Cataract
VISION 2020 "The Right to Sight" is an initiative to help eliminate avoidable blindness by the year 2020, jointly launched by the World Health Organization together with more than 25 international non-governmental organizations involved in eye care and prevention, cure and management of blindness. This initiative will take steps to prevent an estimated 1000 million people from becoming blind over the next two decades. HMG has officially launched Vision 2020 The Right to Sight in Nepal on 2000 AD.
A countrywide data compilation by NNJS in 2003 showed that there are acceptable evidence to show from hospitals information that cataract, trachoma, childhood blindness and refractive error and low vision all figure in the list of unmet needs and thus require to be further addressed by NNJS.
Cataract remains to be the major cause of blindness accounting for more than two thirds of blindness and more than 80% of blindness due to cataract can be avoided. Nepal Blindness Survey (1981) has identified cataract and its sequels as responsible for 72% of all blindness. It is fair to say that all the hospitals under NNJS have taken a lead role in delivering high volume, good quality cataract surgical service.
NNJS strongly stresses the need to increase the number of cataract surgeries for more number of Nepali patients from the current CSR (Cataract Surgical Rate-Number of cataract surgeries per year per million population) of approximately 1650.
Un operated cataract is the main cause of visual loss globally, with an estimated 16 million cases. In the absence of any proven safe and effective prevention of the most common form of cataract, efforts have to focus on surgery for restoration of vision. NBS 1981 estimated prevalence of Blindness rate in Nepal as 0.84 % of total population. Subsequent survey conducted in Bheri and Lumbini Zone shows Prevalence of Blindness as 5.3 % among the elderly population over 45 years. Another survey conducted in Gandaki Zone in 2002 shows prevalence rate 2.6 % in the same age group. Cataract found to be leading cause of blindness accounting for more than 60 % of blindness in all surveys in Nepal. Surveys in Lumbini, Bheri and Gandaki surveys show there is some reduction in prevalence rate of blindness but the blindness problem still remains as challengingly high. The rough calculation on annual incidence based on 0.5 % (estimated reduced prevalence) blindness rate shows there are at least 120,000 eyes become blind (<6>/60) due to cataract in the country. The strategic plan for vision 2020 also recommends the need to increase present CSR of 1650 among Nepali population up to three fold to decrease prevalence of blindness and to cope with estimated incidence rate in the country.
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