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Ayesha Abdullah 03.09.2013

Ayesha Abdullah 03.09.2013. 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

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Ayesha Abdullah 03.09.2013

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  1. Ayesha Abdullah 03.09.2013

  2. 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

  3. Why should Ophthalmology be taught and learnt?

  4. Global distribution

  5. BLINDNESS & VI / LOW VISION10 important facts Approximately 314 million people suffer from serious visual impairment 45 million people are blind and 124 million have low vision 75% of blindness is avoidable - i.e. treatable and/or preventable

  6. 10 important facts 90% of visually impaired people live in developing countries Infectious causes of blindness are decreasing. Blinding trachoma now affects fewer than 80 million people, compared to 360 million in 1985

  7. 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 , lifestyle changes rising incidence of chronic blinding conditions such as diabetic retinopathy Women face a greater risk of vision loss than men

  8. 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

  9. Definition of blindness 1. International Statistical Classification of Diseases & related health problems, 10th revision (ICD-10) Why define? 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

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

  11. 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?

  12. 5 3 6 4 2 1 visual acuity less than 3/60

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

  14. best possible correction

  15. visual field loss Better eye less than 100

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

  17. Let’s examine a few scenarios

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

  19. Causes of blindness- Global level

  20. Global causes of blindness

  21. Distribution of causes of blindness

  22. “ 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

  23. Prevalence & major causes of blindness in Pakistan ?

  24. Cataract

  25. Glaucoma

  26. Corneal opacity

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

  28. Trachoma

  29. Age-related macular degeneration

  30. DIABETIC RETINOPATHY

  31. A person has a visual acuity of 3/60 in the right eye and 6/60 in the left eye according to the WHO (ICD-10) classification he • Has moderate visual impairment • Is a blind person • Is blind in the left eye • Is blind in the right eye • Is normal

  32. 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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