NPCB 1976

Definition of Blindness:

• NPCB: Inability to count fingers from 6 meters (vision ≤ 6/60).
• WHO: Vision ≤ 3/60.

Major Causes of Blindness:

• Cataract (62%)
• Refractive Errors (20%)
• Glaucoma (6%)
• Posterior Segment Disorders (5%)
• Post Capsular Opacification, Corneal Blindness, Surgical Complications (1% each)
• Others (4%)

Types of Blindness:

• Economic: Vision ≤ 6/60.
• Social: Vision ≤ 3/60 or visual field ≤ 10°.
• Absolute: No light perception.
• Manifest: Vision 1/60 to light perception.
• Curable: Reversible with treatment (e.g., cataract).
• Preventable: Avoidable with preventive care (e.g., xerophthalmia).
• Avoidable: Includes both preventable and curable blindness.

Introduction:

• Launched in 1976 as the world's first national-level blindness control programme.
• Goal: Reduce blindness prevalence from 1.4% to 0.3%.
• Progress: Reduced to 1.1% in 2001-02 and 1.0% in 2006-07.
• Decentralized in 1994-95 with the formation of District Blindness Control Societies (DBCS).
• Aligns with Vision 2020: The Right to Sight.

Visual Acuity:

• Defined as the sharpness of vision, measured by comparing what a person can see to what a person with normal vision can see.

Objectives:

1.     Identify and treat blindness at all levels (primary to tertiary).

2.     Strengthen eye care services and deliver quality care.

3.     Upgrade Regional Institutes of Ophthalmology (RIOS).

4.     Improve infrastructure and human resources.

5.     Raise community awareness on eye health.

6.     Promote research in blindness prevention.

7.     Involve NGOs and private practitioners.

Strategies:

• Focus on free cataract surgeries through public and private sectors.
• Expand scope to include other conditions:
  Diabetic Retinopathy, Glaucoma, Corneal Blindness, Vitreo-retinal diseases, Childhood Blindness, etc.

Key Initiatives & Activities:

·        Active Screening: Focus on screening people over 50 years for cataract to reduce backlog.

·        Capacity Building: Train eye care providers and upgrade infrastructure.

·        IEC Activities: Awareness programs on eye care for the community.

·        Strengthening Institutions: Upgrade RIOS, medical colleges, and district hospitals with equipment, staff, and funds.

·        Primary Eye Care: Establish Vision Centers at PHCs and strengthen primary eye services.

·        Mobile Ophthalmic Units (MDMOU):

• Screen patients in remote areas
• Transport patients to hospitals
• Conduct on-spot refraction & provide free glasses
• Detect conditions like diabetic retinopathy & glaucoma
• Display health messages & involve local governance

·        School Eye Screening: Identify and treat refractive errors in primary and secondary school children, with focus on underserved areas.

·        Community Focus: Special emphasis on illiterate rural women, integrating with women & child development schemes.

·        Dedicated Facilities: Build Eye Wards and Eye OTs in district hospitals as needed.

·        Private Sector Involvement: Encourage participation of private practitioners and NGOs.

 Components of NPCB:

1.     Cataract surgery – Core focus of the program.

2.     Eye screening – For early detection of visual impairments.

3.     Eye donation – Promoted through Eye Donation Fortnight (Aug 25–Sep 8).

4.     Voluntary organization participation – NGOs support eye care services.

5.     Vitamin A prophylaxis – Oral syrup for all preschool children.

6.     IEC Activities – Awareness programs like World Sight Day (2nd Thursday of October).

   Integrated Initiatives:

• Free cataract surgeries, medicines, and spectacles (for postoperative care and poor students).
• Free transport for patients from remote areas.
• Coverage of all school children for screening and Vitamin A & immunization.
• Establishment of Eye Banks and one Regional Institute of Ophthalmology (RIO).
• Modern eye care services at Medical Colleges & District Hospitals (DHHs).

 Outcomes & Achievements:

• IOL (Intraocular Lens) surgeries rose from 20% (1997–98) to 95% (2013–14).
• 15.3 million cataract surgeries conducted, preventing blindness.
• 70–80% of targeted school children receive free spectacles yearly.
• Increased eye donation due to awareness campaigns.
• Free treatment provided for diabetic retinopathy, glaucoma, childhood blindness, keratoplasty, etc.

Overview

1. Definition of Blindness

• NPCB: Vision ≤ 6/60 (can’t count fingers at 6 m).
• WHO: Vision ≤ 3/60.

2. Major Causes of Blindness in India

• Cataract – 62%
• Refractive Errors – 20%
• Glaucoma – 6%
• Posterior Segment Disorders – 5%
• Others (incl. PCO, Corneal, Surgical) – 7%

3. Types of Blindness

• Economic: Vision ≤ 6/60
• Social: Vision ≤ 3/60 or field <10°
• Absolute: No light perception
• Manifest: Vision 1/60 to light perception
• Curable: Reversible (e.g., cataract)
• Preventable: Avoidable through prevention
• Avoidable: Curable + Preventable

4. Programme Overview

• Launched: 1976
• Goal: Reduce prevalence from 1.4% to 0.3%
• Vision 2020: “The Right to Sight”
• Decentralized in 1994-95 via District Blindness Control Societies (DBCS)

5. Objectives

• Identify/treat blindness at all levels
• Strengthen eye care services & RIOs
• Develop infrastructure & human resources
• Promote community awareness
• Encourage research & NGO participation

6. Key Strategies

• Free cataract surgeries, medicines, spectacles
• Mobile units (MDMOU) for screening & transport
• Vision Centers at PHCs
• Eye screening for school children
• Vitamin A supplementation for preschoolers
• IEC activities: World Sight Day (2nd Thursday of Oct)
• Focus on rural, illiterate women
• Construct Eye Wards & Eye OTs in districts

7. Programme Components

1.     Cataract Surgery

2.     Eye Screening

3.     Eye Donation (Aug 25–Sep 8)

4.     Voluntary Organizations

5.     Vitamin A Prophylaxis

6.     IEC Campaigns

8. Integrated Initiatives

• Free surgery, transport, drugs, and glasses
• Coverage of all schools and remote areas
• Establish 2 Eye Banks + 1 RIO
• Advanced care at Medical Colleges & DHHs

9. Achievements

• IOL surgeries: 20% (1997-98) to 95% (2013-14)
• 15.3 million cataract surgeries done
• 70–80% of school vision targets met yearly
• Rise in eye donation rates
• Free treatment for DR, Glaucoma, Childhood Blindness, Keratoplasty