BASIC LOW VISION SERVICE

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BASIC LOW VISIONSERVICE

• NEW OPPORTUNITY OF SERVICE UNDER AVOIDABLE
  BLINDNESS INITIATIVE
• Presentation on Adaptable technology for
• Low vision devices by Rtn. Ramesh Sathe
• District - 3130

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Human brain is equipped with 5 SENSES
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WE ARE VISUALLY ORIENTED FROM BIRTH

• Verbal messages are,received quickly, more
  clearly understood and retained longer if they
  are supported by visual example.
• SO POWERFUL IS THE SENSE OF VISION, BUT MILLIONS
  OF PEOPLE SUFFER FROM VISUAL DISABILITIES AND
  UNABLE TO PERFORM DAILY ACTIVITIES.

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BLINDNESS -Three major questions

• WHAT is the magnitude of the problem?
• WHY prevent blindness?
• HOW we can prevent?

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VISION 2020 RIGHT TO SIGHT(17TH February 1999)

• In order to drastically reduce the global burden
  of blindness WHO and broad coalition of INGO and
  private organisations launched global initiative
• RIGHT TO SIGHT VISION - 2020
• The objective is to eliminate avoidable blindness
  by 2020.

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Main causes of blindnessfirst phase of vision
2020

• Cataract - Clouding of crystalline lens.
• Trachoma- is common in areas of the world that
  are socio -economically deprived of basic needs.
• Onchocerciasis (River blindness)
• Childhood blindness.
• REFRACTIVE ERRORS AND LOW VISION

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INDIA IN 2001 HAS STATISTICALLLY SPEAKING 40
MILLION BLIND PEOPLE
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ALL ARE NOT TOTALLY BLIND...! A FACT NOT VERY
COMMONLY REALISED BECAUSE BETWEEN TOTAL
BLINDNESS AND NORMAL VISION THERE EXISTS LARGE
GREY AREA OF LOW VISION ...
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• It is estimated that 28 million people are in
  need of low vision care in India.

If Appropriate LV Device is Given These people
can carry out essential activities required in
day to day life
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A global estimate of LV care

• 148 million Visually Impaired ( Blind LV )
• 8 million blind without perception of light
• 140 Partially sighted out of this 105 million in
  need of cataract surgery and or routine
  refraction.
• 35 million in need of Low vision Care.

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What is Low Vision Service?

• When conventional eyeglasses can no longer help
  and surgery or other treatment not appropriate -
  Then it is time to consider LOW
  VISION DEVICES
• There are many types of LV devices but easy
  availability, affordable cost and training
  facilities are not available in developing
  countries

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Challenging field

• I thought this is a new opportunity of service to
  a lot of poor and needy people if the LV devices
  could be made available at..
• AFFORDABLE AND REASONABLY LOW PRICE
• ....A must in any highly populated poor country.

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The unit can zoom from two inches to infinity,
one unit for near and distance vision. Cost 6,000
US-Not affordable by developing countries
Our Aim to manufacture quality devices
Indigenously at low cost for each application
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Asia Pacific Regional Workshop

• There is a great and urgent need to expand access
  to low vision care.
• Identify and train appropriate personnel for
  delivery of the services.
• Emphasis on Appropriate technology and production
  of low cost Low vision devices
• Ramesh Sathe was one of the Participants in this
  workshop

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Our Contribution to Avoidable blindness Initiative

• We designed a kit for Education and
  rehabilitation of visually impaired people
• Our field trials proved successful as 80.5
  people benefited.

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BLIND EDUCATION

• History records that India and China are the
  pioneers in blind education.
• Present atmosphere about this is depressing as
  number of visually impaired persons is increasing
  and there are negligible facilities available.
• Urgent need to develop Low Vision Service.

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Present Situation

• All organisations working for blind concentrate
  their efforts on Education and Employment
• Visual disability due to aging is common, but
  assistive devices for elderly are not easily
  available.
• Simple devices can improve quality of life of
  Elderly persons

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Vision 2020 Includes three pronged strategy

• Strengthen primary eye care programmes to
  eliminate preventable causes.
• Develop surgical and therapeutic support to deal
  effectively with curable eye problems.
• ESTABLISHING OPTICAL AND LOW VISION SERVICE.

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Basic Low vision service

• Partially sighted person has some residual vision
  and with LV devices can maintain independent and
  productive way of life
• Many patients with Macular degeneration, diabetic
  retinopathy, and some other disabilities can be
  given useful vision for some daily task by
  identifying proper visual aid.
• ..This can change the quality of life

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IDENTIFICATION
Visual acuityPinholeFunctional questions
VA not improved
VA improved
REFRACTION
OPHTHALMIC EXAMINATION
Spectacles
Not treatable
Treatable causes
ASSESSMENT FOR LOW VISION CARE
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OUR FIELD TRIALS
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MAGNIFICATION A SOLUTION

• Increase the size of the object- (Large print
  books,) or use of optical magnifier
• Decrease the viewing distance.
• Closed Circuit TV System
• Telescopic Magnification.

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Ideal Magnifier

• An ideal magnifier would have high power, large
  area, light weight, high working distance and
  crystal clear distortionless Magnification
• But the magnifier incorporating all these
  properties is impossible as per basic laws of
  physics
• We have to give up an advantage in order to gain
  another considering the application.

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Properties Of Magnifier important for Low Vision
Application

• Field of View
• Magnification
• Working Distance
• Mechanical Configuration

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Use of following Types of Magnifiers

• Fresnel lenses
• Aspheric Lenses (mounted in spectacle and stand)
• Prismatic spectacles
• Closed Circiut TV System

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Use of Aspheric Lenses

• LV application requires high power lenses 120 D
  to 300 D
• Spherical surfaces are easiest and economical but
  suffer from spherical aberation, this is
  insignificant upto 12D, but rapidly reduces field
  of view.
• Aspheric lens is the solution, production of
  glass lenses expensive, Therefore we developed
  plastic lenses.

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Prismatic Lenses

• Patients of macular degeneration may improve
  vision by looking to the side of the target so
  that the image is moved off the diseased central
  region of the eye
• A theoretical alternative is to move the image
  onto an adjacent healthy area, using Prismatic
  lenses mounted in spectacle.
• Potentially prismatic spectacles are much more
  useful than conventional LVA,S

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Use of CCTV System

• Optical magnification systems are limited.
• The magnification of a CCTV system is much more.
• Contrast reversal is possible
• Magnification adjustable over a wide range
• Can be used for longer duration.
• Very useful in creating confidence of the patient

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Tool for Education

• Any book can be converted into large print by
  using this magnifier

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Access to Entertainment

• For elderly persons Reading of news paper becomes
  comfortable

Watching TV
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Reading kit for students

• A joint activity in co-operation with National
  Association for the Blind and Govt. of Federal
  Republic of Germany
• Many students will be benefited

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HUMAN RESOURCE

• In all developing countries there is a shortage
  of eye care professionals.
• Therefore help of NGOs /volunteers for eye
  screening in schools, senior citizen clubs is
  essential.
• Creating awareness is another important task.
  Rotary Clubs can do this easily.

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SIGHT IS NEXT TO LIFE

• Protect it
• Save it
• Restore it
• Let us work together

THANK YOU