National Program for Control of Blindness and Visual Impairment (NPCBVI)

Introduction

Blindness refers to a complete lack of vision, and the global prevalence of blindness was estimated to be around two percent. The major causes of blindness include cataracts, corneal opacity, and glaucoma. The blindness control programs developed at the national level by the government aim to reduce the prevalence of blindness by increasing awareness about blindness and eye donation. The program is implemented at various levels, focusing on various eye diseases.

What Is the National Program for Control of Blindness NPCBVI?

The National Program for Control of Blindness and Visual Impairment, launched in 1976, is a centrally sponsored scheme to reduce the prevalence of blindness. Under the national health policy, the target is to reduce the prevalence of blindness to 0.25 percent by 2025.

What Are the Goals and Objectives of the NPCB Plan?

• Reduce the existing backlog of blindness by identifying and providing treatment to individuals with visual impairments at primary, secondary, and tertiary healthcare levels.

• Develop and strengthen the NPCB strategy for promoting eye health and preventing visual impairments. This includes delivering comprehensive eye care services and ensuring the provision of high-quality services.

• Enhance and upgrade ophthalmologic institutes to transform them into specialized centers in various sub-specialties of ophthalmology.

• Strengthen the current healthcare infrastructure and develop additional human resources and facilities to deliver comprehensive eye care.

• Raise community awareness about eye care and preventive measures to maintain good eye health.

• Expand research aimed at preventing blindness and visual impairment.

• Promote the active participation of voluntary organizations and private practitioners in the delivery of eye care services.

What Are the Salient Features of the National Program for the Control of Blindness?

• Free Cataract Surgery: Prioritizing free cataract surgery for those in need.

• Comprehensive Eye Care: Expanding services beyond cataracts to address conditions like diabetic retinopathy, glaucoma, corneal issues, and childhood blindness.

• Population Screening: Actively screening individuals above 50 for eye issues.

• Children's Vision: Screening and providing free eyeglasses to economically disadvantaged children with refractive errors.

• Universal Coverage: Expanding eye care services to reach all areas.

• Healthcare Personnel Training: Developing and enhancing the skills of healthcare professionals.

• Community Awareness: Raising awareness about eye diseases within communities.

• Hospital Upgrades: Improving hospitals with advanced infrastructure, equipment, and sufficient staff.

• Vision Centers: Establishing vision centers in all primary healthcare facilities with a focus on eye care.

• Mobile Eye Units: Increasing accessibility through mobile ophthalmic units for remote populations.

What Are the Key Initiatives Within the Program?

Primary Eye Care Services:

Comprehensive primary health care services, offered through health and wellness centers (HWC), provide preventive and promotional vision care services. These include information, education, and communication (IEC) efforts to promote preventive vision care and encourage eye donations.

Secondary Eye Care Services:

• Cataract Surgeries: Effectively decreasing the wait time for cataract surgeries.

• Refractive Error Screening and Free Spectacle Distribution: Conduct screenings for refractive errors in children and provide free spectacles to those in need through a school eye screening program. Distributing free spectacles to elderly individuals experiencing presbyopia (difficulty in focusing on nearby objects), enabling them to perform near tasks. This is a new initiative introduced under the program.

• Visual Impairment Management: The program now extends its services to cover all forms of visual impairment, including low vision cases. The program has shifted its focus to the treatment and management of various eye conditions, such as:

  • Glaucoma (an eye disease that damages the optic nerve, resulting in vision loss and blindness).

  • Diabetic retinopathy (in patients with high blood sugar levels, damages the blood vessels of the retina, leading to serious vision problems).

  • Vitreo-retinal diseases (it is a group of eye diseases affecting the structures within the eye known as the retina and vitreous).

  • Corneal blindness (an eye disease that changes corneal transparency due to corneal scarring or due to infectious causes).

  • Childhood blindness (commonly caused by vitamin A deficiency, measles, or congenital cataracts, where the child cannot see an object 10 feet away).

• Mobile Ophthalmic Units and Tele-Ophthalmology Network: Expanding the program reach into disadvantaged and remote areas through the utilization of mobile ophthalmic units and a tele-ophthalmology network.

• Eye Banking Services: Improving the eye banking services and collection of donated eyes.

Tertiary Eye Care Services:

• Offering financial support to improve the capabilities of institutes of ophthalmology to provide specialized eye care services.

• Offering practical training to eye surgeons, enhancing their clinical and surgical expertise.

• Running information, education, and communication (IEC) campaigns.

• Conducting research and surveys in the field of eye care.

Infrastructure Development and Capacity Building:

• Providing financial support to strengthen eye care facilities at both primary and secondary levels.

• Offering training programs for paramedical ophthalmic assistants and eye donation counselors (one who is well informed about eye donations).

Newer Initiatives And Areas of Focus Under the Program:

• Comprehensive Eye Care Guidelines: Revising NPCBVI guidelines to provide comprehensive eye health care through health and wellness centers.

• Eye Banking Standards: Launching the standards of eye banking in 2020 to enhance eye donation, tissue collection, processing, quality maintenance, equitable tissue distribution, and institutional capacity for corneal transplantation.

• Eye Bank Network Development: Establishing a network of eye banks and donation centers to promote transparent collection and timely utilization of donated eyes.

• Expanded Disease Focus: Expanding the focus beyond cataracts to include the treatment and management of other eye conditions.

• Trachoma Elimination: Screening, case detection, and treatment for trachoma trichiasis (an eye condition resulting from an infection by the bacterium chlamydia trachomatis, a leading infectious cause of blindness on a global scale) to work towards eliminating trachoma as per the WHO global action plan.

• COVID-19 Safety: Issuing COVID-19 guidelines to ensure safe ophthalmology practices in eye care facilities.

• Super-Specialty Clinics: Establishing specialized clinics for major eye diseases, including diabetic retinopathy, glaucoma, and retinopathy of prematurity.

• Tele-Ophthalmology Expansion: Linking teleophthalmology centers at vision centers with super-specialty eye hospitals to ensure the best possible diagnosis and treatment for eye diseases, especially in challenging terrains and remote areas.

Conclusion

Blindness stands as the biggest public health challenge. The NPCB program, launched in 1976, aims to reduce blindness prevalence to 0.25% by 2025. Ongoing efforts include advancements in the prevention and treatment of various eye conditions. The aim of this program is to provide quality eye care to people of all social strata.