OP10.7 | Blindness, Vision Impairment, NPCB and Vision 2020 — Summary & Reflection

KEY TAKEAWAYS

Blindness, Vision Impairment, NPCB and Vision 2020 — Key Points:

• WHO ICD-11 blindness criterion: VA <3/60 in better eye with best correction, OR visual field <10° around fixation. India's NPCBVI operational criterion: VA <6/60.
• Categories: Mild (<6/12 to 6/18), Moderate (<6/18 to 6/60), Severe (<6/60 to 3/60), Blind (<3/60).
• India — leading cause of blindness: CATARACT (~66% of bilateral blindness). Other major causes: uncorrected refractive errors, glaucoma, corneal blindness, posterior segment disease, childhood blindness (VAD, congenital cataract).
• Avoidable blindness (~80% globally): PREVENTABLE (VAD/xerophthalmia, trachoma) + TREATABLE (cataract, refractive errors, early glaucoma).
• NPCBVI: Launched 1976 (as NPCB); renamed 2017. Flagship = free cataract surgery with IOL. Components: cataract, refractive error, corneal, glaucoma, childhood blindness (VAD supplementation), low vision.
• Vision 2020 'Right to Sight': WHO + IAPB global initiative, launched 1999. India = partner nation. Strategies: disease control (cataract, refractive error, trachoma, onchocerciasis, VAD), human resource development, infrastructure.
• Trachoma eliminated from India (2017). Cataract surgical rates increased dramatically since 1976.
• Key barrier to cataract surgery uptake: fear, transport, escort, awareness — not lack of surgical services.

REFLECT

The 72-year-old farmer in the hook could see clearly again with a 15-minute outpatient procedure — and yet he sat on his blindness for two years because of fear, lack of information, and no one offering to help him get to the hospital. As a future district hospital physician or PHC medical officer, you will have ASHA workers, sub-centres, and community outreach camps as tools. Reflect: what is your role in identifying cataract blind individuals in your catchment area and connecting them to the district hospital eye care system? What will you say to a patient who tells you 'the cataract must ripen before surgery'? The content of this SDL is not just academic — it is a mandate for public health action.