Community ophthalmology aims to provide comprehensive eye health care through public health approaches like epidemiology, health promotion, and primary eye care. It focuses on preventive, curative, and promotive community-based activities. Key aspects include epidemiological studies of eye diseases, policy and planning, management information systems, monitoring and evaluation, environmental eye health, economics of eye care, behavioral sciences, biostatistics, and project management. Community ophthalmology specialists employ public health approaches and work in community settings to address the epidemic of preventable blindness.
This document summarizes information about community ophthalmology and the National Programme for Control of Blindness (NPCB) in India. It discusses the basic principles of community ophthalmology, types of blindness, goals of the NPCB program, and strategies to reduce blindness prevalence such as cataract surgery programs and health education. The global Vision 2020 initiative to eliminate avoidable blindness is also summarized.
1. Approximately 285 million people worldwide have visual impairments, with 246 million having low vision and 39 million being blind.
2. The leading causes of blindness are cataract (62%), refractive error (19.7%), and glaucoma (5.8%).
3. In India, there are 7.8 million blind people and 45 million with low vision, accounting for 20% of the world's blind population.
4. The National Programme for Control of Blindness was launched in 1976 with the goal of reducing blindness prevalence from 1.4% to 0.3% by 2020 through strengthening eye care services, training human resources, and increasing public awareness.
Aphakia and its causes. Correction of Aphakia. Advantages and disadvantages of different corrections. Surgeries and related signs and symptoms of aphakia. Complications related to Aphakia.
PARALYTIC SQUINT
KANISHK DEEP SHARMA
ROLL NO. 50
Uncoordinated eye movement
Angle of squint varies
Motor imbalance
ETIOLOGY
Lesion of nerve
Lesion of muscles
Lesions due to
Injury
Inflammation-syphilis, disseminated sclerosis
Vascular diseases-hemorrhage, aneurysm,arteriosclerosis
Neoplasms-brain tumor
Toxins-alcohol, lead, carbon monoxide
Degeneration-chronic nuclear ophthalmoplegia
Myasthenia gravis
SYMPTOMS
DIPLOPIA
In field of action of paralyzed muscle
Long duration- suppression of false image
Vertigo & nausea
Action required towards paralysed muscle
False projection
Binocular diplopia
Secondry deviation
Defective ocular motility
Complementary head postures
Attempt to lessen diplopia
Head tilt to avoid torsion
SEQUALAE
Weakness of paretic muscle
Overacting contralateral synergistic muscle
Inhibitory palsy of contralateral antagonist
TESTS
Record of visual acuity
Ocular motility
Perimetry
Inspection of compensatory head postures
Diplopia charting
Dark room procedure
Armstrong's glasses
4ft distance, fine linear light
Primary & other positions of gaze measured
Hess charting
Explains muscle paralysis & pathological sequlae
Field of binocular fixation
Forced duction test
MANAGEMENT
Treatment of cause
Conservative measures
Vit B complex, systemic steroids
Diplopia treatment
Occluder on affected eye
SURGERIES
Muscle weakening procedure
Recession, marginal myotomy, myectomy
Muscle strengthening procedures
Resection, tucking advancement
Changing direction of muscle action
THANK YOU
The cover test is used to qualitatively measure strabismus. It involves covering each eye separately while having the patient fixate on a target. This allows the examiner to observe any movement in the uncovered eye, indicating the presence or absence of a manifest deviation. There are three main types of cover tests: direct cover test to detect manifest squint, cover-uncover test to detect heterophoria, and alternate cover test to differentiate between unilateral and alternating squint and determine if the deviation is concomitant or paralytic. The results of the cover test help diagnose the type of strabismus present.
Community ophthalmology focuses on preventive aspects of eye care directed at a population rather than curative care for individual patients. It aims to prevent blindness and visual impairment through primary eye care, epidemiological assessment of communities, and programs targeting major causes of blindness like cataract, refractive error, and childhood blindness. The WHO guidelines recommend conditions that primary eye care workers can treat, refer after initial treatment, and refer directly for treatment. Community ophthalmology is needed globally as 285 million people have vision impairment and 90% live in developing countries, where 80% of cases are preventable or treatable.
The cornea is the main refractive element of the eye, contributing 70% of the eye's refractive power. Even minor changes to its shape can significantly alter the image formed on the retina. The cornea has an elliptical anterior surface and a circular posterior surface. It varies in thickness from center to periphery. Corneal topography is used to map the shape of the cornea using various techniques such as Placido disk, elevation-based, and Scheimpflug imaging. Topography provides quantitative data on corneal curvature, thickness, and irregularities that aid in diagnosing conditions like keratoconus.
Convergence insufficiency is the inability to maintain binocular convergence without undue effort. It is the most common cause of eyestrain. It can be caused by refractive errors, presbyopia, muscle imbalances, or other factors like wide pupil distance. Clinical features include eyestrain in desk workers and blurred near vision. Diagnosis involves measuring near point of convergence over 10cm and difficulty maintaining 30 degrees of convergence. Treatment includes optical correction, orthoptic exercises to improve near point convergence and fusional vergence, relaxation exercises, and prism therapy. Surgical treatment is a last resort.
This document summarizes information about community ophthalmology and the National Programme for Control of Blindness (NPCB) in India. It discusses the basic principles of community ophthalmology, types of blindness, goals of the NPCB program, and strategies to reduce blindness prevalence such as cataract surgery programs and health education. The global Vision 2020 initiative to eliminate avoidable blindness is also summarized.
1. Approximately 285 million people worldwide have visual impairments, with 246 million having low vision and 39 million being blind.
2. The leading causes of blindness are cataract (62%), refractive error (19.7%), and glaucoma (5.8%).
3. In India, there are 7.8 million blind people and 45 million with low vision, accounting for 20% of the world's blind population.
4. The National Programme for Control of Blindness was launched in 1976 with the goal of reducing blindness prevalence from 1.4% to 0.3% by 2020 through strengthening eye care services, training human resources, and increasing public awareness.
Aphakia and its causes. Correction of Aphakia. Advantages and disadvantages of different corrections. Surgeries and related signs and symptoms of aphakia. Complications related to Aphakia.
PARALYTIC SQUINT
KANISHK DEEP SHARMA
ROLL NO. 50
Uncoordinated eye movement
Angle of squint varies
Motor imbalance
ETIOLOGY
Lesion of nerve
Lesion of muscles
Lesions due to
Injury
Inflammation-syphilis, disseminated sclerosis
Vascular diseases-hemorrhage, aneurysm,arteriosclerosis
Neoplasms-brain tumor
Toxins-alcohol, lead, carbon monoxide
Degeneration-chronic nuclear ophthalmoplegia
Myasthenia gravis
SYMPTOMS
DIPLOPIA
In field of action of paralyzed muscle
Long duration- suppression of false image
Vertigo & nausea
Action required towards paralysed muscle
False projection
Binocular diplopia
Secondry deviation
Defective ocular motility
Complementary head postures
Attempt to lessen diplopia
Head tilt to avoid torsion
SEQUALAE
Weakness of paretic muscle
Overacting contralateral synergistic muscle
Inhibitory palsy of contralateral antagonist
TESTS
Record of visual acuity
Ocular motility
Perimetry
Inspection of compensatory head postures
Diplopia charting
Dark room procedure
Armstrong's glasses
4ft distance, fine linear light
Primary & other positions of gaze measured
Hess charting
Explains muscle paralysis & pathological sequlae
Field of binocular fixation
Forced duction test
MANAGEMENT
Treatment of cause
Conservative measures
Vit B complex, systemic steroids
Diplopia treatment
Occluder on affected eye
SURGERIES
Muscle weakening procedure
Recession, marginal myotomy, myectomy
Muscle strengthening procedures
Resection, tucking advancement
Changing direction of muscle action
THANK YOU
The cover test is used to qualitatively measure strabismus. It involves covering each eye separately while having the patient fixate on a target. This allows the examiner to observe any movement in the uncovered eye, indicating the presence or absence of a manifest deviation. There are three main types of cover tests: direct cover test to detect manifest squint, cover-uncover test to detect heterophoria, and alternate cover test to differentiate between unilateral and alternating squint and determine if the deviation is concomitant or paralytic. The results of the cover test help diagnose the type of strabismus present.
Community ophthalmology focuses on preventive aspects of eye care directed at a population rather than curative care for individual patients. It aims to prevent blindness and visual impairment through primary eye care, epidemiological assessment of communities, and programs targeting major causes of blindness like cataract, refractive error, and childhood blindness. The WHO guidelines recommend conditions that primary eye care workers can treat, refer after initial treatment, and refer directly for treatment. Community ophthalmology is needed globally as 285 million people have vision impairment and 90% live in developing countries, where 80% of cases are preventable or treatable.
The cornea is the main refractive element of the eye, contributing 70% of the eye's refractive power. Even minor changes to its shape can significantly alter the image formed on the retina. The cornea has an elliptical anterior surface and a circular posterior surface. It varies in thickness from center to periphery. Corneal topography is used to map the shape of the cornea using various techniques such as Placido disk, elevation-based, and Scheimpflug imaging. Topography provides quantitative data on corneal curvature, thickness, and irregularities that aid in diagnosing conditions like keratoconus.
Convergence insufficiency is the inability to maintain binocular convergence without undue effort. It is the most common cause of eyestrain. It can be caused by refractive errors, presbyopia, muscle imbalances, or other factors like wide pupil distance. Clinical features include eyestrain in desk workers and blurred near vision. Diagnosis involves measuring near point of convergence over 10cm and difficulty maintaining 30 degrees of convergence. Treatment includes optical correction, orthoptic exercises to improve near point convergence and fusional vergence, relaxation exercises, and prism therapy. Surgical treatment is a last resort.
Cycloplegic refraction involves temporarily paralyzing the ciliary muscle with eye drops in order to determine a person's full refractive error. This is important for children who accommodate too much. Common cycloplegic agents include atropine, homatropine, and cyclopentolate. Cyclopentolate is often the drug of choice due to its faster onset and shorter duration. A cycloplegic refraction allows an accurate assessment of refractive error, especially in children and other patients where accommodation can affect results.
Vision therapy involves various eye exercises and techniques to treat eye movement disorders and other vision issues. Some common techniques described in the document include Brock string, barrel card/3 dot card, chiastopic fusion using colored circles or eccentric circles, tranaglyph, and vergence rock. These techniques aim to develop convergence skills, eliminate suppression, increase fusional vergence ranges and facility, and achieve single binocular vision through activities like fusion of targets at varying distances and under different visual conditions. Equipment used includes strings, cards with dots or circles in varying configurations, prisms, and electronic devices to practice fusion. Therapies continue until specific criteria for convergence ability, awareness of eye movements, and fusion are met.
The document provides information about the Jackson Crossed-Cylinder (JCC) technique for determining astigmatism during eye exams. It discusses the optics and proper use of the JCC. It describes the historical origins of the JCC, how it works, and the step-by-step procedure for using it to refine the axis and power of astigmatic corrections. Common sources of error are also outlined. The JCC is presented as an important tool for optometrists to accurately measure and correct astigmatism in clinical practice.
Amblyopia is a condition of reduced vision in one or both eyes that is not caused by structural eye problems. It occurs during early childhood development when there is inadequate visual stimulation to one or both eyes. Common causes include strabismus, significant refractive error differences between the eyes, form deprivation, and abnormal binocular interaction. Treatment involves correcting any refractive errors and using occlusion therapy or drugs to blur vision in the non-amblyopic eye, forcing use of the amblyopic eye. Occlusion therapy is the most common treatment but requires compliance to achieve results. Other options include penalization, visual stimulation, and drugs, but occlusion remains the standard first approach. Success depends on early diagnosis and treatment before age 7.
This document discusses strabismus (misalignment of the eyes) including:
1. Definitions of strabismus, heterophoria (latent squint), and heterotropia (manifest squint).
2. Types of strabismus including esotropia (inward turning), exotropia (outward turning), and vertical deviations.
3. Extraocular muscles that control eye movement and their nerve supply.
4. Medical and surgical treatments for strabismus including occlusion therapy, prisms, botulinum toxin injections, and different surgical procedures.
Primary level eye care services include screening programs, community awareness activities, and basic treatment. Services focus on refractive error correction, presbyopia management, and referring patients for further care. Key aspects are integrating eye care into primary health systems, training community health workers, and ensuring affordable access to eye examinations and corrective devices through community-based screening.
This document provides an overview of retinoscopy, including:
- A brief history and the development of different types of retinoscopes.
- The optical principles behind how retinoscopy works to assess refractive error.
- Different techniques for performing retinoscopy, including static, dynamic, and near retinoscopy.
- Factors that can impact the results or make retinoscopy more difficult in some patients.
- Uses of retinoscopy beyond assessing refractive error, such as detecting other ocular issues.
This document discusses suppression, which is one of the three mechanisms of sensory adaptation that occurs in patients with strabismus. Suppression refers to the active inhibition of the image from the deviated eye to avoid diplopia. There are different types of suppression depending on factors such as etiology, retinal area involved, constancy, and the eye affected. Several tests are used to diagnose suppression including the Worth four dot test, Bagolini striated glass test, and visual acuity testing. Treatment involves refractive correction, occlusion therapy, eye alignment procedures, and anti-suppression exercises.
This document discusses various congenital anomalies that can occur in the eye. It covers anomalies of the eyelid, cornea, lens, uveal tract, retina, choroid, lacrimal apparatus, orbit, and optic nerve. For each structure, it provides examples of specific anomalies such as ptosis, coloboma, aniridia, persistent pupillary membrane, optic nerve hypoplasia, and more. It describes the signs, causes, and other clinical features of each congenital ocular anomaly.
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESSManoj Arockia
The National Programme for Control of Blindness in India was launched in 1976 with the goal of reducing blindness prevalence from 1.4% to 0.3%. Its key activities include expanding eye care services, establishing permanent infrastructure, and intensifying eye health education. It operates through a three-tier system at the peripheral, intermediate, and central levels. At each level it focuses on providing primary, secondary, and tertiary eye care services. It has also adopted strategic plans like 'Vision 2020: Right to Sight' to address specific blinding conditions and achieve its goal of eliminating avoidable blindness by 2020.
Anisometropia is a condition where the two eyes have unequal refractive power. It can be congenital due to unequal eyeball growth, or acquired such as after cataract surgery. There are different types including simple where one eye is normal and the other myopic or hyperopic, compound where both eyes are myopic or hyperopic but to different degrees, and mixed where one eye is myopic and the other hyperopic. Treatments include spectacles up to 4 diopters of difference, contact lenses for higher degrees, and refractive surgery for high unilateral refractive errors.
This document discusses the importance of sports vision and the role of optometrists in evaluating various visual skills needed for athletes. It outlines how optometrists can test visual acuity, depth perception, eye tracking, hand-eye coordination and more. The document also describes various vision training techniques and devices that can help improve these skills. Maintaining good ocular health and using protective eyewear can help prevent sports-related eye injuries.
This document discusses measuring interpupillary distance (IPD). It begins by defining IPD as the distance between the centers of the two pupils. It then lists several instruments that can be used to measure IPD, including rulers, gauges, and digital meters. The document provides techniques for measuring both binocular and monocular IPD using a ruler. It also discusses measuring near IPD, either directly or by calculating it using the three-quarter rule based on dioptric demand and distance PD. An example calculation of near IPD is shown.
Types of pediatric contact lens [autosaved]Bipin Koirala
This document discusses pediatric contact lens fitting and evaluation. It begins by outlining the advantages of contact lenses over glasses for children, including a wider field of view. Key considerations for fitting include small eye size, tear production, and compliance. Conditions that may require lenses include refractive errors, amblyopia treatment, and aphakia following cataract surgery. Evaluations include testing visual acuity and ocular health. Lens options discussed are silicone, hydrogel, and rigid gas permeable lenses. Special fitting considerations for aphakic children include initially high powers of +20D to +35D, depending on age.
The document summarizes the Amsler grid, a diagnostic tool used since 1945 to screen for and monitor macular diseases. It consists of a grid with a central dot that patients look at to detect any distortions, gaps, or blurred areas in their central vision. Various versions are available, including ones with different colors, patterns of lines, or dot sizes to test specific parts of the visual field and detect different types of visual abnormalities that could indicate conditions like macular degeneration or glaucoma. The procedure involves having patients view the grid with each eye separately at 16 inches and report any anomalies in the lines of the grid.
This document discusses community ophthalmology and the prevention of blindness. It describes community ophthalmology as a shift from individualized eye care to a community-directed approach aimed at improving overall ocular health. Both hospital-based and community-based services are essential. The document also discusses defining and determining the magnitude of blindness, its leading causes globally and in Nepal, and approaches to control blindness through primary, secondary and tertiary prevention activities.
The National Programme for Control of Blindness (NPCB) in India was launched in 1976 with the goal of reducing blindness prevalence to 0.3% by 2020. A 2006-07 survey showed blindness rates fell from 1.1% to 1%. Major developments included inclusion in the Prime Minister's 20-point programme in 1982 and a 1994-2001 World Bank-funded cataract blindness control project. NPCB's objectives are to reduce backlog blindness through identification and treatment, develop eye care facilities, human resources, and quality services. It employs a four-pronged strategy of strengthening services, developing human resources, promoting outreach and awareness, and institutional capacity building. Revised strategies shift to fixed facilities, expand World Bank
Cycloplegic refraction involves temporarily paralyzing the ciliary muscle with eye drops in order to determine a person's full refractive error. This is important for children who accommodate too much. Common cycloplegic agents include atropine, homatropine, and cyclopentolate. Cyclopentolate is often the drug of choice due to its faster onset and shorter duration. A cycloplegic refraction allows an accurate assessment of refractive error, especially in children and other patients where accommodation can affect results.
Vision therapy involves various eye exercises and techniques to treat eye movement disorders and other vision issues. Some common techniques described in the document include Brock string, barrel card/3 dot card, chiastopic fusion using colored circles or eccentric circles, tranaglyph, and vergence rock. These techniques aim to develop convergence skills, eliminate suppression, increase fusional vergence ranges and facility, and achieve single binocular vision through activities like fusion of targets at varying distances and under different visual conditions. Equipment used includes strings, cards with dots or circles in varying configurations, prisms, and electronic devices to practice fusion. Therapies continue until specific criteria for convergence ability, awareness of eye movements, and fusion are met.
The document provides information about the Jackson Crossed-Cylinder (JCC) technique for determining astigmatism during eye exams. It discusses the optics and proper use of the JCC. It describes the historical origins of the JCC, how it works, and the step-by-step procedure for using it to refine the axis and power of astigmatic corrections. Common sources of error are also outlined. The JCC is presented as an important tool for optometrists to accurately measure and correct astigmatism in clinical practice.
Amblyopia is a condition of reduced vision in one or both eyes that is not caused by structural eye problems. It occurs during early childhood development when there is inadequate visual stimulation to one or both eyes. Common causes include strabismus, significant refractive error differences between the eyes, form deprivation, and abnormal binocular interaction. Treatment involves correcting any refractive errors and using occlusion therapy or drugs to blur vision in the non-amblyopic eye, forcing use of the amblyopic eye. Occlusion therapy is the most common treatment but requires compliance to achieve results. Other options include penalization, visual stimulation, and drugs, but occlusion remains the standard first approach. Success depends on early diagnosis and treatment before age 7.
This document discusses strabismus (misalignment of the eyes) including:
1. Definitions of strabismus, heterophoria (latent squint), and heterotropia (manifest squint).
2. Types of strabismus including esotropia (inward turning), exotropia (outward turning), and vertical deviations.
3. Extraocular muscles that control eye movement and their nerve supply.
4. Medical and surgical treatments for strabismus including occlusion therapy, prisms, botulinum toxin injections, and different surgical procedures.
Primary level eye care services include screening programs, community awareness activities, and basic treatment. Services focus on refractive error correction, presbyopia management, and referring patients for further care. Key aspects are integrating eye care into primary health systems, training community health workers, and ensuring affordable access to eye examinations and corrective devices through community-based screening.
This document provides an overview of retinoscopy, including:
- A brief history and the development of different types of retinoscopes.
- The optical principles behind how retinoscopy works to assess refractive error.
- Different techniques for performing retinoscopy, including static, dynamic, and near retinoscopy.
- Factors that can impact the results or make retinoscopy more difficult in some patients.
- Uses of retinoscopy beyond assessing refractive error, such as detecting other ocular issues.
This document discusses suppression, which is one of the three mechanisms of sensory adaptation that occurs in patients with strabismus. Suppression refers to the active inhibition of the image from the deviated eye to avoid diplopia. There are different types of suppression depending on factors such as etiology, retinal area involved, constancy, and the eye affected. Several tests are used to diagnose suppression including the Worth four dot test, Bagolini striated glass test, and visual acuity testing. Treatment involves refractive correction, occlusion therapy, eye alignment procedures, and anti-suppression exercises.
This document discusses various congenital anomalies that can occur in the eye. It covers anomalies of the eyelid, cornea, lens, uveal tract, retina, choroid, lacrimal apparatus, orbit, and optic nerve. For each structure, it provides examples of specific anomalies such as ptosis, coloboma, aniridia, persistent pupillary membrane, optic nerve hypoplasia, and more. It describes the signs, causes, and other clinical features of each congenital ocular anomaly.
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESSManoj Arockia
The National Programme for Control of Blindness in India was launched in 1976 with the goal of reducing blindness prevalence from 1.4% to 0.3%. Its key activities include expanding eye care services, establishing permanent infrastructure, and intensifying eye health education. It operates through a three-tier system at the peripheral, intermediate, and central levels. At each level it focuses on providing primary, secondary, and tertiary eye care services. It has also adopted strategic plans like 'Vision 2020: Right to Sight' to address specific blinding conditions and achieve its goal of eliminating avoidable blindness by 2020.
Anisometropia is a condition where the two eyes have unequal refractive power. It can be congenital due to unequal eyeball growth, or acquired such as after cataract surgery. There are different types including simple where one eye is normal and the other myopic or hyperopic, compound where both eyes are myopic or hyperopic but to different degrees, and mixed where one eye is myopic and the other hyperopic. Treatments include spectacles up to 4 diopters of difference, contact lenses for higher degrees, and refractive surgery for high unilateral refractive errors.
This document discusses the importance of sports vision and the role of optometrists in evaluating various visual skills needed for athletes. It outlines how optometrists can test visual acuity, depth perception, eye tracking, hand-eye coordination and more. The document also describes various vision training techniques and devices that can help improve these skills. Maintaining good ocular health and using protective eyewear can help prevent sports-related eye injuries.
This document discusses measuring interpupillary distance (IPD). It begins by defining IPD as the distance between the centers of the two pupils. It then lists several instruments that can be used to measure IPD, including rulers, gauges, and digital meters. The document provides techniques for measuring both binocular and monocular IPD using a ruler. It also discusses measuring near IPD, either directly or by calculating it using the three-quarter rule based on dioptric demand and distance PD. An example calculation of near IPD is shown.
Types of pediatric contact lens [autosaved]Bipin Koirala
This document discusses pediatric contact lens fitting and evaluation. It begins by outlining the advantages of contact lenses over glasses for children, including a wider field of view. Key considerations for fitting include small eye size, tear production, and compliance. Conditions that may require lenses include refractive errors, amblyopia treatment, and aphakia following cataract surgery. Evaluations include testing visual acuity and ocular health. Lens options discussed are silicone, hydrogel, and rigid gas permeable lenses. Special fitting considerations for aphakic children include initially high powers of +20D to +35D, depending on age.
The document summarizes the Amsler grid, a diagnostic tool used since 1945 to screen for and monitor macular diseases. It consists of a grid with a central dot that patients look at to detect any distortions, gaps, or blurred areas in their central vision. Various versions are available, including ones with different colors, patterns of lines, or dot sizes to test specific parts of the visual field and detect different types of visual abnormalities that could indicate conditions like macular degeneration or glaucoma. The procedure involves having patients view the grid with each eye separately at 16 inches and report any anomalies in the lines of the grid.
This document discusses community ophthalmology and the prevention of blindness. It describes community ophthalmology as a shift from individualized eye care to a community-directed approach aimed at improving overall ocular health. Both hospital-based and community-based services are essential. The document also discusses defining and determining the magnitude of blindness, its leading causes globally and in Nepal, and approaches to control blindness through primary, secondary and tertiary prevention activities.
The National Programme for Control of Blindness (NPCB) in India was launched in 1976 with the goal of reducing blindness prevalence to 0.3% by 2020. A 2006-07 survey showed blindness rates fell from 1.1% to 1%. Major developments included inclusion in the Prime Minister's 20-point programme in 1982 and a 1994-2001 World Bank-funded cataract blindness control project. NPCB's objectives are to reduce backlog blindness through identification and treatment, develop eye care facilities, human resources, and quality services. It employs a four-pronged strategy of strengthening services, developing human resources, promoting outreach and awareness, and institutional capacity building. Revised strategies shift to fixed facilities, expand World Bank
The document discusses blindness, including its definition, categories of visual impairment, major causes, and the problem statement. It covers changing concepts in healthcare with regards to eye care and prevention of blindness through primary, secondary and tertiary prevention methods. The Vision 2020 initiative to eliminate avoidable blindness is also summarized. Major causes of blindness in India are discussed, along with epidemiological determinants and methods of intervention through primary, secondary and tertiary care. Specific prevention programs like trachoma control, vitamin A prophylaxis and occupational eye health services are highlighted.
Session 100 usable by everybody design principles for accessibility on mac...stephentwo
The document discusses design principles for accessibility on Mac OS X. It covers three main focus areas: users, technologies, and developers. For users, it discusses considerations for visual, auditory, cognitive and physical disabilities. It provides examples of built-in accessibility features like VoiceOver, adjustable font sizes, sound alternatives to audio feedback, full keyboard support, and simplifying interfaces. For developers, it recommends following principles of perceivable, operable, understandable and robust design when implementing universal access.
The document provides information about low vision rehabilitation and tips for independence with low vision. It defines low vision as vision impairment that cannot be fully corrected and discusses how low vision specialists can assess functional vision and prescribe optical and electronic aids, as well as provide rehabilitation services, to help those with low vision maximize their remaining sight and function independently. Common causes and types of vision loss are described along with the roles of different eye care professionals in low vision care.
This document discusses visual disorders and low vision. It defines different levels of visual impairment from moderate to profound based on best corrected visual acuity and visual field diameter. Causes of low vision including various eye diseases are described. Methods of low vision evaluation and different low vision devices like magnifiers, telescopes, electronic devices are explained. Low vision rehabilitation strategies including use of assistive devices and training are also summarized.
The document outlines the National Prevention of Blindness Program which aims to eliminate avoidable blindness in the Philippines by 2020 in accordance with the global VISION 2020 initiative. It identifies the top three preventable causes of blindness - cataract, refractive errors, and childhood blindness. The program's vision is for all Filipinos to enjoy the right to sight by 2020 through strengthening partnerships, empowering communities, providing quality eye care, and alleviating poverty by restoring sight. Key objectives include increasing cataract surgeries and reducing visual impairment from refractive errors and childhood blindness.
This document discusses control of blindness globally and in India. It defines blindness and provides classifications of visual impairment. Around 180 million people worldwide are visually disabled, with 80% of cases being avoidable. In India, the major causes of blindness are cataract, refractive error, and glaucoma. Prevention strategies include primary, secondary, and tertiary eye care as well as specific programs and long-term measures. The National Programme for Control of Blindness was established in 1976 with the goal of reducing blindness prevalence. It focuses on developing eye care infrastructure, human resources, and participation of voluntary organizations. The program's objectives are to reduce the backlog of blindness cases and improve service quality.
National Programme for Control of Blindness (NPCB) was launched in 1976 with the goal of reducing blindness prevalence from 1.4% to 0.3%. Main causes of blindness are cataract, refractive error, corneal blindness, glaucoma, and others. NPCB aims to reduce backlog of blindness, develop eye care facilities in every district, and improve human resources and service delivery. It functions at central, state, and district levels. Strategies include strengthening service delivery, developing human resources, promoting awareness, and building institutional capacity. The Vision 2020 initiative also aims to eliminate avoidable blindness by 2020 through a four-tiered structure of centers of excellence, training centers, service centers, and vision centers.
Viral conjunctivitis shows a fine, diffuse pinkness of the conjunctiva, which is easily mistaken for the ciliary infection of Iris (Iritis), but there are usually corroborative signs onmicroscopy, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.
Some other viruses that can infect the eye include Herpes simplex virus and Varicella zoster
1) Blindness is defined as visual acuity less than 3/60 or inability to count fingers at 3 meters. It affects 180 million people worldwide, of whom 45 million are blind.
2) Cataract (19 million), glaucoma (6.4 million), and trachoma (5.6 million) are the leading causes of blindness globally. In India, cataract causes 62.6% of blindness.
3) Prevention programs focus on primary, secondary, and tertiary eye care as well as specific initiatives for conditions like trachoma and school eye health services. The goal is to reduce blindness prevalence through improved access to eye care.
Conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva caused by bacteria, viruses, allergens, or chemicals. There are five main types defined by their causes. Symptoms include redness, tearing, thick discharge, itching, and blurred vision. Treatment depends on the cause, but may include antibiotics, antivirals, or avoiding allergens. It is highly contagious and spreads easily between people and objects. Proper hygiene can help prevent transmission.
The document discusses India's Vision 2020 plan to become a developed nation. It states that achieving this vision will require strong commitment from political leadership and that implementation should be de-linked from political parties. It outlines some key areas of focus for Vision 2020, including administrative efficiency, supporting small and medium enterprises, eliminating poverty, improving health and education, and developing infrastructure like transportation and power plants. The document also provides background on operational research and how modeling approaches could help achieve the goals of Vision 2020.
This document discusses eye care for critically ill patients in the ICU. It notes that the eyes can provide important diagnostic clues for underlying diseases and that ICU patients are at risk for various eye complications due to factors like altered blinking reflexes and eyelid closure. It recommends that ICUs assess patients' ability to close eyelids daily and monitor for eye issues weekly. Eye care including cleaning and lubrication every 2 hours is advised for patients unable to close eyes independently. Maintaining eyelid closure or using mechanical methods if needed is also recommended. The use of polyethylene covers is cited as more effective than ointments at preventing corneal abrasions.
The document discusses bats and their ability to use echolocation to catch insects at night. It notes that bats emit rapidly beating cries and listen to the echoes to detect prey. A similar human analog is a blind person tapping with a cane to sense their environment through sound. The document also mentions that bats and other animals like dolphins have sonar abilities that rival or surpass modern radar and sonar technology.
This document defines and describes various types of conjunctivitis, including infective bacterial conjunctivitis caused by organisms like Staphylococcus aureus and transmitted through flies or poor hygiene. Viral conjunctivitis is common and often caused by adenovirus. Ophthalmia neonatorum describes bilateral inflammation in infants less than 30 days old which can be caused by gonorrhea, chlamydia, or chemicals. Allergic conjunctivitis includes seasonal forms related to airborne allergens. Granulomatous conjunctivitis involves proliferative lesions possibly from tuberculosis, sarcoidosis, or leprosy. Cicatricial conjunctivitis can arise from conditions like
This document provides information about optometry and the optometric education process. It defines optometry as primary eye care and outlines the roles and responsibilities of optometrists. The document discusses the education path to becoming an optometrist, including undergraduate prerequisites, optometry school curriculum, clinical rotations, residencies, and licensing requirements. It also highlights features of the New England College of Optometry such as their clinical education model, research opportunities, and campus location in Boston.
This document discusses primary eye care (PEC) and its importance as a component of primary health care. PEC aims to change eye care services from being limited to hospitals in cities to countrywide blindness prevention programs. It describes the elements of primary health care that relate to PEC, such as immunization, control of endemic diseases, and provision of essential drugs like tetracycline eye ointment. The document also outlines the goals, components, and workers involved in comprehensive eye care delivered at the community level to make services universally accessible.
The document discusses the field of public health dentistry. It provides definitions of key terms like public health and dental public health. It describes the historical development of public health and changing concepts in public health from disease control to health promotion to social engineering to health for all. It outlines tools used in dental public health like epidemiology and biostatistics. It discusses characteristics of ideal public health measures and services provided through public health dentistry.
Determining an ocular health problem as a public health issuesurajsenjam
This document discusses criteria for determining if an ocular health problem should be considered a public health issue. It outlines five criteria: 1) the magnitude of disease outcomes in the population, 2) the burden of disease outcomes in terms of morbidity, mortality, economics and quality of life, 3) if outcomes are increasing and expected to increase further, 4) if outcomes are perceived as a threat, and 5) if outcomes can be prevented at a public level. The document argues that for ocular health, outcome prevention should be prioritized over disease prevention. It provides examples analyzing various eye diseases in terms of the five criteria to determine their status as public health issues.
Co-ordinated malaria research for better policy and practice: the role of res...ACT Consortium
Prof. David Schellenberg from the London School of Hygiene & Tropical Medicine presents on behalf of the ACT Consortium at the European Congress on Tropical Medicine and International Health in Basel, Switzerland, 8 September 2015
Introduction Lecture for Implementation ScienceMartha Seife
This document provides an overview of a workshop on implementation science held in Hawassa University from August 21-25, 2017. The purpose of the workshop was to familiarize participants with implementation science concepts and methods and help them develop individual implementation science projects. Topics covered included an introduction to implementation science, the know-do gap between evidence and practice, definitions of implementation science, and examples of social and system interventions to reduce perinatal mortality. Implementation challenges and the role of evidence-based practices in implementation science were also discussed.
This document provides an overview of operational research (OR). It discusses the history, definition, scope, phases and applications of OR. OR aims to apply scientific techniques to improve decision making and maximize benefits. It has been used extensively in public health to strengthen programs. Some examples of OR discussed are studies conducted by RNTCP to improve tuberculosis case detection and treatment. OR plays an important role in evaluating and improving health systems but faces challenges like limited funding and trained workforce.
Epidemiology is defined as the study of the distribution and determinants of health-related states in populations. It differs from clinical medicine in that it focuses on groups rather than individuals and uses quantitative tools to study communities. Epidemiology has many uses including healthcare management by making community diagnoses, understanding disease processes, guiding public health practice through disease investigation and surveillance, and informing clinical practice and research through evaluating treatments and assessing effectiveness of diagnostic procedures. Overall, epidemiology provides essential population-level insights that aid in healthcare planning, policy development, and clinical decision-making.
This document discusses several key ethical issues in public health, including disparities in health and access to care, responding to infectious diseases, international health cooperation, exploitation of individuals, health promotion, and ensuring participation, transparency and accountability. It also compares research activities and non-research public health practices, noting some common ethical tensions between individual and community interests as well as oversight mechanisms.
Vision health an integral part of public health in nigeriaChibuzor Emereole
A article on why vision care should be inclusive in the Nigerian concept of public health. The article provides the avenues through which advocacy, and public-private partnerships can be employed to achieve this feat, in view of the VISION 2020 - Right to Sight by all by the year 2020.
Epidemiology slides by Kuya Kabalo.pptxKUYA KABALO
this presentation gives an overview of epidemiology , concepts ,definition , types of epidemiological studies , uses of epidemiology , scope and application of epidemiology
advantages and disadvantages of each epidemiological study
aims of epidemiology is also covered in this presentation
The document discusses key issues in health system development and the Thai experience as an example. It summarizes that Thailand achieved early Millennium Development Goals through sustained action over time to address access barriers, including expanding infrastructure and human resources, gradually increasing financial risk protection, and strengthening community awareness of health programs. This sustained action was enabled by values-based leadership, support from elites, use of evidence, decentralized decision-making, and flexible implementation within a pro-poor, pro-rural ideology.
This document outlines a proposal for a study on the knowledge, attitudes, and practices of nurses regarding the prevention of occupational hazards at two health care facilities in Abuja, Nigeria. The study aims to assess the nurses' level of knowledge, attitudes, and preventive practices. It will employ a descriptive research design and survey all 36 nurses at the sites using a questionnaire. The theoretical framework is Florence Nightingale's Environmental Theory. The proposal describes the research settings, population, instrument development and validation, data collection, and analysis methods. The goal is to understand how to better educate nurses and minimize workplace hazards.
The world's population is growing larger, older, and sicker, placing increasing challenges on healthcare systems to expand access to care with finite resources. Chronic diseases now account for 70% of illnesses, and the population over 50 will increase by over 500 million by 2025. Healthcare systems face constraints like aging populations, growing disease burdens, and limited budgets. However, new medical technologies in development and advances in data analytics provide optimism for healthier futures. Key questions remain around how to introduce high-value innovations and make systems more sustainable.
The document discusses evidence farming as an approach to evaluating mobile health (mHealth) applications and interventions. Evidence farming involves extracting evidence from care process data and manipulating care processes with flexible protocols. This allows generating hypotheses at the population level while maintaining some internal validity. The document proposes an open architecture called OpenmHealth to support evidence farming and crowdsourcing evidence through modules for usage analytics, randomized trials, individualized studies, and sharing findings. The goal is a learning community that can rapidly disseminate and iterate on evaluation methods that matter to improving mHealth.
The document summarizes Bryan's attendance at the Medinfo 2010 conference, including:
- The conference covered topics like adoption determinants, implementation, citizen-centric e-health, and evaluation methodology.
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- Bryan attended several presentations related to clinical modeling, standardization, and openEHR and participated in workshops on software development.
Ross McKenna
Portfolio Manager, Health System Infrastructure
Information Strategy and Architecture
National Health Board Business Unit
Ministry of Health
The Role Of Telehealth In Emerging Models Of CareYasnof
Between 2006 and 2036 the proportion of New Zealand’s population aged 65 or over as a proportion of the working-age population is expected to rise from 18 to 40%,” The number of people over Chronic conditions are estimated to account for 70 percent of health funding and 80 percent of all deaths in New Zealand and health workforce numbers per person are expected to decrease over next 20 years. This presentation explores the potential of Telehealth to address these challenges
This document provides guidance on formulating a systematic review question. It discusses the key components of a review question, including defining the population, intervention/exposure, comparison, outcomes, and study type (PICOS/PECOS).
The research question should be relevant and important. Types of questions include those about causation, diagnosis, prognosis, and treatment effects. The population, intervention/exposure, comparison, and outcomes should each be clearly defined. An example review question on interventions against Taenia solium specifies pigs and humans as the population, various drugs and sanitation programs as interventions, non-treated groups as the comparison, and efficacy and acceptance as outcomes. Study design such as observational studies and randomized controlled trials should also be
Surveillance Systems: Their Role in Identifying Risk and Resilience Factorsippnw
The document discusses a multinational injury surveillance pilot project in Africa from 2006-2007 that aimed to collect injury data across multiple countries on factors like cause, context, and victim demographics. The project found that data collection completeness gradually increased over time. Interpersonal violence made up 64.5% of injuries and data showed details on factors like the age, sex, location and mechanisms of these violent incidents. The project demonstrates the value of injury surveillance systems for understanding problems and informing prevention strategies.
Similar to Community ophthalmology: concept & practices (20)
Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) CosmeticsMuskanShingari
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Emotion-Focused Couples Therapy - Marital and Family Therapy and Counselling ...PsychoTech Services
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Breast cancer :Receptor (ER/PR/HER2 NEU) Discordance.pptxDr. Sumit KUMAR
Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)MuskanShingari
Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
Phosphorus, is intensely sensitive to ‘other worlds’ and lacks the personal boundaries at every level. A Phosphorus personality is susceptible to all external impressions; light, sound, odour, touch, electrical changes, etc. Just like a match, he is easily excitable, anxious, fears being alone at twilight, ghosts, about future. Desires sympathy and has the tendency to kiss everyone who comes near him. An insane person with the exaggerated idea of one’s own importance.
congenital GI disorders are very dangerous to child. it is also a leading cause for death of the child.
this congenital GI disorders includes cleft lip, cleft palate, hirchsprung's disease etc.
1. Current Concept and Practices of
Community Ophthalmology
Dr. Suraj Senjam
Faculty of Community Ophthalmology
Dr. R P Centre AIIMS New Delhi
2. Questions
What do you understand by Community Ophthalmology?
Why do we need to have such discipline ?
What should be the curriculum for this discipline?
What are spectrum of activities ?
Who are going to provide this ?
3. Community ophthalmology
Initial viewed: Ophthalmology services should be solely provided
through tertiary health centers by Ophthalmologists
Epidemic of preventable blindness and visual impairment
Many eye problems are within the purview of public health concerned
First proposed by Dr. Patricia E. Bath in 1978
Relatively new in the Biomedical Sciences
Very few Institutions has this discipline
4. Community ophthalmology
Public Health Ophthalmology
Community Eye Health
Preventive Ophthalmology
Focus: Three community based activities:
preventive,
curative,
promotive.
British Journal of Ophthalmology, 1987, 71, 116-117
5. Community Ophthalmology
21st Century
The perspective of Public Health Discipline is growing, so as
too Community Ophthalmology
Applied all public health sub-dimensions
6. Community Ophthalmology
An important branch of community medicine that aims at
comprehensive eye health care in the community setting employing
the knowledge of public health and social & preventive medicine to a
large extent, viz. epidemiology, health promotion, health economics,
heath management, environmental health, public health policy &
planning, social sciences & behavioral health, medical biostatistics
and primary health care.
7. Community Ophthalmology Vs. Community eye care services
Community eye care services
I. Promotive-Eye Health
Promotion
II. Preventive-screening
III. Curative
IV. Referral
V. Rehabilitation-visual
E.g. Eye Camp, School screening
People think these are the activities
7
Community Ophthalmology
1) Community eye care services
2) Epidemiology of eye Diseases
3) Epidemiological studies
4) Policy & Planning of Eye health
5) Management Iinformation System (MIS) on
eye health
6) Monitoring and evaluation
7) Environmental eye health
8) Eye Health economics
9) Behavioral & Social Sciences on eye care
10) Biostatistics
11) Managing and Presenting Public Health
Data
12) Project Cycle Management
8. Community Ophthalmology: Promotive-Eye
Health Promotion
Educational or IEC materials for each important problems
Pamphlets, posters, banner, hoarding flip chart etc
Small booklets like what a patient should know about glaucoma/ DR etc
Booklets on low vision information
Improving personal hygiene, sanitation, environment modifications, diet habit
Various Media:
Audiovisual and folk song, skit drama etc
Eye health talk or Mela
9. Community Ophthalmology: Preventive
measures
1. Etiological preventive measures
Nutritional blindness secondary to Vit. A deficiency
Clean face and good hygiene and sanitation
Onchocerciasis spread by black flies
2. Prevention from Blind and visual impairment
Surgical intervention of angle closure Glaucoma, DR,
3. Prevention from further loss of quality of life, deterioration of
livelihood
Visual rehabilitation and vision aids
10. Community Ophthalmology
Curative
Surgical removal of cataract
LASIK
Treatment of conjunctivitis
Rehabilitation
Mobility and orientation training
Training on Daily Living Activities
Community Based Rehabilitation
11. Epidemiology of eye Diseases
1. Non-infective
Example: Cataract, Refractive errors, Glaucoma
2. Infective
Example: Trachoma, Conjunctivitis, Onchocerciasis
Cataract
Classification, Prevalence, incidence, risk factors, trends, ecological study
finding, Sign and symptoms , morbidity, economical impact, prevention and
screening and briefly about management
Trachoma
Problems statement, epidemiological determinants-agent factors, Host factors
environmental factors, mode of transmission, Sign and symptoms, control
measures
12. Epidemiological studies
Study of the distribution, frequency and determinants of health
related events or diseases in a defined population and application of
this study to the control of health problems
Distribution: what ? Who? Where ? When?
Frequency: Incidence, prevalence,
Determinants: probable risk factors, protective factors
13. Epidemiological study
A. Descriptive studies
Individuals
I. Case reports
II. Case series
III. Cross-sectional
Population or ecological studies
B. Analytical studies
I. Case control
II. Cohort
III. Trials
DR. RPC AIIMS 13
In Community Ophthalmology
14. Cross Sectional Survey
1. Ideal Epidemiological survey
Sample –representative
Result-generalizable
Time consuming
Need more resources
Need epidemiologist
Suitable for high income
countries
DR. RPC AIIMS 14
2. Rapid Assessment survey
Not representative
Not generalizable
Less time consuming
Need less resources
Simplified sampling methods
Suitable for low-middle income
countries
16. Scientific study: Protocol
Sample size
Sampling techniques
Data collection
Data management
Data analysis and dissemination
17. Policy & Planning for Eye Health
Better health policy is a driving force for better life
Policy making based on sound scientific knowledge
Health research-evidence based decision making
National Blindness Survey (RAAB) in India
Program reform with special emphasis on structural and implementation
Financing eye health care-insurance, user fees
Public-Private partnerships in the services delivery
18. Management Information System
Better the information system, better the health care
delivery, management and outcome
Designing good MIS
Information on human resources, infrastructures, equipment,
activity related
Geographical information on hospital facilities
Computerize information system
Monitoring and evaluation
MIS use for different management level
19. Program Monitoring and evaluation
Cataract surgical program
School vision screening program
20. Environmental and eye health
Population changes (demography)
Effect on life expectancy on eye health
Migration effect
Physical environment
Temperature, UV, air pollution, humidity, wind, soil, chemicals
Urban housing, lighting system
Biotic environment
Infectious agents, vectors, forestry etc
Domestics environment
Water supply, sanitation, smoking, diet, lifestyle etc.
Work habits
Politico-cultural environments
Conceptual or cultural practices, equity of health accessibility, national priority
Socio-economic environment
poverty
21. Eye Health Economics
Economics is the sciences of choice
Government
Hospital eye health care or
Public health ophthalmic program
Allocative efficiency
Some of amount resources where to allocate (program
competes each other for resources allocation)
How many of the resources to allocate to each program
One program gains at the expense of other
This will by addressed by Cost-Benefit Analysis
22. Eye Health economics
Technical efficiency
Best way to achieve the given objective
The patient will be treated, but question is how
Comparison of options with the same goal
Day care cataract surgery vs. inpatient stay surgery for cataract
Day care LASIK vs, inpatient stay
This will be addressed by Cos-Effective Analysis
23. Behavioral & Social Sciences on eye health
Socio-cultural Belief (harmful or beneficial effect)
Social norm
Human behavior towards eye problems
Factors influencing on decision to seek eye care
QOL after treatment
Individual behavior to treatment adherence
Example: Urban people not willing to spend on glasses, rather prefer
spend on smart phone, mobile
24. Theories to change individual behavior
Health belief model
Originally developed to explain why individuals participate in
health screening and immunization program
Models explain the likelihood of an individual taking action
against a given health problem
It can be applied in eye health
Why few individuals still not corrected their refractive error or
not undergone cataract surgery
25. Biostatistics
Software packages for analysis
Analysis of quantitative data
Analysis of qualitative data
Multivariate analysis
26. Managing and Presenting Public Health Data
When the data is large enough
Develop data management plan for use in ophthalmic health
Roles-primary investigator, coordinator, data manager
Coding system
Consistency checking
Double entry technique
Labels and file organization
27. Summarizing and presenting data
Adage: A picture is worth a thousand words
Keeping in mind the primary purpose is to communicate the information
Tables
Graphs
Charts
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