NationalProgramme

forControlofBlindness

facilitator:

Dr.NAVPREET
AssistantProf.,Deptt.ofCommunityMedicine
GMCHChandigarh

DefinitionofBlindness
Blindness is defined under following headings
(NPCB):
SimpleDefinition:Inabilityofapersontocountfingersfroma
distanceof6metersor20feet
TechnicalDefinition: Vision6/60orlesswiththebestpossible
spectaclecorrection

For International comparison, WHO has defined

RevisionofCategoriesofVisualImpairment
Presentingdistancevisualacuity
Category

Worsethan Equaltoorbetterthan

Mildornovisualimpairment:
0
Moderatevisualimpairment: 1

6/18

6/60

Severevisualimpairment:

6/60

3/60

Blindness:

3/60

1/60*

Blindness:

1/60*

Lightperception

Blindness:

Nolightperception

Undeterminedorunspecified

*OrCountfingers(CF)at1metre.

6/18

Ref:W.H.O.

Typesofblindness
Curableblindness:Thatstageofblindnesswherethedamage
isreversiblebypromptmanagemente.g.cataract
Preventable blindness: The loss of blindness that could have
been completely prevented by institution of effective
preventive or prophylactic measures e.g. xerophthalmia,
trachoma,andglaucoma
Avoidableblindness:Thesumtotalofpreventableorcurable
blindnessisoftenreferredtoasavoidableblindness.

MagnitudeofProbleminIndia
Estimatedprevalenceofblindness(2004):
11.2per1000population
0.1per1000population:014years
0.6per1000population:1549years
77.3per1000population:50years&above

Female (12.2 per 1000 population) > Male (10.2 per

CausesofBlindnessinIndia

NationalProgrammefor
ControlofBlindness
Launchedinyear1976
100%centrallysponsoredprogramme
Incorporates the earlier
Programme(startedin1968)

Trachoma

Control

Goal:Toreducetheprevalenceofblindnessfrom1.4
to0.3%

Revisedstrategies
Baseduponthefindingofthesurveyconductedduring199899&19992000:

1. TomaketheNPCBmorecomprehensive by
strengtheningservicesforotherblindnesslikecorneal
blindness,
refractiveerrorsinschoolgoingchildren,
improvedfollowupserviceofcataractoperatedpersons
and
treatingothercausesofblindnesslikeglaucoma
2.Toshift
fromeyecampapproachtoafixedfacility,
from conventional surgery to IOL implantation for better
quality postoperativevision.

3.Toexpandtheworldbankprojectactivities
like constructions of eye OTs, eye wards at distt. Level,
trainingofeyesurgeons,moderncataractsurgery&supplyof
eyeequipments.
4. To strengthen participation of voluntary organizations in the
programme&toearmarkgeographicareastoNGOsandgovt.
hospital&improvetheperformanceofgovt.units.
5. To enhance coverage of eye care services in tribal &
underserved areas through identification of bilateral blind
patients, preparation of village wise blind register & giving
preferencetobilateralblindpatientsforcataractsurgery

Objectives
1. To reduce backlog of blindness through
identification&treatmentofblind.
2. Todevelopeyecarefacilityforeverydistrict.
3. Todevelophumanresourcesforeyecareservices
4. Toimprovequalityofservicedelivery
5. To secure participation of civil society & private
sector

InfrastructureDevelopmentforEyeCare
Item
StrengtheningofPHCs
CentreMobileUnits
StrengtheningofDistrictHospitals
UpgradingofDept.ofOphthalmologyin
MedicalColleges
EstablishmentofRegionalInstitutes
OphthalmicAssistanttrainingcenters
DistrictMobileUnits
StateOphthalmicCells
EstablishmentofDBCSs
EyeBank(Govt.)
ParamedicalOphthalmicAssistantsposted

Currentachievement
5,633
80
445
82
11
39
341
21
604
166
4,881

OrganizationalStructureforNPCB

ServiceDelivery&ReferralSystem

Activities
1. Cataract operation: IOL implantation has been
emphasized.
2. InvolvementofNGOs
3. Civil works: Construction of eye wards, OTs & dark
room were undertaken in 7 states under World Bank
assistedproject
4. Training to eye surgeons, PHC MO, ophthalmic
assistant,ophthalmicHWs
5. Commodityassistantlikesutures&IOLs,slitlamps,A
scans, Yag lasers, keratometres are procured centrally
&distributedtostates&DBCS

6. IEC
7. MIS
8. Monitoring&evaluationrapidassessmentsurveys,
beneficiaryassessmentsurvey,visualoutcome
surveys
9. Collection&utilizationofdonatedeyes:
Nearly20,000donatedeyesarecollectedperannum

10.SchoolEyeScreeningProgramme :
Firstscreeningbytrainedteachers.
Childrensuspectedtohaverefractoryerrorsareconfirmedby
ophthalmicassistants.
Correctivespectaclesareprescribedorprovidedfreeofcostto
poor

NewInitiatives

Dedicatedeyewards&eyeOTs inDH&SDHasperdemand.
AppointmentofOphthalmicsurgeons&O.A.innewDHs&SDHs.
AppointmentofO.A.inPHCs
AppointmentofEyeDonationCounselorsineyebanks
GrantinaidforNGOsformanagementofvariouseyediseases
PPP
SpecialattentiontoNEStates
TelemedicineinOphthalmology
VitaminAsupplementandMMRvaccinationthroughDBCS
funds.

 WorldBankassistedcataractblindnesscontrol
project (19942002):
Implementedin8states.
15.35millionoperationshadbeendoneagainst11million
target.
IOLimplantationhadbeenincreasedfrom3%in1993to
75%in2002.

DanishassistancetoNPCB(19982003):
Fundswereutilizedforthetraining,developmentofMIS,
supplyofequipment.

Vision2020:RighttoSight
Aglobalinitiativehasbeentakentoreduceavoidable
blindnessby2020.
Indiaalsohascommittedtothisinitiative.

Planofaction
1. Targetdiseases:
Cataract, Refractive Errors, Childhood Blindness,
Glaucoma,DiabeticRetinopathy.

2. Humanresourcedevelopment
3. Infrastructuredevelopment:
Proposed4tierstructureincludes:
CentresOfExcellence(20),
TrainingCentres(200),
ServicesCentres(2000),
VisionCentres(20,000).

ProposedStructure
forVISION2020
CentreofExcellence20

Pri
ma
ry

Se
co
nd

ary

Te
r ti

a ry

Professionalleadership;
Strategydevelopment;CME;
Layingofstandards&Quality
assurance;Research

TrainingCentres200
Tertiaryeyecare
Training&CME

ServiceCentres2000
Cataractsurgery;Othercommoneyesurgeries;
Facilitiesforrefraction;Referralservices

VisionCentres20000
Refraction&Prescriptionofglasses;Primaryeyecare;
Schooleyescreeningprogramme;Screeningandreferralservices

Prevention&controlofchildhoodblindness:
1. Strengtheningschooleyescreeningprogramme
2. Increaseincollectionofdonatedeyes
3. Developingpediatriceyeunits

Targetedinterventionforunderserved
population
1. Settingupvisioncentres
2. Activevillageregistry
3. ActiveinvolvementofNGOs,panchayats,&
community

 GlobalEliminationofBlindingTrachoma:
Trachomastillendemicin46countries.Thereare
146millionactivecasesofthedisease.
Almost6millionpeopleareblindorvisuallydisabled
asaresultoftrachoma.

SAFEstrategy:
S Surgery
A Antibioticuse
F Facialcleanliness
E Environmentimprovement

Thanks