Epidemiological determinants
.
● Age
1. About 30 percent of blind in India are said to lose their eyesight before. They
reach age of 20 yrs and many under age of 5 yrs
2. Refractive error ; trachoma ; conjunctivitis ; and malnutrition ( vit a deficiency )
are imp causes of blindness among children and younger age
3. Cataract , refractive error , glaucoma and diabetes are cause of blindness in
middle age group
4. Accidents and injuries can occur in any age gp more importantly 20 to 40 yr
group
Sex
● A higher prevalence is reported in females more than males , this has been
attributed to a higher prevalence of trachoma , conjunctivitis and cataract
among females
● MALNUTRITION:
● It is not only closely associated with low vitamin a intake but also with
infectious disease of childhood especially measles. And diarrhoea which
precipitate malnutrition
● In many cases PEM is also associated with blindness
● Severe blinding corneal destruction due to vit A deficiency eg keratomalacia is
largely limited to first 4 to 6 yr of life and is frequent among those 6 months to
4 yrs of life
Occupation:
● People working in factories , workshops , and cottage industries are prone to eye
injuries because of exposure to dust , airborne particles ,flying objects , gases ,
fumes ,radiation ,electrical flash
● Many workers including doctors developed premature cataract due to exposure to x
rays ,uv rays , heat waves
Social class:
● There is a close relationship between incidence of blindness and socio economic
status , blindness is twice more prevalent in poorer sections than well to do
Social factors:
● Many people lose their eyesight because of meddlesome ophthalmology by quacks
● The basic social factors are ignorance ,poverty ,low standard of community hygiene
and inadequate health services
Changing concepts in eye health care
Primary health care :
● One of the significant development in field of eye health care over last few
years has been concept of primary health care that is inclusion of eye care
component in primary healthcare system
● It is today recognised as model for eye care at community level
● The promotion and protection of eye health together with on spot treatment
for commonest eye disease are it’s cornerstones
● The final objective of primary eye care is to increase the coverage and quality
of eye health care through primary health care approach and thereby
improving the utilisation of existing resources
Epidemiological approach
● The epidemiological approach which involves studies at population level has been recognised
● It focuses among other things , on the measurement of incidence ,prevalence of diseases and their risk factors
● The local epidemiological situation will determine action needed
Team concept :
● In many developing countries there is only one eye specialist for millions of people
● Increasingly therefore healthcare leans on use of auxiliary health personnel to fill many gaps
● In India this gap is fill by village health care workers ,ophthalmic assistant,multipurpose workers and voluntry agencies
Establishment of national programmes
● Many programmes were first started by voluntary agencies concerned with blindness prevention ( eye camps ) and some of them focused on single disease like trachoma
● The increasing recognition of primary health care approach to blindness resulted in comprehensive national health care programmes for prevention of blindness
