyana,
Hait, Jamaica
and St Lucia, the project also supports
training for primary health care
workers, low vision personnel,
refractonists, optometrists,
ophthalmologists, maintenance
technicians, spectacle dispensing
technicians-clerks and spectacle lab
technicians.
Lab Technician training
Delegates had the opportunity to provide an update
on eye health services in their country. This is an
overview of some of their achievements, challenges
and plans:
ANTIGUA Opened three community vision centres in
Claire Hall, Grays Farm and Johnsons Point (health
centres) and plan to open several more; Situaton
Analysis of Diabetc Retnopathy Services undertaken in
2013; Limited natonal data available on surgical
outputs.
BARBADOS - Currently drafing an Eye Care Policy and
Strategy; Public sector Diabetc Retnopathy screening
service to commence in 2013; No low vision services
available in the public sector.
BELIZE - Situatonal Analysis of Blind & Visually
Impaired Children in Belize published by UNICEF;
Natonal Diabetc Retnopathy Screening and Treatment
Program startng; Lack of inclusion of eye health in
MOHs plans and policies
DOMINICA New equipment available including Diode
Laser Unit and Digital Camera; Dominica Government
ratfed the United Naton Conventon of the Rights of
4

Persons with Disabilites; Government fnancial support
required for eye health, partcularly human resource and
infrastructure development.
GUYANA - Guyana Eye Care Strategic Framework (2013-
2020) approved by Ministry of Health and included in
the Natonal Health Plan; Contnued strengthening of
public sector screening and treatment for glaucoma;
Need to increase numbers of eye health professionals
and source funds for diabetc retnopathy screening and
treatment programme.
HAITI Eye clinics of two public hospitals equipped
(Eliziar Germain & St Nicholas); CNPC working with Orbis
to deliver and further develop an efectve surgical
programme model; Working with Government to
include eye health indicators in the Natonal Health Plan.
JAMAICA No Natonal eye health data made available;
Mandeville Regional Hospital facility update shows
decrease in number of persons visitng clinic and
number of surgeries in 2013; Mandeville plans include
opening new operatng theatre for eye health and
development of DR screening and treatment
programme.
ST KITTS & NEVIS - Improvement in school screening
programme and acquisiton of equipment, including a
fundus camera, B-scan and indirect ophthalmoscope; No
public sector refractve error programme; Plans to
fnalise Strategic Framework, policies and other
guidelines for the Ophthalmic Unit.
ST LUCIA - World Glaucoma Day, World Sight Day and
White Cane Day celebrated and used to sensitze the
populaton; Selectve Laser Trabeculoplasty Study in its
fnal stages; Plans to develop operatng theatre at
Victoria Hospital and undertake Diabetc Retnopathy
services situaton analysis.
SURINAME Strong central ophthalmology department
providing a high standard of eye care, utlising outreach
for natonal coverage; Sub-specializatons available
including Paediatric ophthalmology, Vitreo-retnal and
Glaucoma; Plans include constructon of new eye
hospital and further involvement in scientfc research.
TRINIDAD & TOBAGO - DM Ophthalmology and
ophthalmic nurses training ongoing; Cataract surgery
waitng lists reducing; Plans to introduce DR screening
programme and undertake Natonal Eye Survey.
C
h
o
o
s
in
g
s
p
e
c
t
a
c
le
s
in
B
e
liz
e

H
a
p
p
y
c
lie
n
t
s
in
H
a
it
i
W
o
r
ld
S
ig
h
t
D
a
y
in
T
r
in
id
a
d

O
u
t
r
e
a
c
h
in
S
u
r
in
a
m
e

5

Improving Diabetc Retnopathy
Screening and Treatment
Programmes in the Caribbean
Discussions were opened by Dr Michael Eckstein,
Consultant Vitreoretnal Surgeon, Clinical Lead
Sussex Diabetc Retnopathy Screening
Programme, Brighton and Sussex University
Hospital, UK.
Dr Eckstein informed delegates of the reasons
why Diabetc Retnopathy (DR) is so important:
Fourth most common cause of world blindness
1 in 5 of all diabetcs become signifcantly
visually impaired afer 15 years
Most common cause of blindness in the
working populaton of industrialized countries
Incidence / prevalence is increasing
Is both preventable and treatable
Dr Andrew Cooper, Director of Programmes - The
Queen Elizabeth Diamond Jubilee Trust, provided
an overview of The Trust and its focus on fghtng
blinding diseases like Trachoma, Glaucoma and
Diabetes across the Commonwealth.
Dr Cooper invited delegates to become involved
in development of a Caribbean DR Screening and
Focus on Disease ControlDiabetc Retnopathy
Treatment Programme proposal for
consideraton by the Trust. Proposal
development should consider, among
other things, how to incorporate services
into wider public health systems; how to
implement a cost efectve and
sustainable model; how learning from
elsewhere can be incorporated and how
to build on existng programmes.
Delegates worked together, using the
Caribbean Diabetc Retnopathy
Programme Concept paper as a guide, to
identfy the key players, key stages,
tmelines and resources required for full
proposal development. This excellent
opportunity to collaborate with The
Queen Elizabeth Diamond Jubilee Trust
and expand DR screening and treatment
services in the Caribbean will be taken
forward in 2014.
Learning & Informaton Sharing
A series of lively thematc discussions were held throughout the meetng where experiences
and informaton were shared some key points are captured below:
Creatng efectve Natonal V2020 Commitees
V2020 Commitee should ensure involvement and coordinaton of diferent organisatons and
community representatves
V2020 Commitee must include Ministry of Health and NGO representatves and should
include Ministry of Finance representatve
Utlise resources and capacites of diferent Commitee members to develop or bring in new
resources
Consolidate and report natonal eye health data on a quarterly or six-monthly basis
Build relatonships with media to help create public awareness & promote initatves /
services.
6

Learning & Informaton Sharing
Incorporatng Primary Eye Care (PEC) into Primary Health Care (PHC)
Primary Eye Care training for PHC workers should be ongoing
Training should be targeted at those who have the remit to use it
Ensure the necessary basic tools are available at primary level guidelines, VA testng,
referral pathways, public informaton materials.
Introduce a few components of PEC initally. Keep it simple, stck to priorites and create
something that can be built on and developed over tme.
Including Refractve Error in school children in natonal policies and plans
PAHO guidelines available for Caribbean on screening school children
Guyana school screening guidelines available
Include teachers associatons & PTAs in issues concerning school screening and child eye
health
Guidelines should be updated to deal with compliance.
Natonal Eye Health Surveys
Need to convince MOH and other key stakeholders that a natonal survey is necessary and a
good use of resources
Important to have baseline data for any health issue and surveys are a means of doing this
Surveys provide a means of measuring and demonstratng progress. Being able to show
progress and impact is important to governments.
Survey is also a tool for planning and promotes efectve use of resources.
Engaging non-health sectors in eye health / preventon of visual impairment
Media health personnel are not always the best educators and communicators. Using
media professionals for public awareness and developing communicatons skills of health
personnel is benefcial.
Human Rights groups have a strong lobby and posing eye health as a right can help to
cultvate relatonships and put eye health on the agenda
Ministry responsible for infrastructure need roads to access care, develop centres.
Ministries of Labour Employment of persons with visual impairment, health and safety in
the workplace relatng to preventon of visual impairment.
Ministries of Finance can put the economic argument forward regarding preventon of
blindness cost benefts, cost efectveness and value for money.
7

In 2013 the Guyana V2020 Commitee facilitated the
fnalisaton of the Guyana Eye Care Strategic Framework
(2013-2020). This document was endorsed by the Ministry
of Health, with an abridged version included in the
Natonal Health Plan.
Dr Shailendra Sugrim, Chair of the Natonal Vision 2020
Commitee and Consultant Ophthalmologists & Glaucoma
Specialists at the Georgetown Public Hospital guided
delegates through the process of framework development,
which included:
Utlising the Strategic Framework for V2020: The
Right to Sight (Caribbean Region) as a guide
Undertaking a study of the eye care sector in Guyana (commissioned by PAHO)
Publicaton of the report Situaton Analysis: Eye Care in Guyana
Planning meetng with stakeholders in 2012 utlising their expertse and the Situaton
Analysis to draf the Guyana eye care framework
Establishing a writng and editng commitee and review mechanism
Final draf approval by Ministry of Health
Abridged version included in Natonal Health Plan
Publicaton of the Guyana Eye Care Framework (2013-2020)
This rigorous and efciently implemented process has resulted in a publicaton which will guide
development and delivery of eye care services in Guyana.
Developing the Guyana Eye Care Strategic Framework
Research - Knowledge, Attude and Practce (KAP) studies
Glaucoma KAP study
Glaucoma is the leading cause of irreversible
blindness worldwide, but blindness from
glaucoma is preventable by early detecton and
appropriate treatment.
In this study the agencies involved aim to
explore the knowledge, attudes and practces
of patents living with glaucoma in four
Caribbean countries: Barbados, Guyana,
Jamaica and St. Lucia. The results of this study
will enhance our understanding of the issues
which are afectng glaucoma patents and
having an impact on their ability to manage
their disease. In the long term, study fndings
should inform public health policy and clinical
strategies to improve the care of glaucoma
patents.
Dr Dawn Grosvenor, Consultant
Ophthalmologist, Glaucoma Specialists and
Principal Investgator for the study explained
why the study is necessary, how it was
developed, who is involved and what the
implementaton tmelines are, notng that data
collecton had just commenced as of December
2013.

Diabetc Retnopathy KAP Study
Diabetc Retnopathy is a relatvely common
complicaton of diabetes and lef untreated it
can lead to irreversible blindness. Dr Charles O
Pierce, Research Registrar, Ophthalmology,
University of Southampton, UK and Principal
Investgator explained how this study aims to
identfy the educatonal needs of diabetc
patents and also inform future health
awareness strategies. The study will take place
in Barbados, St. Lucia, Guyana and Jamaica and
as of December 2013 it is in the early stages of
development.
8

What the Delegates had to say..
Very informatve and interestng
meetng; partcipants are able to
benchmark best practces for
improvement within their own
countries

Highlight training opportunites for
eye health professionals

Very good meetng which
highlighted that we stll have a lot of
work to do if we are to realise the
goals of V2020

Great, great meetng very well
organised and informatve

Include more examples of successful
eye care programmes and best
practce

Schedule more tme for discussing
natonal problems and seeking group
solutons

I will take informaton back to my
country and work with others to form
a V2020 Commitee

The organisers and supporters would like to thank everyone for their continued
commitment to achieving the goal of eliminating avoidable blindness by integrating
equitable, sustainable, comprehensive eye-care systems into national health systems.
We look forward to continued and productive collaboration.
The contents of this publicaton are the sole responsibility of CCB-Eye Care Caribbean and Sightsavers and can in no way be taken to refect the views of the European Union.