fight for sight
White Cane Day falls today, October
Sri Lanka has a population of approx.
20 million. One third of this population is over 40
years (approx. 6.5 million).
The causes of blindness and low vision
in the adult population are:
- Age onset cataract
- Diabetic Retinopathy
According to accepted standards, countries
in and around the Indian subcontinent, should have the
services of at least three ophthalmologists for one
million population. Further 3000 cataract surgeries
should be performed per one million population.India,
Nepal, Pakistan & Bangladesh have more than this
ratio (India – 12,000 ophthalmologists, population
1.3 billion; Nepal - 116 ophthalmologists, population
24.5 million, Bangladesh 600 ophthalmologists, population
In Sri Lanka (population 20 million)
we have only 50 ophthalmologists including those in
the private sector. But inspite of a low ophthalmologists
to population ratio, in 2005 the Sri Lankan ophthalmologists
made a major breakthrough by performing more than 3,000
cataract extractions per million population.
What we should be more proud about
is the fact that our ophthalmologists serve in remote
parts of the country such as Ampara, Jaffna, Vavuniya,
Kalmunai, Batticaloa, Moneragala, Mahiyangana, Kuliyapitiya,
Puttalam and Trincomalee.
Though the blindness due to cataract
is now somewhat contained, two other dreaded causes
of blindness are emerging. These are Diabetic Retinopathy
It is believed that our country has
750,000 diabetics and 300,000 suffering from glaucoma.
Loss of vision due to glaucoma and diabetic retinal
disease can be avoided if the disease is identified
As such it is best for all adults
over 40 years of age to get themselves checked for diabetes,
especially if there is a history of diabetes in the
Similarly, all adults being tested
for reading glasses should request the optician or eye
surgeon to examine their eyes for glaucoma.
Diabetic Retinopathy &
Glaucoma are blinding diseases
Diabetic retinopathy if detected early,
can be controlled by change of lifestyle, diet, strict
control of diabetes and by the use of laser.
Unfortunately we have very few laser
delivery equipment in our country – a laser costs
approx. Rs. 5.5 million (cheaper than a new car).
Glaucoma if detected early, can be
controlled by the use of eye drops. These drops are
rather expensive and have to be used daily for a lifetime.
The search for less costly sources is rather urgent,
since patients fall out of treatment schedules due to
lack of funds.
With regard to childhood blindness
and blindness around birth, the common causes are:
- First cousin or close relative
marriages, where one out of three offspring are affected.
- German measles (Rubella) affecting
the mother in the first three months of pregnancy.
- Low birth weight/premature babies
who develop a progressive retinal disease.
- Delayed or mismanaged second stage
of labour, resulting in foetal hypoxia causing severe
- Meningo-encephalitis (seen commonly
with fever and fits) during the first few years after
First cousin marriages are now rather
rare due to awareness. Rubella is also very well controlled
by the Ministry of Health but greater attention at childbirth
to prevent foetal hypoxia is desirable.
Age onset cataract is the highest
cause of blindness and low vision, in most parts of
We are fortunate that our ophthalmologists
are in a position to restore vision to cataract patients
in a matter of minutes.
The Sri Lanka Eye Foundation is committed
to help both the surgeon and the patient to get relief
from blindness due to cataract. They supply an intra-ocular
lens free of cost to any person who needs it –
and also are in a position to supply equipment and consumables
to the surgeons.
The main sponsor for the Foundation’s
activities in prevention and reduction of blindness
is Christoffel Blinden Mission (CBM), Germany. The other
sponsors are Sight Savers International (SSI), UK and
International Resources for the Improvement of Sight
Let’s all join hands and fight
(The writer is Chairman Sri Lanka