WHO/Yoshi Shimizu
                                ? Credits

                                Eye care, vision care, vision impairment and blindness

                                  Overview

                                  "In a world built on the ability to see, vision, the most dominant of our senses, is vital at every turn of our lives. The newborn depends on vision to recognize and bond with its mother; the toddler, to master balance and learn to walk; the schoolboy, to walk to school, read and learn; the young woman to participate in the workforce; and the older woman, to maintain her independence.

                                  WHO is committed to working with countries to improve the delivery of eye care, in particular through primary health care; to improving health information systems for eye care; and to strengthening the eye care workforce –three enabling factors for implementing integrated people-centred eye care." Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

                                  Eye conditions are remarkably common. Those who live long enough will experience at least one eye condition during their lifetime.

                                  Globally, at least 1 billion people have a near or distance vision impairment that could have been prevented or has yet to be addressed. Reduced or absent eyesight, if not receiving timely attention and care, can have major and long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities, the ability to access public services and general health status.

                                  Reduced eyesight can be caused by a number of factors, including systemic diseases like diabetes, trauma to the eyes, age-related macular degeneration, cataracts and infectious diseases of the cornea and trachoma. The majority of people with vision impairment are over the age of 50 years; however, vision loss can affect people of all ages. Blindness and vision impairment more severely impact on the life of people in low- and middle-income settings where accessibility to most essential services and specific government-supported aids may be lacking. 

                                  Prevention

                                  Eye conditions that can be targeted effectively with preventive strategies include myopia, ocular trauma and the majority of infectious eye diseases. In addition, the prevention or management of systemic disease, such as diabetes, can be effective in reducing the risk of ocular diseases.

                                  For example, preventative lifestyle changes among children, including a combination of increased time spent outdoors and decreased near-work activities, can delay the onset and slow the progression of myopia which reduces the risk of high myopia and its complications.

                                  Treatment and Rehabilitation

                                  The treatment of eye conditions targets curing as well as addressing symptoms and progression. Treatment of chronic eye conditions also aims to prevent or delay the onset of irreversible vision impairment.

                                  Surgery can remove cataracts and optical correction (i.e. spectacles, contact lenses) can eliminate  the majority of refractive errors. Treatment for other eye conditions, such as glaucoma, diabetic retinopathy, pterygium, strabismus, retinopathy of prematurity, amblyopia require longer-term follow-up to control the progression of the condition. For glaucoma, ongoing management is required to reduce the risk of further progression through a number of possible treatment options including therapeutic eye drops, surgery, or a combination of these.

                                  Treatment is also required and available for the majority of eye conditions that do not typically cause vision impairment, such as dry eye, conjunctivitis and blepharitis. Treatment of these conditions is often directed at alleviating the symptoms. Worthy of mention is that certain eye conditions that do not typically cause vision impairment, may do so, if left untreated.  

                                  Rehabilitation

                                  Congenital vision impairment and vision impairment and blindness caused by many major eye conditions (e.g. diabetic retinopathy glaucoma and age-related macular degeneration) cannot be reversed, and rehabilitation will be required.

                                  A broad range of vision rehabilitation interventions are available, including optical magnifiers, environmental modification (e.g. improved lighting), Braille reading, screen readers, smartphone wayfinders, counselling and home skills training, such as orientation and mobility training with white canes to ensure free, independent and safe mobility.

                                  2.2 billion

                                  people globally

                                  have a vision impairment

                                  Fact sheet

                                  Key activities

                                  Package of eye care interventions

                                  The WHO Package of Eye Care Interventions (PECI) will be a planning tool containing evidence-based eye care interventions to assist countries in making decisions on which interventions to prioritize, how these can be budgeted, and then integrated into national health services packages and policies.

                                  The PECI will support countries to determine the a) workforce competencies, equipment, medicines and consumables necessary, b) assistive technologies needed, and c) costs associated with the implementation of eye care interventions.

                                  It is anticipated that the PECI will be finalized and available for use in 2021.

                                  Information sheet

                                  Setting feasible global eye care targets for 2030

                                  Resolution WHA73.4 (‘Integrated people-centered eye care, including preventable vision impairment and blindness’) requests WHO to prepare, in consultation with Member States, recommendations on feasible global targets for 2030 on integrated people-centred eye care, focusing on effective refractive error coverage and effective cataract surgery coverage, for consideration by the Seventy-fourth World Health Assembly (2021).

                                  In line with this request, in 2020, WHO undertook a consultative process with Member States, non-State Actors and experts from the field of eye care to develop recommendations on global targets for 2030 for eye care. Further details can be found here

                                  A guide for action for integrated people-centred eye care (IPEC)

                                  The Guide for Action for Integrated People Centered Eye Care will include a series of linked resources to help governments through a process of situation assessment, strategic planning, development of monitoring, evaluation and review processes; and implementation of the strategic plan. Key components of this tool will include:

                                  • A revised, electronic version, of the Eye Care Service Assessment Tool (ECSAT)
                                  • Comprehensive menu of indicators that Member States can select from to facilitate monitoring of strategies and actions for eye care provision at the national and/or sub-national level

                                   Mobile health toolkit for myopia

                                  Myopia, also known as short-sightedness, represents a growing public health issue. The primary focus of the initiative will be to increase awareness and health literacy amongst parents of children and adolescents of modifiable risk factors of myopia, the potential irreversible consequences of high myopia and the importance of spectacle compliance and regular eye examinations. The mHealth toolkit will include a database of messages and guidance on implementation, monitoring and evaluation of the initiative to support countries in enhancing their domestic services for myopia education and prevention.

                                  You can view existing toolkits here