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Ayesha Abdullah 08.09.2012

Ayesha Abdullah 08.09.2012. Why should Ophthalmology be taught and learnt?. w. LEARNING OBJECTIVES. By the end of this lecture the students should be able to: Define blindness, visual impairment & low vision according to the WHO- ICD-10 classification

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Ayesha Abdullah 08.09.2012

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  1. Ayesha Abdullah 08.09.2012

  2. Why should Ophthalmology be taught and learnt? w

  3. LEARNING OBJECTIVES By the end of this lecture the students should be able to: Define blindness, visual impairment & low vision according to the WHO- ICD-10 classification Critically evaluate the definition & its implications Describe the global burden of blindness & visual impairment. Identify the major causes of blindness at global and national level. Recognize the impact of blindness on the life of the individual and the society

  4. Azeem Khan a 65 year old person suffered from gradual loss of vision for the past two years. He now has difficulty in recognizing his own family members from a distance of about a yard. He recently retired as a school teacher.

  5. Gul Mohammad a 04 year old child had a history of recurrent diarrohea and upper respiratory infections. He lost sight after having an episode of eye illness at the age of two. Currently he can only see light.

  6. Haroon is a thirteen year old student of class five. He has been using spectacles since early childhood. Without his spectacles he cannot recognize a person a yard away.

  7. Gulzar a 35 year old motor mechanic sustained injury to both his eyes in a bomb blast. Now he can see nothing but darkness.

  8. Definition of blindness 1. International Statistical Classification of Diseases & related health problems, 10th revision (ICD-10) Blindness is defined in different ways in different countries according to the purpose of definition i.e legal, social, clinical etc WHO recommends the ICD-101 –based definition In Pakistan we use the same

  9. http://apps.who.int/classifications/icd10/browse/2010/en

  10. Definition of blindness (ICD-10,Visual impairment (VI) categories 3, 4 & 5) Blindness is defined as a visual acuity (VA) of less than 3/60 (20/400) in the better eye with best possible correction Or A visual field in the better eye to less than 100 from fixation Key words?

  11. 5 3 6 4 2 1 visual acuity less than 3/60

  12. Which one is the better eye? 6/12 1/60 1/60 2/60 in the better eye

  13. best possible correction

  14. visual field loss Better eye less than 100

  15. Blindness;09.01.09

  16. Blindness;09.01.09

  17. Blindness;09.01.09

  18. Ind-Society Individual Organ Disease ——> Impairment ——> Disability ——> Handicap Organ system Damage Disadvantages to a person because of the impairment & disability Loss of performance

  19. Let’s examine a few scenarios

  20. EPIDEMIOLOGY OF BLINDNESS AND VISUAL IMPAIRMENT; MAGNITUDE AND CAUSES

  21. MAGNITUDE OF BLINDNESS & VI- 10 important facts Approximately 314 million people suffer from serious visual impairment Of these, 45 million people are blind and 124 million have low vision Yet 75% of blindness is avoidable - i.e. treatable and/or preventable

  22. 10 important facts 90% of visually impaired people live in developing countries Infectious causes of blindness are decreasing as a result of public health interventions and socio-economic development. Blinding trachoma now affects fewer than 80 million people, compared to 360 million in 1985

  23. 10 important facts 153 million people’s visual impairment is due to uncorrected refractive errors. In most cases, normal vision could be restored with eyeglasses Aging populations and lifestyle changes mean that chronic blinding conditions such as diabetic retinopathy are now rising Women face a greater risk of vision loss than men

  24. 10 important facts Without effective, major intervention, the number of blind people worldwide is projected to increase to 76 million by 2020  Restorations of sight, and blindness prevention strategies are among the most cost-effective interventions in health care

  25. Global distribution

  26. Causes of blindness, Global level

  27. Global causes of blindness

  28. Distribution of causes of blindness

  29. “ Avoidable & unavoidable blindness” • Blindness which could be either treated or prevented by known, cost-effective means • Cataract • Refractive errors • Diabetic retinopathy • Unavoidable blindness • Retinal causes of childhood blindness • ARMD

  30. Prevalence & major causes of blindness in Pakistan msqheartline@hotmail.com ?

  31. Cataract

  32. Glaucoma

  33. Corneal opacity

  34. Childhood blindnessmortality & morbidity Corneal xerosis Normal Keratomalacia Bitot spot Vitamin A deficiency

  35. Trachoma

  36. Age-related macular degeneration

  37. learning resources • http://www.who.int/mediacentre/factsheets/fs282/en/ (WHO website) • http://www.v2020.org/page.asp?section=000100010002 ( Vision 2020 website) • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486591/pdf/bullwho00405-0112.pdf • http://www.who.int/classifications/apps/icd/icd10online/ (ICD-10) • http://www.who.int/blindness/Change%20the%20Definition%20of%20Blindness.pdf • Textbook • Johnson GJ, Minassian DC, Weale RA, WestSk (editors). Prevalence, incidence and distribution of visual impairment. In The epidemiology of eye disease, 2nd Ed. London. Arnold 2003; 3-5

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