World Initiative

VISION 2020: Right to Sight

P. Vassileva

Co-chair IAPB EuropeUniversity Eye hospital “Prof. Pashev”

47th Panhellenic Ophthalmological

28 May - 01 June 2014, Thessaloniki, Greece

Outline

Avoidable blindness

Vision 2020: The Right to Sight

Regional and local achievements:

Setting priorities

Delivery of eye services

HR development

Preventive ophthalmology

“Sight is a basic

human right of

everyone, and

its preservation is

obligation of

everybody”

Acad. K. Pashev -

1908

80% of blindness is avoidable:

- preventable (20%) or

- treatable (60%)

4 out of 5 people

who are blind do not need to be

Blindness –

the most feared disability:

People phobias: vision loss is the

most feared disability before

cancer and heart disease

Difficulties of daily living

Risk of falls

Problems in education and

professional development

Social isolation and dependence

High risk of depression

Twice higher mortality rate

Impact of Blindness

Global population – increasing

Global population – aging

Most blinding eye diseases – age related

BLINDNESS MAGNITUDE:

Age related distribution of moderate and severe visual impairment and

blindness – estimated for each WHO region!

Global Initiative for the Elimination

of Avoidable Blindness – Vision 2020

“Right to Sight”

Developed during the 1990s by:

• International Council of Ophthalmology

• World Health Organization / IAPB

• NGO’s in Ophthalmology

Launching February 1999: at WHO Geneva,

New York, Tokyo, London

To reverse the tendency of doubling of blind

by 2020!

„Our mission is to eliminate the main

causes of blindness in order to give all

people in the world, particularly the

millions of needlessly blind,

THE RIGHT TO SIGHT.“

Right to sight 2020

Plan for action:

* control of eye diseases and eye

care services

* HR development and training of

specialists

* appropriate technology and

infrastructure

Needs Assessment

To determine priorities for:

* strengthening the ophthalmic

manpower, and

* delivery of eye care services.

Data are needed on:

* the prevalence of blindness,

* the leading causes of blindness.

Sofia Eye Survey

Population based study

on randomized sample of 2.5 million

(South-Western Bulgaria and Sofia City):

* rate of visual impairment 1.32 %

* rate of blindness 0.49%.

- visual screenings at homes:

8275 persons screened

- Specialized eye exam of

visually Impaired

- rural areas – twice more visually impaired

All 194 WHO States – Committed

to Investing in Eye Health

Develop and implement Vision 2020

National Plans

Over 100 countries drafted National Plans

Over 115 countries have formed National

Prevention of Blindness Committees

Over 150 countries have participated in Vision

2020 Workshops

Main Causes of Blindness

in European region:

Cataract

Glaucoma

AMD

Diabetic Retinopathy

Childhood blindness

Human and financial aspects of overcoming

avoidable blindness: economic return on

investment – very high!!

Example: cataract – the most cost-effective procedure in medicine.

Increase Number of Cataract Surgeries

Manpower

Issues of Numbers

Issues of Training

Issues of Efficiencies

Poverty associated visual impairment:

“First the world will become rich, and

than – healthy” (Al Sommer, JHU)

Countries and regions endemic to

trachoma, onchocerciasis, lepracy

Valuable, precise, informative

Limitations – high price, no reimbursement from the NHIF

Diabetic Retinopathy

World Initiative Vision 2020:

The Right to Sight

Eye care = the three “А”:

* accessible

* affordable

* appropriate

Childhood blindness

The most common causes of vision

impairment in children:

Refractive errors (myopia)

Amblyopia

Strabismus

Congenital anomalies

ROP¹'²

1. Simons K. Vision screening in infants and children. Paediatr Child Health. 1998 Jul-Aug; 3(4): 261–262.

2. Eugene M. Helveston The Strabismus Minute, Vol.2, No. 4 Copyright (C) 2000

Hypoplasia n. opticus

Prevalence of Childhood

Blindness

1.0-1.5/1,000 0.7-0.9/1,000 0.4-0.6/1,000 0.2-0.3/1,000

Gilbert et al

International

requirements:

Prophylactic ophthalmic

examinations for

children:

Up to the 3-rd month

3-rd year

6-th year

Annually during

school years

Childhood blindness - screening in remote areas

Free exams for children on 1st

June and one week before the beginning of school

South-East Ophthalmologic Society (SEEOS):

Founded 2003, representatives from 14 countries

Black Sea Ophthalmological Society (BSOS):

Founded 2002, representatives from 10 countries

Board of SEEOS

At The Annual Congress in Budapest, 2009

International Symposia on VISION 2020

during Annual national meetings:

- starting 1999 at UBO,SEECO, BSOS

ARVO Mission

"The purposes of ARVO shall be to

encourage and assist research, training,

publication, and dissemination of

knowledge in vision and ophthalmology."

Article 1.02 of the Bylaws

Promote scientific interactions and exchange between

basic scientists and clinicians

Foster translational research and move forward proven

scientific, breakthroughs from the laboratory to clinical

practice

Recruit and retain scientists to all fields of vision

research

Disseminate scientific research findings

Complement ARVO's mission: to further global eye and

vision research for the prevention of blindness and the

reduction in eye diseases

South-East European – Association for

Research in Vision and Ophthalmology

(SEE-ARVO)

Voted during the SEEOS

General Assembly in Budapest

(June 2009)

Officially recognized in

October 2009 as an ARVO

Chapter Affiliate

The first SEE-ARVO session –

Tirana, Albania (2010)

SEE-ARVO symposia during

SEEOS and BSOS

Congresses, and National

ophthalmologic meeting and

events

SEE-ARVO Structure

Steering Committee:

Petja Vassileva (ARVO

member, SEE-ARVO

President), Bulgaria

Gabor Mark Somfai (ARVO

member, SEE-ARVO Secretary

General), Hungary

Janos Nemeth (ARVO

member), Hungary

Nikita Gabric (ARVO

member), Croatia

Zoltan Zsolt Nagy, Hungary

Christina Grupcheva, Bulgaria

Other members:

Slobodanka Latinovich, Serbia

Magdalena Velevska, Macedonia

Miklos Resch, Hungary

Lotta Salminen (ARVO member), Finland

Selaru Daniela Felicia, Romania

Gabor Deak, Hungary

Erika Tatrai, Hungary

Scientific Interest

The membership of SEE-ARVO

presents scientific interest in:

• anterior segment surgery

• tear film and ocular surface

• glaucoma

• surgical and medical retina

• corneal transplantation

Human Resource Development –

Cross-border education in South Eastern Europe

Promoting the highest standards of ophthalmic knowledge

and educations - centers of excellence

Creating models and standards of eye care, technologies and

procedures

Advanced life-long learning /professional development

Global world – communication, networking for advancing:

Education

Quality of care

Exchange of expertise

The importance of “training for trainers”

Development of future academic

ophthalmologists

Residents have primary responsibility

for teaching medical students and fellow

residents

“Teaching is learning twice”

Teaching skills enhance professional

and scientific competency

Teaching – a critical component of

residents’ experience.

Teaching Strategies

What makes a good teacher?

Over perform - above objectives and

expectations

Flexible with changes, responsible with

their obligations

Charismatic and emotional personality

Ability to inspire and motivate others

Ability to work under pressure

Organized and accomplished person

Creative and positive attitude towards

work

Successful Residents at EBO Diploma

Examination – Paris

The goal – excellence in education!

Challenges & How to Face Them

Increasing strain on the system of

academic medicine as a whole

Tight budgets

Clinical competition

Pressure to do research

Administrative problems

Surgical training is recognized to be an

issue – wet lab accessibility should be a

basic requirement for every subspecialty

training institution in order to avoid

patients risk

Subspecialty Courses

Wet Labs

VISION 2020: how are we doing?

What we have achieved

What still needs to be done

- 2000 - 45 mln blind

314 mln low vision

- 2010 – 39,8 mln blind

285 mln low vision- decrease

of 29 mln!

Meanwhile 18% increase of those aged 50+

BLINDNESS MAGNITUDE

- Ministry of Health - official government

support

- Eye care professionals

- INGO’s: CBMI, ORBIS, IEF

- Service clubs: LIONS, ROTARY

- Major institution: Medical Universities

- Patients’ representative

- Other expertise/ celebrities

Key players in

National programs:

Participation of:

• The church

• NGOs

• Local authorities

• Society

• Prominent figures

• Mass media

VISION 2020

- AWARENESS

- ADVOCACY

- NETWORKING

- SHAIRING OF IDEAS

- GUIDELINES

- PARTNERSHIP

“Vision 2020”* It does not represent a new organization or

institution

* It’s not a philosophy or ideology

* It is a possibility for decisive impact on

the decrease of the treatable and

preventable blindness

* “I SEE”:

I - integration

S - sustainability

E- equity

E- excellence

* Burden of blindness

* Public health approach:

- to close the gap between best Services

and no services at all

* Issues of inequity and disparity

* Marginalized socio-economic groups

Important challenges for our region!

VISION 2020

The International Agency for the

Prevention of Blindness (IAPB)

www.iapb.org

Vision 2020 – a catalyst to unite us!

Working together to eliminate avoidable

blindness!