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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
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Outline
Avoidable blindness
Vision 2020: The Right to Sight
Regional and local achievements:
Setting priorities
Delivery of eye services
HR development
Preventive ophthalmology
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“Sight is a basic
human right of
everyone, and
its preservation is
obligation of
everybody”
Acad. K. Pashev -
1908
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80% of blindness is avoidable:
- preventable (20%) or
- treatable (60%)
4 out of 5 people
who are blind do not need to be
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Blindness –
the most feared disability:
People phobias: vision loss is the
most feared disability before
cancer and heart disease
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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
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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!
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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!
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„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.“
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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
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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.
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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%.
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- visual screenings at homes:
8275 persons screened
- Specialized eye exam of
visually Impaired
- rural areas – twice more visually impaired
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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
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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.
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Increase Number of Cataract Surgeries
Manpower
Issues of Numbers
Issues of Training
Issues of Efficiencies
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Poverty associated visual impairment:
“First the world will become rich, and
than – healthy” (Al Sommer, JHU)
Countries and regions endemic to
trachoma, onchocerciasis, lepracy
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Valuable, precise, informative
Limitations – high price, no reimbursement from the NHIF
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Diabetic Retinopathy
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World Initiative Vision 2020:
The Right to Sight
Eye care = the three “А”:
* accessible
* affordable
* appropriate
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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
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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
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International
requirements:
Prophylactic ophthalmic
examinations for
children:
Up to the 3-rd month
3-rd year
6-th year
Annually during
school years
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Childhood blindness - screening in remote areas
Free exams for children on 1st
June and one week before the beginning of school
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South-East Ophthalmologic Society (SEEOS):
Founded 2003, representatives from 14 countries
Black Sea Ophthalmological Society (BSOS):
Founded 2002, representatives from 10 countries
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Board of SEEOS
At The Annual Congress in Budapest, 2009
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International Symposia on VISION 2020
during Annual national meetings:
- starting 1999 at UBO,SEECO, BSOS
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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
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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
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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
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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
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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
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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.
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Teaching Strategies
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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
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Successful Residents at EBO Diploma
Examination – Paris
The goal – excellence in education!
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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
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Subspecialty Courses
Wet Labs
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VISION 2020: how are we doing?
What we have achieved
What still needs to be done
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- 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
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- 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:
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Participation of:
• The church
• NGOs
• Local authorities
• Society
• Prominent figures
• Mass media
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VISION 2020
- AWARENESS
- ADVOCACY
- NETWORKING
- SHAIRING OF IDEAS
- GUIDELINES
- PARTNERSHIP
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“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
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* 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
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The International Agency for the
Prevention of Blindness (IAPB)
www.iapb.org
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Vision 2020 – a catalyst to unite us!
Working together to eliminate avoidable
blindness!