Primary Eye Care and Community Participation

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Primary Eye Care and Community Participation

• Dr. Saman Wimalasundera MBBS, DO, PhD
• Senior lecturer in community medicine
• community ophthalmologist
• Community Ophthalmology center
• Department of community medicine
• P.O.Box 70,
• Galle
• Sri Lanka

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Primary eye care and community participation

• Delivery of primary eye care has its specific
  roles and targets in the community and good
  community participation is an essential component
  in the successful prevention of blindness
  program.

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• Primary eye care is the primary health care
  approach to the prevention of blindness.

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Essential components of primary eye care

• Promotive
• Preventive
• Curative
• Rehabilitative

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(1) Promotive eye care

• 1.Creating and awareness of the blinding
  diseases existing in the community and the ways
  of preventing or curing it.
• 2.How to use the available recourses to
  overcome the problems.

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(2) Preventive eye care

• 1.Motivation of individuals and their
• communities to participate in blindness
• prevention activities.
• 2.Social and community development that promotes
  health
• 3.Change of behavior and environment

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Examples

• Provision of adequate safe water.
• construction of latrines refuse pits
• maintenance of environmental hygiene.
• Consumption of food rich in vitamin A.
• Care for individuals at risk.

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• Prevention of measles, malnutrition and
• diarrhea in children
• Protection of eyes against injuries.
• Immunization (E.g. Measles)
• Screening of antenatal mothers for sexually
• transmitted diseases.
• Family planning

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(3) Curative activities

• 1. To carry out treatment procedures for simple
  common diseases that lead to blindness or
  impaired vision if not treated
• e.g. corneal ulcers, refractive errors etc.
• 2. First aid treatment for eye injuries.
• 3.Timely referral to secondary level.
• 4.Identification of potentially blinding disease
  
• conditions for proper management
• 5.Identification of curable blinding diseases
• e.g.cataract and referral for treatment

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(4) Rehabilitative activities

• Target group Incurably blind people
• What can the primary eye care workers
• do to them ?
• They should be assured that they are not
• completely useless

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• Some carefully selected appropriate training
  should be given to them to acquire some skills
• Make them functional and do not allow to depend
  on the others totally.

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Development of primary eye care program

• A good primary Eye care Program will depend on
• existing health care services and availability of
  trained health care workers (Manpower)
• Political and professional motivation

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• (3) Resources for training, to conduct programs
  and to monitor it.
• Supplies for primary eye care workers.
• Funding for capital and recurrent expenditure.
• Close liaison with secondary and tertiary centers
• Careful Planning and evaluation

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Basic equipment essential for PEC program

• Snellens chart and pinhole
• Hand magnifying lens
• Good source of light (Torch with batteries)
• Eye dressings
• Teaching materials

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Different Types of Primary Eye care Programs that
can be used in the community

• Depend on the need of the local community
• and available resources
• 1. Need assessment Programs
• 2. Screening for blinding diseases
• 3. Comprehensive care Eye camps
• 4. Out reach Surgical Camps
• 5. Health Education Programs

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Sustainability of the PEC programs

• Depend on the following areas
• Technical sustainability - Training of
  technical staff
• Financial sustainability - Continuous
  allocation of funds necessary
• Operational sustainability - Monitoring of
  the activities regularly.

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Community Participation
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Ottawa charter and health promotion

• In 1986 an international conference
• called Ottawa charter adopts five principal
• elements that improve health promotion.

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The Five principals are

• Healthy public policy
• Personnel skills development
• Community participation
• Healthy and supportive environment
• Re-organization of health services
• Community participation is a major
• emphasis in eye health promotion.

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• The promotion of eye health and to
• reduce the risk of blindness though
• community ophthalmology needs good
• community participation

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Community participation is influenced by

• Community beliefs and perceptions
• Motivation of people in the community
• Awareness of the problems related to blindness

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Community participation can be improved by

• Encouraging the people with early symptoms by
  their families to attend to available health
  services

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• By creating and awareness through health
  education programs
• - Mass media programs
• - Through volunteers or community health
  workers by small group discussions
• - Through community leaders
• - Self help groups
• - Improving education of children through
  schools

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Community participation enhances eye health

• By attending to the community health programs for
  early detection
• By following treatment procedures until full
  recovery

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• By adopting changes in life style that encourages
  eye health
• By improving the living environment in the
  communities to reduce the risk of transmission of
  eye diseases
• By creating a community demand by the people of
  the community to develop infra structure
  facilities by policy makers that improves eye
  care services.

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• There is a high demand for a
• community based approach in the
• prevention of blindness. That needs
• proper community participation.