Henry Journal of Ophthalmology & Optometry

The problem of blindness is universal but the magnitude varies from region to region based on the economic status, awareness, infra- structure, availaibility of facilities including manpower.

Prevention of blindness is known to be one of the most cost ef- fective health interventions and can be underatken. It should start at the individual, family and community level, since Blindness knows no geographical, economic or cultural bounds. It respects neither age nor gender.

“Life without sight is difficult. Life without vision is impossible.”

• • One of the basic human rights is the “ Right to see”.
• • Senile changes there for a universal inevitable aspect of life 
• • Eyes continue to grow in all dimensions with consequent changes in refraction upto about the age of eight years
• • Children are our future and need attention first 
• • WHO in 2010 estimated that approxiamtely 285 million people were visually impaired and 39 million were blind
• • Visual impairement is more common in amongst older age group, while childhood blindness remains a gigantic problem with an es- timated 4 million blind children below the age of 15 years. The child has to spend many years of blindness (blind years) resulting in personal, family and national economic loss
• • Prevelance of childhood blindness in developing countries is esti- mated to be as high as 5/1000. In contrast to 0.3/1000 in devel- oped countries
• • Recent data suggests that there are 124 million people in the world with low vision
• • Cataract remains the leading cause of blindness globally except in most developed countries
• • Uncorrected refractive error, is 42% out of the 19 million children who are visually imapired, refractive error is responsible for ima- pirement of vision of 12 million
• • Corneal problem account for 4% if Blindness
• • Malnutrition is another leading cause of Blindness especially in developing world

In the light of such a scenario, it is becoming increasingly mandatory to take measures to prevent Blindness and as such the program initiated by me in 2012 could be a good supplement to 2020 program of WHO.

‘PRAYAS’ is a program formulated with the fundamental idea behind it “Awareness generation with community participation” to prevent blindness specially in the underserved population such being known as tribal in India and others alike in the developing countries.

“Alone we can do so little. Together we can do so much”. 

Helen Keller ‘Prayas’ is a Hindi word derived from Sanskrit meaning endeavor being an ancient Sanskrit word which refers to the efforts and attempts to start a task, endeavor or exertion made by a person in order to do the task by hard degree of efforts or hardwork devoted to complete it. 

Incidetaly ‘Prayas has some Mythological significance as well as being a popular name in India used by more than 200 people as the name of their children. Besides Prayas is also one of the largest non Profit organisations, its goal being to protect the rights of marginalised children, women and young people. Remember the fundamental Human right of Human beings is to ‘see’. 

Thus, we make sure that no human being should be blind or remain blind. 

For this we will have to resist persons doomed of blindness with available resources and talent. 

Because it not only affects physical, social, familial, professional, psychological, emotional and cultural areas of huma life but strangulates the progress as well.

It is a matter of concern that many efforts are being made through various programs and policies made but insufficiency of community participation is pulling us back from success.

Remember that blindness enhances poverty or poverty pertains to blindness.

Ironically, 80% of eye diseases, cause of blindness can be prevent- ed or cured but we failed because of lack of awareness and devotional efforts. It is painful to note that in developing counties prevelance of blindness is 5 to 10 times more in comparison to the developd ones. 90% of the people with weak sight live in this segment of the globe and blindness captures a major part of this. Keeping this scenario in mind, I framed the program ‘Prayas’ with the basic theme of awareness gen- eration with community participation for the pediatric and senior citizen group irrespective of the sex, especially for the underserved population-Tribal, as we call them in India and backward areas of the other developing countries, which envisages to take care of:

• • Refractive Error
• • Malnutrition
• • Corneal Blindnes-Eye Donation

Refractive error has been prioritized in this program because it is the second common cause of blindness after cataract. It is estimated that 153 million people are visually impaired by refractive errors. The tragedy being that both the medical personnel and to be treated, do not take the problem seriously. We have to identify a methodology for quick qualitative and quantitative assessment of this malady and availability of spectacles at affordable cost. In my experience use of ‘Focometer’ could serve the purpose effectively.

Malnutrition another component of Prayas program needs to be taken care of on priority basis because of its large number in India and other developing countries, especially in SAARC and other regions.

Corneal blindness has been attracting attention because of inad- equate availability of cornea donor eyes required for corneal grafting. every attempt is made to popularise eye doantion but result has not been rewarding.

In my opinion “ an instantaneous solution could be legalising re- moval of eyes from people dying in road accidents. According to a report by WHO. 1.25 million people die each year globally in traffic crashes. A fact not attracted attention so far”.

Thus, for effective implementation of the program we should or- ganise meetings with local people of all walks of life including Rotary and Lion’s International and aprise them through audio visual presen- tations, as I did,with the intricacies of refractive errors, malnutrition and corneal blindness and evolve methodology for use by the local population. A team comprising of ophthalmic surgeon, optometerist and optician can be of good use to give dividend and as such we can surely curb the Global Blindness and take people from Darkness to Light the objective we want to achieve.