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OBJECTIVES:
To raise the awareness among students about World and Indonesian blindness problems and its prevention strategies
INTRODUCTION
Vision is important: - life survival - correlate to quality of lifes ability, intelegency, productivity, social economic
work
cost
goverment : facilities for blinds people
1 6/60 6/18 2 3/60 6/60 3 1/60 3/60 4 Light perception 1/60 5 No light perception _______________________________________________ Criteria : 3,4,5 : Blindness
INDONESIAN BLINDNESS:
Causes of blindness survey 1982 survey 1996
__________________________________________
1. Cataract 2. Glaucoma 3. Retinal diseases 4. Refraction 5. Corneal diseases 0.76 % 0.10 % 0.03 % 0.06 % 0.13 % 1.02 % 0.16 % 0.09 % 0.11 % 0.06 %
1,2,3: aging peoples & life expectancy ( + ) 5: vitamin A deffisiency (- ) ocular infection (-) nutrition (+)
BLINDNESS IN ASIA:
Indonesia ------- 1.5 % Bangladesh --------1 % Myanmar ---------0.9 % Bhutan --------- 0.8 % India ------ 0.6 % Ceylon --- 0.5 % South Korea ------ 0.4 % Thailand --- 0.3 %
BLINDNESS PROBLEMS:
< 0.5% ---0.5 % - 1 % --->1% ---Clinical problems Community health problems Social problems
3- Strategies: cost effective close collaboration among partners global awareness community level 4- Program: Disease prevention & control Personel training Strengthening eye infra structure Apropriate and affordable technology Mobilization of resources
4. Peoples behaviour aspect: Indonesian survey: 79.1 % eyes patient did not look for a treatment Among them who looked for a treatment: 6.7 % used self treatment, 5.4 % went to the hospital, 2.8 % went to the health centre
The person
Ability to ADL Soc.Ec.Cons equences
Medical, surgical
3. Target:
Under five, school ages, productive ages, old peoples Health staffs Professionals NGOs Government
4. Strategies:
Advocation / promotion Eye health care: Primary eye health care ( PEC ) --- health centre Secondary health care ( SEC ) --- district hospital Tertiary health care ( TEC ) ---- province hospital Increase of eye specialist production Education training Research NGOs partnership Develope Information system
PRIMARY EYE CARE: Area : Health centre Services : curative policlinic, admission Refferal TEC & PEC Report & recording Health education Community partisipation SECONDARY EYE CARE: Area : District hospital Service : PEC curative + standard & simple surgery Refferal PEC & TEC Report & recording Health education
TERTIARY EYE CARE: Area : Province hospital Services : SEC curative + hi tech surgery Refferal SEC & PEC Report & recording Health education Research
CATARACT:
Cataract is lens opacity Most common cause of blindness worldwide ( 17 million ) 2020 estimated to be 40 million Surgery: effective & efficient Majority of cases: old age Risk factors: genetic, cigarette smoking,ultra violet exposure,nutrition,diabetic,alcohol use,steroid use
GLAUCOMA
Glaucoma: Primary angle closure Primary open angle common on > 40 years, women > man Risk factors: anatomic predisposition (shallowing anterior chamber, smaller corneal diameter) myop, hypermetrop Prevention: screening
TRACHOMA:
- Infectious eye disease caused by: chlamydia trachomatis - WHO: to cause 15% world blindness - Risk factors : poor community, flies, ethnic, younger age - Trachoma prevention: primary : hygiene secondary : antibiotica tertiary : surgery WHO: strategies of prevention & treatment SAFE : S surgery A antibiotica F face cleanliness E environtment
REFRACTIVE ERROR:
Large proportion : productive age Most common responsible for visual impairment: myopia Risk factors: genetic, near work,intellegence, premature Prevention: spectacle, contact lens, surgery
VITAMINE A DEFFICIENCY:
* 5 - 10 children develop xerophthalmia / year 500.000 blind * Risk factors: geographic, socio culture, measles * Clinical classification: Night blindness ( XN ) Conjunctival Sign ( XI A & XI B ) Xerosis & Bitots spot Corneal Sign ( X2, X3A, X3B) Corneal Scar (XS) * Prevention: Periodic vit A supplementation Fortification of food stuff Vit A rich food
DIABETIC RETINOPATHY:
- Leading cause of blindness in USA & UK among 2074 years old - Risk factors: older age, family history of diabetes, obesity
INTEGRATIONS PROGRAM:
Programs Eye health programs: Preventive, curative, promotive, refferal
1.Maternal and child health care: * pregnant mother toxoplasmosis, rubela, chlamidia, gonorrhoe, Vit. A deff * baby & children cataract congenital & juvenil, eye infection, leucocoria, strabismus, refraction 2. Nutrition vit. A defficiency 3. Health environment trachoma ( or other contagious eye diseases ) 4. Health Industry industrial accident, industrial health care
INTEGRATIONS PROGRAM:
Programs
5. Health education 6. Policlinic (out patient) 7. Dental health care 8. School health care
Refferences:
1. Van Newkirk M, et al 2003 2004 , Basic and Clinical Science Course, section 13.International Ophthalmology.American Academy of Ophthalmo logy, San Fransisco. 2. Dep. Kes RI: Survei Kesehatan Indera Penglihatan 1993-1996