Blindness remains a significant global health challenge, affecting millions due to preventable or treatable conditions. The primary culprits behind vision impairment and blindness include refractive errors, cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration. Sadly, access to appropriate interventions for these conditions remains limited, with only 36% of individuals with refractive errors and 17% of those with cataracts receiving necessary treatment. This translates to an estimated 2.2 billion people worldwide struggling with near or distant vision impairment, with approximately 1 billion cases being preventable.
In a candid conversation with Firstpost, Dr. Uday Tekchandani, a renowned Consultant Ophthalmologist, Vitreoretina, Uveitis and ROP Specialist at Dr. Agarwals Eye Hospital (Wadala), sheds light on the leading causes of blindness, the importance of early diagnosis, and the remarkable strides made in neonatal care, particularly concerning Retinopathy of Prematurity (ROP).
Unveiling the Leading Causes of Blindness
Dr. Tekchandani outlines the major contributors to blindness: cataracts, diabetic retinopathy, macular degeneration, and glaucoma. He highlights that while these conditions are significant, the most common cause of visual impairment globally is uncorrected refractive error, emphasizing the need for corrective lenses or spectacles.
The Power of Early Diagnosis and Regular Eye Check-ups
Dr. Tekchandani underscores the critical importance of early diagnosis in effectively treating blinding eye diseases. He advocates for comprehensive eye check-ups for every child by school age, or earlier if any visible issues or signs are present, such as white discoloration in the eyes. Adults over 40, especially those with a family history of glaucoma, should undergo regular screenings to prevent irreversible blindness from untreated glaucoma. Furthermore, individuals diagnosed with diabetes should immediately consult an eye doctor for a retinal exam to detect and manage diabetic retinopathy before it progresses.
Understanding Retinopathy of Prematurity (ROP)
Dr. Tekchandani explains that Retinopathy of Prematurity (ROP) is a condition affecting the retina of prematurely born babies, potentially leading to irreversible blindness by the time the child reaches six months old. The premature birth leads to underdeveloped retinal blood vessels, and the change in environment after birth can hinder their development, leading to the formation of abnormal blood vessels. This can cause bleeding, tension on the retina, and ultimately retinal detachment.
Addressing ROP: Advancements and Neonatal Care
Dr. Tekchandani emphasizes the significant advancements made in treating ROP, moving from laser therapy alone to newer injections directly administered into the child’s eye. He also highlights the improved surgical techniques and equipment, particularly small incision vitrectomy, leading to better surgical outcomes for affected children. Moreover, advancements in neonatal care, especially the ability to safely administer general anesthesia to these vulnerable infants, have played a crucial role in preventing blindness. He stresses the importance of neonatal care facilities adhering to guidelines for oxygen administration and quality care for at-risk neonates.
Breaking Down the Statistics on ROP in India
Dr. Tekchandani shares alarming statistics on ROP in India, revealing that the country contributes approximately 10% of all global ROP cases. Up to 32% of at-risk infants screened exhibit some form of ROP, with 18% displaying severe ROP requiring laser treatment, injections, surgery, or a combination of interventions. He underscores the importance of awareness about the disease and timely screening and treatment to avoid children presenting late with advanced stages of ROP.
The Importance of Early Screening for Children
Dr. Tekchandani emphasizes the crucial role of early screening in preventing blindness in children. He outlines essential steps parents and caregivers should take:
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Limit Screen Time:
Minimize screen time for children, especially under two years old. For older children, limit it to educational activities. Excessive screen time can lead to digital eye strain, progressive refractive errors, and various health issues.*
Safety Precautions:
Keep chemicals and sharp objects out of reach to prevent accidents.*
Regular Eye Exams:
Ensure every child undergoes an eye exam by an ophthalmologist once they start school. This helps diagnose refractive errors and prevent amblyopia (lazy eye).*
Early Screening for Refractive Errors:
Seek immediate consultation if a child exhibits difficulty distinguishing between similar-looking objects or numbers, gets too close to the blackboard or objects to read, or squints to see better.*
Abnormal Eye Symptoms:
Promptly consult an ophthalmologist for any abnormal discoloration of the eyes, such as a white or yellow reflex, or any deviation of the eyes (squinting), as these could indicate serious conditions.*
Movement and Vision Issues:
Pay attention to signs like difficulty navigating unfamiliar environments, bumping into obstacles, or struggling to see in daylight or at night, as they may indicate genetic eye diseases.*
Allergies:
Consult an ophthalmologist for appropriate eye drops to prevent eye allergies from progressing into serious conditions.*
Outdoor Activities:
Encourage at least 90 minutes of outdoor activities in natural sunlight daily for eye development and to help prevent rapid progression of refractive errors.*
Premature Infants:
Ensure every child born prematurely (before 34 weeks of gestation) and weighing less than 2 kilograms is examined by a trained ophthalmologist by 30 days of age for ROP screening.Dr. Tekchandani’s insights provide a comprehensive understanding of the leading causes of blindness, the critical role of early diagnosis and treatment, and the importance of awareness and timely intervention, particularly for Retinopathy of Prematurity. By adhering to these guidelines and promoting access to quality eye care, we can significantly reduce the burden of preventable blindness and ensure a brighter future for generations to come.
