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Eye Care Situation of Nepal

Eye Care

Background

In 1999, WHO estimated there were 45 million blind people and 135 million with low vision globally
and that the number of blind people would double in 20 years if existing trends continued. Therefore,
the global initiative of Vision 2020 ‘The Right to Sight’ was launched in February 1999 by WHO and the International Agency for the Prevention of Blindness. Vision 2020 provides the guidelines, targets, and strategies needed to reduce the prevalence of blindness in developing countries to eliminate avoidable blindness by the year 2020. Nepal adopted the Vision 2020 initiative in 1999. Prior to 1980, eye care services in Nepal were rudimentary. There were only three ophthalmologists outside Kathmandu and only 16 hospital beds were dedicated to eye patients in the whole of Nepal. Eye care services took a great leap forward after the Nepal Blindness Survey (1981) identified the magnitude of the problem. The government eye care system and human resources were unable to cope with the huge magnitude of the problem. Support was solicited from various national and international organizations to combat blindness in Nepal. Program objectives were established and Nepal began to build the infrastructure to address the problem. Primary, secondary and tertiary level
eye care facilities were established in areas with the greatest need. The programme simultaneously trained eye care professionals to staff the new hospitals and clinics. Following the launch of Vision 2020, the government’s eye care programme introduced vertical programmes to manage and treat cataracts, trachoma, xerophthalmia, refractive error and low vision.

The eye programme had significant impacts within a decade of the launch of Vision 2020. The programme is run by Nepal Netra Jyoti Sangh and is a successful example of an NGO-run eye care programme. The prevalence of blindness has reduced from 0.84 percent in 1981 to 0.35 percent at the current time.However, the number of blind people remains about the same as the population has doubled since1981. And the definition of blindness has changed as a visual acuity (VA) of <6/60 is considered as economic blindness. Due to technological advances and greater visual needs of the population, almost all patients whose eyes have a VA<6/60 due to cataracts are advised to undergo surgery while many patients demand surgery. This has doubled the workload of the eye care programme.

Until now, Nepal has been able to clear the backlog of blindness among those who can access service and the causes are avoidable. The remaining proportion are resistant cases, cases with unavoidable causes and cases unable to access services. Much remains to be done to achieve the national Vision
2020 goal.
There has been much progress on developing the eye care infrastructure. Almost all districts have a primary eye care center or eye hospital although most eye hospitals are in the Tarai or major cities. The technology for eye care is regularly updated and of internationally accepted standards and there are now many more ophthalmologists, ophthalmic assistants, optometrists, eye care managers and equipment maintenance personnel. Recommendations for the second decade of the Vision 2020 period include training more personnel, assigning them to work in underserved areas, expanding eye care services in remote areas, developing new strategies with defined targets and indicators and instituting regular monitoring of eye care. The government has a minimum presence in eye care. There has been an NGO partnership programme for the last three decades. Primary eye care has not been effectively integrated into primary health care in spite of persistent efforts by NGOs.

Nepal’s signing of the Global Eye Health Action Plan (endorsed by the sixty-sixth World Health Assembly, 2013) provides the opportunity to further progress to prevent visual impairment and strengthen the rehabilitation of blind people in communities and to move forward for eliminating blindness in the country. In view of the need to develop and strengthen policies to reduce avoidable visual impairment by 25 percent by 2019 from 2010, the apex body for eye health, MoH held a workshop in December 2014 to operationalize the Global Action Plan in Nepal. Based on the three objectives of the Global Action Plan (2014-2019), recommendations were made to develop and strengthen policies to achieve the global targets. Work is ongoing to achieve the goal of the Global Action Plan, “To reduce overall blindness below 0.2 percent among the visual acuity <3/60 and <0.4 percent among the visual acuity 6/60 by the year 2020”.

Achievements in 2072/73
In 2072/73, Nepal’s hospitals, eye care centres (ECCs) and outreach clinics provided 3.2 million
outpatient consultations and performed 309,919 eye surgeries.

Source: DoHS, Annual Report 2072/73 (2015/16)
For more achievement result please visit Ministry of Health, Department of Health Services Website. 

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