A Population Profile Survey of Patients Attending comprehensive Ophthalmic Camps in Nashik District Conducted by Maratha Vidya Prsarak Samaj

- A 2 Years Study
Presented by DR. POOJA KHARBANDA M. S. OPHTHALMOLOGY NEW DELHI

Aim
To find out the profile of patients who had undergone cataract surgeries in ophthalmic camps conducted from 2008-2010 covering rural and tribal regions of nashik district

DR. POOJA KHARBANDA

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Materials and Methods

Various camps were arranged covering all talukas of nashik district Active screening to identify patients including paediatric age group was done and patients to be operated were selected for SICS & Phacoemulsification surgeries Pre and Post operative surgical relevant data was recorded using a pre tested semi open proforma The data including age, gender and socio-economic determinants was analysed Comprehensive eye care and mass cataract camps were conducted
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 Comprehensive eye care camps were concerned with primary eye care approach providing several types of services for many ocular or systemic conditions that lead to visual disability or blindness if left untreated Identifying corneal disease Cataracts Refractive errors Glaucoma Squints Eye infections Allergies Trauma Other common eye conditions.
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The Need - To Reach the Unreached !

Despite the magnitude of the problem of avoidable blindness in developing countries, studies have shown that only a small percentage of the people needing cataract surgery or other treatment actually seek it Moreover, eye care in the developing world still suffers from: 1. Financial and logical barriers to access 2. Low patient awareness of services available 3. Low doctor/patient ratio In other words, it is necessary for eye care institutions to reach out to potential patients the "unreached" in order to provide their services to the people who need them most

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Community Partner (Sponsor) to Conduct a Camp?

Any individual or voluntary social service organization - such as

Lions Rotary Religious groups Industries Trusts Banks Hospitals Community based NGOs Recreation and welfare clubs Farmers associations Village presidents

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Sponsors' role The sponsors have the primary role of setting up campsite preferably a school venue with the necessary support facilities viz. furniture, electricity, water etc. and also to care of the publicity needs. They are responsible for assembling patients and providing lodging and food for the medical team Selecting an ideal place for a camp A village with a population of ten to twenty thousand including the surrounding areas in an accessible radius of 5 Kms is selected for conducting an eye camp. A convenient venue (such as a large school building in the area) and a suitable date (which does not interfere with local festivals, marriages and other functions or with other camps) will be selected for conducting the camp. The village should have good access to the nearby villages to benefit the patients around the main village

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The sponsors are supposed to: Delegate a separate team of members and volunteers to look after the community mobilization Arrange boarding and lodging for the medical team if the location is beyond 125km from the base hospital Arrange local transport facility for patients between the villages and the site of the camp, if the camp venue is not accessible within a radius of 5 to 10 Kms Plan for manpower and finance to prepare the camp venue and conduct widespread publicity through all possible media. The camp organizer from Aravind Eye Hospital works along with sponsor for effective execution of promotional activities COMMUNITY EYE CLINICS
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Brief Review About NPCB & Vision 2020

For strengthening / expansion of Eye Care Units in Rural and tribal areas

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National Programme for Control of Blindness

It was launched in the year 1976 as a 100% Centrally Sponsored scheme with the goal to reduce the prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02, prevalence of blindness is estimated to be 1.1%. Target for the 10th Plan is to reduce prevalence of blindness to 0.8% by 2007 prevalence of Blindness is 1% (2006-07 Survey) Main causes of blindness are as follows: - Cataract (62.6%) Refractive Error (19.70%) Corneal Blindness (0.90%), Glaucoma (5.80%), Surgical Complication (1.20%) Posterior Capsular Opacification (0.90%) Posterior Segment Disorder (4.70%), Others (4.19%) Estimated National Prevalence of Childhood Blindness Low Vision is 0.80 per thousand The objectives of the programme are: To reduce the backlog of blindness through identification and treatment of blind To develop Eye Care facilities in every district To develop human resources for providing Eye Care Services To improve quality of service delivery To secure participation of Voluntary Organizations in eye care
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VISION 2020
Structure and Activities:
VISION 2020 was proposed by Dr. Abdul Kalam in 1999 VISION 2020 is the global initiative for the elimination of avoidable blindness, launched in 1999, jointly by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with an international membership of NGOs, professional associations, eye care institutions and corporations Over two decades, it is hoped that VISION 2020 will prevent 100 million people from becoming blind VISION 2020 seeks to eliminate the main causes of avoidable blindness in order to give all people in the world, particularly the millions of needlessly blind, the right to sight

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DR. POOJA KHARBANDA

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Various steps involved in an eye camp are as follows: Step 1: Patient registration: The camp team, composed of ophthalmologists and paramedical staff, proceed to the camp site Step 2: Preliminary vision test: Preliminary vision test is performed by ophthalmic assistants. Vision charts, such as the Snellen (in the local language) and E type charts, are used Step 3: Preliminary examination: Ophthalmologists perform the preliminary examination Step 4: Tension and duct examination: Patients above the age of 40 have their intraocular pressure tested
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Step 5: Refraction: Refraction is performed on patients who have refractive errors, presbyopia, outdated glasses, or pseudo-aphakia Step 6: Final examination: Senior Ophthalmologists evaluate the test findings Step 7: Counselling: Patients advised for surgery or further specialty interventions are educated by the counsellors to uptake the relevant eye care Step 8: Optical Services : Opticians (sales person and technicians from optical division) also attend the screening camp as part of the medical team

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Manpower and Duties

In addition to routine eye care workers:
Eye surgeon Optometrist Ophthalmic Nurses Refractionists Ophthalmic Assistants OT Staff Public health workers

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DR. POOJA KHARBANDA

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WORKS
Screening for visual defects using Snellens chart and examination for obvious anomalies IOP checking using Shiotz tonometer Refraction Drug distribution Diagnosing, treating and referral Health education Logistics
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EYE CAMP METHODOLOGY

Methodology envisages the involvement of District Administration Health and Authorities and company officials in projecting its corporate image as follows in the process of Eye-screening Camps & Cataracts operations:Identifying in consultation with Power Grid officials cluster of 30-40 villages in the area of companys operations. 2. Identifying venues of organizing the camp such as school, health centre 3. Holding meeting with school principles, Gram Pradhans, Sarpanch etc., for purpose of publicity 4. Printing of publicity material-handbills, posters, banners, prescription sheets, newspaper through loudspeakers covering weekly markets, school and villages Panchayat 5. Arrangement of Doctors and paramedical staff (optometrist etc) who will screen the patients during the camp 6. Arrangement of medicines for distributers during the camp 7. Arrangement of spectacles for distribution during the camp 8. Arranging transport for shifting cataract patients from venue of eye camp to hospital 9. Arranging transport for shifting patients for hospital to venue site after cataract operation 10. Arrangement of accommodation and food 11. All cataract operation will be done by the experienced eye surgeons with IOL implant (Phaco/SICS) 1.

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OBJECTIVES
The main objectives of the programme are:
a) To provide high quality of eye care to the affected population b) To expand coverage of eye care services to he underserved area c) To reduce the backing of blindness by identifying and providing services to the affected population d) To develop institutional capacity for eye care services by providing support for equipment and material and training personnel

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VARIOUS TALUKAS OF NASHIK DISTRICT

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DR. POOJA KHARBANDA

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PETH 2008 Camp

Total operated patients 36 Male 9 Female 23

40

36

35

30 23 25

20

15

10

0 Total operated patients male female

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CHANDWAD-2008 Camp
july aug sept oct nov dec total
250

Total operated patients 49 48 30 51 25 35 238

Male 25 25 15 45 15 20 145

Female 30 27 20 30 10 25 142
238

200 145 142

150

100 51 25 27 30 15 20

50

49 25 30

48

45 30 25 15 10 nov Male

35

20 25

0 july aug Total operated patients sept oct dec Female total

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CHANDWAD-2009 Camp
jan feb mar apr may jun jul aug sep oct nov dec
120 100 84 84 65 60 4341 40 23 20 0 jan feb mar apr may jun jul Male aug sep oct Female nov dec 15 10 5 48 40 38 40 24 16 21 9 12 24 43 25 18 7 34 4143 113

Total operated patients 84 113 63 15 38 40 21 24 7 43 84 16

Male 43 48 40 10 18 16 9 10 3 18 41 9

Female 41 65 23 5 20 24 12 14 4 25 43 7

80 63

1820

14 10

16 97

Total operated patients

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PETH-2009 Camp
jan feb march total
100 90 80 70 60 50 40 30 20 10 0 jan Total operated patients feb march Male total Female 24 15 8 7 9 32 22 13 56 52 41

Total operated patients 56 15 22 93

Male 24 8 9 41

Female 32 7 13 52

93

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SINNER-2009 Camp
sep oct nov dec total
250
230

Total operated patients 89 40 84 17 230

Male 42 13 40 3 98

Female 47 17 44 14 122

200

150 122 100 98 84

89

50

42

47

40 13 17

40 44 17 3 14

0 sep oct nov dec total

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Total operated patients Male

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IGATPURI-2010 Camp
feb march april total

Total operated patients 15 38 8 59

Male 2 20 5 27
59

Female 13 18 3 32

60

50

40

38 32

30 20 20 15 13 8 5 2 0 feb march april 3

27

18

10

total

Total operated patients

Male

Female

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SURGANA & CHANDWAD-2010 Camp

jan feb mar apr may jun jul aug sep total

Total operated patients 9 11 10 9 2 15 75 34 77 242

Male 5 5 7 4 2 8 35 18 46 130

Female 4 6 3 5 0 7 40 16 31 112
242

250

200

150

130 112 75 3540 9 5 4 11 5 6 10 7 3 9 4 5 15 2 2 0 8 7 77 46 31

100

50

34 1816

jan

feb

mar

apr

may

jun
Male

jul

aug
Female

sep

total

Total operated patients

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Total no. of male operated 43%

Total no. of female operated 57%

43% 57%

Total no. of male operated

Total no. of female operated

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Total no. of cataract surgeries done-1077 1077

Total no. of patients examined-8517 8517

1077

8517

Total no. of cataract surgeries done-1077

Total no. of patients examined-8517

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Total no. of camps conducted by MVP Samaj Hospital in 2 years-150 150

Others 5

150

total no. of camps conducted by MVP Samaj Hospital in 2 years-150

others

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CONCLUSION

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DR. POOJA KHARBANDA

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DR. POOJA KHARBANDA

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REFERENCES
Community Eye Health Journal Vol. 11 to 23; 1998 to 2010 Clinical Ophthalmology Kanski Bulletine of the World Health Organztion, Vol. 1 to 88; 194 Jose R. Rathore AS, Sachdeva S. Community Opthalmology (Revised Indian) community Med 2010; 35:365-8 .2010

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EYES ARE THE DIVINE GIFT GIVEN BY GOD

LETS JOIN HANDS IN TAKING CARE OF THEM

Sarvendriyam Pradhanam Vayanedrayam

THANK YOU

DR. POOJA KHARBANDA M. S. OPHTHALMOLOGY S.R. NEW DELHI