Download Global Perspectives of Blindness

Fighting Blindness in
Non-Western Countries
The socioeconomic impact of the leading causes
of blindness was the impetus for creating many
disease control programs such as Onchocerciasis
Control Programme in 1975. OCP was successful
in eliminating onchocerciasis as a public health
problem in 10 of the 11 countries in which it
operated.
As early as the late nineteenth century,
during a time of hightened quest for infectious
agents, a German missionary naturalist in Ghana,
identified effilaria. In worms of variable length,
living freely or encysted in nodules under the
skin, they could survive for about twelve years.
Their eggs, in the uterus of the female, engender
microscopic larvae, call microfilaria, which can be
found abundantly in the dermis of the skin, the
lymphatic ganglions and eye tissues, live for one or
two years.
Now in the 21st century, there are political and philanthropic groups like the Bill and Melinda Gates and World Optometry Foundations,
granting millions of dollars toward the eradication
of such diseases as onchocerciasis and trachoma,
as well as unnecessarily blinding conditions like
cataract.
Education and support could mean the
difference between a life of poverty and a life of
opportunity for someone who is needlessly blind or
visually impaired.
Links & Resources
www.vision2020.org
www.bmj.com
www.who.int/ncd/vision2020_actionplan
Global
Perspectives
of Blindness
www.cartercenter.org
www.socyberty.com/disabled/low-vision-in-nigeria-independence-day-for-the-blind-and-visuallyimpaired
Text goes here.
www.medicalnewstoday.com/articles/144278.php
www.stanford.wellsphere.com
www.nytimes.com/2002/0310/world/sudan
Lawson, Ligon, Berger
& Bermejo
[email protected]
214-675-4061
Trachoma
Onchocerciasis
and Cataract
Trachoma
Trachoma is the world’s leading infectious cause of
preventable blindness. Most common in Africa, the
Middle East, and parts of Asia this painful eye infection
is caused by a bacterium prevalent in poor communities with limited access to adequata sanitation and clean
water, which leads to a build-up of scar tissue, forcing
the eyelid to curl inward. With each blink, the eyelashes rake over the cornea. Vision is diminished and if
left treated, results in permanent blindness. Trachoma
sufferers eventually blink themselves blind, yet, the
simple surgery has a success rate of 80% and can cost as
little as $10 per person. For those in the early stages of
trachoma, a course of tetracycline ointment or an oral
dose of the antibiotic Zithromax will stop the infection.
Endemic in 55 countries, with 75% of the afflicted
in Africa, trachoma has left 8 million people irreversibly
blind and another 84 million are in need of treatment.
Women and children are most often affected, with
women three times more likely to be blinded by trachoma than men.
Trachoma is spread through a cycle of infection and
reinfection, often, mother to child and back, so long
term elimination is dependent on such preventive, innovative community-based programs as enhanced school
health, education and health worker training to provide
trichiasis surgery.
Early rteatment, before the development of scarring
and lid deformities has an excellent prognosis.
Cataract
Cataract, a clouding of the lens of the eye that impedes
light traveling through to the retina, is responsible for
almost half of the seven million blind Africans, meaning, three and a half million Africans are needlessly
blind. Globally, it’s the single most important cause of
blindness, with estimates at nearly 18 million people
who are bilaterally blind from cataract.
Cataract occurs at a younger age in Africa and
blinds many people there in the prime of their lives.
Blindness there also carries with it a mortality rate four
times higher, and two thirds of the blind people in Africa are women. In many areas, men have twice the access
to eye care as women. A five year study of Guatemalans
cooking on open fires, comined with studies in Asia,
suggest indoor air pollution, (as sell as over exposure to
the sun’s uv rays) can cause potentially and unnecessarily blinding cataracts.
In the U.S., an opthalmologist would usually ypically see about 50 cases of cataract a year.
In comparison, an opthalmologist in India, where
blindness caused by cataract remains a scourge,
there might be as many as 50 cases in a morning!
The primary limitations for eradicating
preventable cataract blindness in non-western
countries are lack of resources and political will
addressing it as a global public health issue.
The W.H.O.’s global Vision 2020 aims to
eliminate blindness due to cataract by providing
education, surgical services at a rate eliminating the
backlog of cataract at an affordable rate, and offering high quality, low cost intraocular lenses.
Onchocerciasis
Once a leading cause of preventable blindness, the
global disease burden of onchocerciasis, a parasitic
infection causing blindness in sub-Saharan Africa, Latin
America and Yemen, has been reduced as a result of successful disease control programs led by the W.H.O. Past
containment efforts relied on spraying larvacide, which
had qualified sucess in reducing the black fly population. That success was short-lived.
Using donated supplies and the services of groups
like the Carter Center, the W.H.O estimates onchocerciasis can be so severly reduced, “...it could be eliminated
as a public health problem.”
Onchocerciasis, also known as ‘River Blindness,’ is
one of a handful of eye diseases hovering on the brink of
eradication, but is hard to finish off. Chances of resurgence appear to be increasing in the Kossou Dam area
of the Ivory Coast, where larvacide was once focused.
Black fly infestation is again prevalent in the area, driving farmers from fields. Invermectin handouts started
again, but the rivier divides the warring factions and
the health system is broken.
Health experts gathered in the Sudan, where war
has raged for almost two decades, blocking most humanitarian efforts, have come up with a straightforard,
yet daunting antidote to the disease: peace.