Gender and Eye HealthWorld Sight Day 2009

2/3 of the Blind in the World are Women

80% of Blindness is Avoidable

World-wide Gender Disparity

• Women are key income producers and in raising children

• Young girls care for infants, tend to remain within villages

• Women are caregivers– In treating women, we treat many children,

elderly, women and men

Gender Disparities

• Women live longer/age-related diseases– AMD– Cataracts

• Reasons other than Age – Dry eye, trachoma, auto-

immune diseases– Access to care ½ that of men

• unoperated cataract adult/child

– Poor access to follow up

Trachoma

• Women bear ~75% of trachoma-related blindness – role in community- work in fields, child

rearing– contact with children who harbor

chlamydia

• Women are less likely to have access to care for trichiasis

Trachoma

• Chlamydia trachomatis infection– antibiotics

• Repeated infections and scarring of palpebral conjunctiva

Trachoma

• Entropion and trichiasis– surgery

• Corneal opacification from irritating lashes

Trachoma - Solutions• Awareness

– Education (SAFE), involve family in decision – Key informants– Female-female communication

• Access– Antibiotics to reach males and females

equally; multiple approaches– Bring surgery to the community

• Acceptance– Involve local leaders– Teach surgical approach, assure competent

surgeons for both genders

North Carolina Initiative

Sandy Barnhart– Barriers to eye health in Randolph

County, NC– Qualitative approaches (focus groups,

surveys)– Quantitative (local health department

statistics, Center for Disease Control)

Randolph County

• Median income (2002) - $23,629 ($27,785)

• High School dropout – 6.3% vs. 4.9%

• Bachelor's degree – 11% vs. 22%

• Births to mothers who smoke – 18% vs. 14%

• Low birth weight infants more than in state which is 13.6% of live births (US rate-12.7%)

Opportunities for Ophthalmologists

• World-wide– Organizations (Carter Center, ORBIS, etc.)

• US– Education (smoking, BMI, diabetes, toxocara)– Vision 2020 initiative to eradicate avoidable

blindness by 2020– Data collection (little data on eye health and

gender at county level)– Barriers differ regionally

Communication is a Key

References

http://www.womenseyehealth.org/educational/educational.htm

http://www.who.int/topics/blindness/en/

http://www.preventblindness.org/

http://www.seva.org/

http://www.iefusa.org

http://www.aao.org/

http://VISION2020.org

Praveen@aravind.org

kcco@kcmc.ac.tz

rpkandel@wlink.com.np

Maggie@seva.ca

suzgilbert@earthlink.net