VISION 2020: The Global Initiative

Introduction

There are 4.95 million blind people worldwide, which is 0.36 % of the total population. Blindness can result from various causes. Preventable causes are as high as 80 % contributing to global blindness. The major causes of blindness include cataracts, glaucoma, and age-related macular degeneration. Increasing awareness and treatment for preventable causes of blindness can reduce the social burden of blindness. Various national and international programs work on providing effective treatment to areas where medical facilities are not available.

What Was Vision 2020?

Vision 2020 was a global initiative of the International Agency for the Prevention of Blindness (IAPB). It was implemented to eliminate avoidable blindness by the year 2020. The program worked towards achieving a focused goal of eliminating preventable and treatable blindness. Vision 2020 works in coordination with the World Health Organization (WHO), government, eye care organizations, health professionals, and other working individuals in this field. Vision 2020 made a huge difference to eye health at the global level, also expanding their work to those countries or regions that need special attention.

What Are the Guiding Principles of Vision 2020?

The principles can be summarized into:

• Integrated into existing healthcare systems.

• Sustainable in terms of money and resources.

• Equitable care and services to all people.

• Excellence in patient care and treatment.

More than 100 United Nations Member States supported this initiative and also established the national prevention of blindness and eye care in their countries.

What Are Vision 2020 Objectives?

• The increased awareness about blindness and the possible avoidable causes and their treatment options were discussed.

• Availability of resources, to increase awareness, prevention, treatment, and rehabilitation process.

• Proper planning, development, and implementation of VISION 2020 programs in all countries.

• A strong partnership with the Ministry of Health, International NGOs (nongovernmental organizations), and professional organizations.

What Are the Main Elements of National Programs?

• Cost-effective disease control.

• Human resources development.

• Infrastructure development.

Which Are the Targeted Diseases Under Vision 2020?

• Cataract.

• Trachoma.

• Refractive error.

• Low vision.

• Glaucoma.

• Diabetic retinopathy.

• Age-related macular degeneration.

• River blindness.

• Vitamin A deficiency.

What Are the Key Areas of Action?

Vision 2020 selected five key areas, which include:

1. Cataract.

2. Trachoma (bacterial infection of the eye caused by Chlamydia trachomatis).

3. Onchocerciasis (eye and skin disease caused by microfilariae, resulting in severe itching and skin reactions).

4. Childhood blindness.

5. Refractive error and low vision.

These five eye diseases were chosen based on the burden these diseases add to blindness and the feasibility and affordability of the treatment. With proper diagnosis and treatment, these conditions can be corrected and can eliminate blindness.

How Does Vision 2020 Work in India?

• In India, the aim was to eliminate avoidable blindness.

• The National Forum (VISION 2020: The Right to Sight INDIA) was the key organization, which was formed in 2004.

• Improve the quality of life for visually challenged people.

• To eliminate blindness, working with eye care organizations in India, providing affordable treatment and rehabilitation of the visually challenged.

• Implemented various practices with a special focus on poor and marginalized sections of the population, where proper medical treatments are not available.

What Are the Strategic Approaches in Vision 2020?

1. Strengthening Advocacy:

• Increasing public awareness and information about eye care, eye diseases, and prevention of blindness.

• Introducing topics related to eye care in the educational system.

• Involvement of various organizations in strengthening the treatment facilities.

• Strengthening the functioning of district blindness control society.

• Implementation of hospital programs for eye donation.

2. Reduction of the Disease Burden:

Vision 2020 mainly focuses on targeted diseases and focuses on prevention and treatment of the conditions. Disease control programs implemented for:

• Cataract - Increased facilities for surgical intervention and prevention of blindness from cataracts.

• Childhood Blindness - Implementation of school eye screening programs and Vitamin A supplementation to children.

• Refractive Error and Low Vision - Introducing refractive centers in PHCs (primary health centers) and low vision service centers in all tertiary centers.

• Corneal Blindness - Eye banking.

• Glaucoma - Periodic screening at eye care institutions and eye camps.

• Diabetic Retinopathy - Awareness program for diabetic patients and encouragement of periodic eye checkups.

• Trachoma - SAFE strategy:

• Surgery for advanced trachoma.

• Antibiotics.

• Facial cleanliness.

• Environmental improvement.

3. Strengthening Human Resources:

• Training of postgraduates and increasing seats for an eye specialist.

• Increase in the number of paramedical graduates.

• Introduction of newer ophthalmic institutes for screening, early diagnosis, and treatment.

• Development of active and dedicated district program managers.

4. Infrastructure Development:

• The program VISION 2020 works coordinated with the world health organization (WHO) and International Agency for the Prevention of Blindness (IAPB).

• WHO works on the implementation of the program by reaching various Ministries of Health.

• IAPB works together with Non Governmental development organizations (NGDO), Professionals, and corporations towards the formation of National VISION 2020 bodies.

• The national VISION 2020 bodies work and develop the District VISION 2020 service units.

• Development of district-level eye care with primary eye care services introduced into primary eye care systems.

• The principles for implementing the program at the district level.

  • Integrated.
  • Sustainable.
  • Equitable.
  • Excellent.

• Educating practitioners, hospitals, and clinics with information about good quality and affordable treatment technologies.

• Donation of eye care equipment to countries that cannot afford the purchase of new ones.

• To assist in the selection and purchase of appropriate equipment for proper diagnosis and treatment planning.

• Introduction of newer technologies for diagnosis and treatment planning.

What Is Eye Care Infrastructure Development Under Vision 2020?

The VISION 2020 program, divided the infrastructure into primary, secondary, and tertiary.

• Primary Level - Primary infrastructure development focused on starting vision centers (20000 nos). The functions include primary eye care, refraction and prescription of eyeglasses, school eye screening program, and referral services.

• Secondary Level - Stating of service centers (2000 nos). They aimed to provide services for cataract surgeries, facilities for refraction, other eye surgeries, and referral systems.

• Tertiary System - This includes working in training centers (200 nos) and providing tertiary eye care services like retinal surgery, corneal transplantation, and glaucoma surgery, working in centers of excellence (20 nos) provides professional leadership services for eye care services. Conducting research studies on eye care treatment strategies.

What Was the Outcome of Vision 2020?

According to the world report, the program was a success in achieving unified eye health at global, regional, and national levels. It strengthens national programs for the prevention of blindness and supports the development of eye care plans.

Conclusion

The implementation and working of VISION 2020 made a great impact on global eye health care. This program extended the eye care services to places, where they had less access to healthcare services. Created awareness among the people, where many diseases could be treated and blindness can be prevented. This ultimately leads to improved quality of life and reduces the social burden on blind people.