ISSN: 1391 - 0531
Sunday, Octomber 15, 2006
Vol. 41 - No 20

Let’s fight for sight

White Cane Day falls today, October 15

By Dr. C.R. Seimon

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
  • Glaucoma

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 140 million).

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 and Glaucoma.

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 early.

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 family.

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 brain damage.
  • Meningo-encephalitis (seen commonly with fever and fits) during the first few years after birth.

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 the world.

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 (IRIS).

Let’s all join hands and fight for sight.

(The writer is Chairman Sri Lanka Eye Foundation)

Top to the page

Copyright 2006 Wijeya Newspapers Ltd.Colombo. Sri Lanka.