Dr. Pooja Kharbanda Ppt 64th DOS Annual Conference, Appreciation Award Paper

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    Presented by

    DR. POOJA KHARBANDA

    M. S. OPHTHALMOLOGY

    NEW DELHI

    A Population Profile Survey of Patients

    Attending comprehensive

    Ophthalmic Camps in Nashik

    District Conducted by

    Maratha Vidya Prsarak Samaj- A 2 Years Study

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    Aim

    To find out the profile of patients who had

    undergone cataract surgeries in ophthalmic

    camps conducted from 2008-2010 coveringrural and tribal regions of nashik district

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    Materials and Methods

    Various camps were arranged covering all talukas of nashikdistrict

    Active screening to identify patients including paediatricage group was done and patients to be operated wereselected for SICS & Phacoemulsification surgeries

    Pre and Post operative surgical relevant data was

    recorded using a pre tested semi open proforma

    The data including age, gender and socio-economic

    determinants was analysed

    Comprehensive eye care and mass cataract camps were

    conducted

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    Comprehensive eye care camps were concerned with primary eye careapproach providing several types of services for many ocular or

    systemic conditions that lead to visual disability or blindness if left

    untreated

    Identifying corneal disease

    Cataracts

    Refractive errors

    Glaucoma

    Squints

    Eye infections

    Allergies

    Trauma

    Other common eye conditions.

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    The Need - To Reach the

    Unreached !

    Despite the magnitude of the problem of avoidable blindness indeveloping countries, studies have shown that only a small percentage of the

    people needing cataract surgery or other treatment actually seek it Moreover,

    eye care in the developing world still suffers from:

    1. Financial and logical barriers to access

    2. Low patient awareness of services available

    3. Low doctor/patient ratio

    In other words, it is necessary for eye care institutions to reach out to

    potential patients

    the "unreached" in order to provide their services to thepeople who need them most

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    Community Partner (Sponsor) to

    Conduct a Camp?

    Any individual or voluntary social service organization - such as

    Lions

    Rotary

    Religious groupsIndustries

    Trusts

    Banks

    Hospitals

    Community based NGOsRecreation and welfare clubs

    Farmers associations

    Village presidents

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    Sponsors' role

    The sponsors have the primary role of setting up campsite preferably a school

    venue with the necessary support facilities viz. furniture, electricity, water etc.

    and also to care of the publicity needs. They are responsible for assembling

    patients and providing lodging and food for the medical team

    Selecting an ideal place for a camp

    A village with a population of ten to twenty thousand including the

    surrounding areas in an accessible radius of 5 Kms is selected for conducting

    an eye camp. A convenient venue (such as a large school building in the area)

    and a suitable date (which does not interfere with local festivals, marriagesand other functions or with other camps) will be selected for conducting the

    camp. The village should have good access to the nearby villages to benefit

    the patients around the main village

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    The sponsors are supposed to:

    Delegate a separate team of members and volunteers to look after the

    community mobilization

    Arrange boarding and lodging for the medical team if the location is beyond

    125km from the base hospital

    Arrange local transport facility for patients between the villages and the site

    of the camp, if the camp venue is not accessible within a radius of 5 to 10

    Kms

    Plan for manpower and finance to prepare the camp venue and conduct

    widespread publicity through all possible media. The camp organizer from

    Aravind Eye Hospital works along with sponsor for effective execution of

    promotional activities COMMUNITY EYE CLINICS

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    Brief Review About NPCB & Vision 2020

    For strengthening / expansion of Eye Care Units in Rural

    and tribal areas

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    It was launched in the year 1976 as a 100% Centrally Sponsored scheme with the goal toreduce the prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02,

    prevalence of blindness is estimated to be 1.1%. Target for the 10th Plan is to reduce

    prevalence of blindness to 0.8% by 2007 prevalence of Blindness is 1% (2006-07

    Survey)

    Main causes of blindness are as follows: - Cataract (62.6%) Refractive Error (19.70%)Corneal Blindness (0.90%), Glaucoma (5.80%), Surgical Complication (1.20%) Posterior

    Capsular Opacification (0.90%) Posterior Segment Disorder (4.70%), Others (4.19%)

    Estimated National Prevalence of Childhood Blindness Low Vision is 0.80 per thousand

    The objectives of the programme are: -

    To reduce the backlog of blindness through identification and treatment ofblind

    To develop Eye Care facilities in every district

    To develop human resources for providing Eye Care Services

    To improve quality of service delivery

    To secure participation of Voluntary Organizations in eye care

    National Programme for Control of

    Blindness

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    Structure and Activities:

    VISION 2020 was proposed by Dr. Abdul Kalam in 1999

    VISION 2020 is the global initiative for the elimination of avoidable blindness,

    launched in 1999, jointly by the World Health Organization (WHO) and theInternational Agency for the Prevention of Blindness (IAPB) with an

    international membership of NGOs, professional associations, eye care

    institutions and corporations

    Over two decades, it is hoped that VISION 2020 will prevent 100 million

    people from becoming blind

    VISION 2020 seeks to eliminate the main causes of avoidable blindness in

    order to give all people in the world, particularly the millions of needlessly

    blind, the right to sight

    VISION 2020

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    Various steps involved in an eye camp are as follows:Step 1:

    Patient registration: The camp team, composed of ophthalmologists andparamedical staff, proceed to the camp site

    Step 2:Preliminary vision test: Preliminary vision test is performed by ophthalmicassistants. Vision charts, such as the Snellen (in the local language) and E type

    charts, are used

    Step 3:Preliminary examination: Ophthalmologists perform the preliminary

    examination

    Step 4:Tension and duct examination: Patients above the age of 40 have theirintraocular pressure tested

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    Step 5:Refraction: Refraction is performed on patients who have refractive errors,

    presbyopia, outdated glasses, or pseudo-aphakia

    Step 6:

    Final examination: Senior Ophthalmologists evaluate the test findings

    Step 7:Counselling: Patients advised for surgery or further specialty interventions areeducated by the counsellors to uptake the relevant eye care

    Step 8:Optical Services : Opticians (sales person and technicians from optical division)also attend the screening camp as part of the medical team

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    Manpower and Duties

    In addition to routine eye careworkers:

    Eye surgeon

    Optometrist

    Ophthalmic Nurses

    Refractionists

    Ophthalmic Assistants

    OT StaffPublic health workers

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    WORKS

    Screening for visual defects using Snellens chart andexamination for obvious anomalies

    IOP checking using Shiotz tonometer

    Refraction

    Drug distribution

    Diagnosing, treating and referral

    Health education

    Logistics

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    EYE CAMP METHODOLOGY

    Methodology envisages the involvement of District Administration Healthand Authorities and company officials in projecting its corporate image as

    follows in the process of Eye-screening Camps & Cataracts operations:-1. Identifying in consultation with Power Grid officials cluster of 30-40 villages in the area ofcompanys

    operations.

    2. Identifying venues of organizing the camp such as school, health centre

    3. Holding meeting with school principles, Gram Pradhans, Sarpanch etc., for purpose of publicity

    4. Printing of publicity material-handbills, posters, banners, prescription sheets, newspaper through

    loudspeakers covering weekly markets, school and villages Panchayat

    5. Arrangement of Doctors and paramedical staff (optometrist etc) who will screen the patients during

    the camp

    6. Arrangement of medicines for distributers during the camp

    7. Arrangement of spectacles for distribution during the camp8. Arranging transport for shifting cataract patients from venue of eye camp to hospital

    9. Arranging transport for shifting patients for hospital to venue site after cataract operation

    10. Arrangement of accommodation and food

    11. All cataract operation will be done by the experienced eye surgeons with IOL implant (Phaco/SICS)

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    OBJECTIVES

    The main objectives of the programme are:

    a) To provide high quality of eye care to the affected population

    b) To expand coverage of eye care services to he underserved area

    c) To reduce the backing of blindness by identifying and providing

    services to the affected population

    d) To develop institutional capacity for eye care services by providing

    support for equipment and material and training personnel

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    DR. POOJA KHARBANDA DOS 64TH ANNUAL CONFERENCE

    VARIOUS TALUKAS OF NASHIK DISTRICT

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    PETH 2008 Camp

    0

    5

    10

    15

    20

    25

    30

    35

    40

    Total operated patients male female

    36

    9

    23

    Total operated patients Male Female

    36 9 23

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    CHANDWAD-2008 Camp

    49 48

    30

    51

    2535

    238

    25 2515

    45

    1520

    145

    30 2720

    30

    10

    25

    142

    0

    50

    100

    150

    200

    250

    july aug sept oct nov dec total

    Total operated patients Male Female

    Total operated

    patients Male Female

    july 49 25 30

    aug 48 25 27sept 30 15 20

    oct 51 45 30

    nov 25 15 10

    dec 35 20 25

    total 238 145 142

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    CHANDWAD-2009 Camp

    84

    113

    63

    15

    38 40

    2124

    7

    43

    84

    16

    43 4840

    10

    18 16

    9 10

    3

    18

    41

    9

    41

    65

    23

    5

    2024

    12 14

    4

    25

    43

    7

    0

    20

    40

    60

    80

    100

    120

    jan feb mar apr may jun jul aug sep oct nov dec

    Total operated patients Male Female

    Total operated patients Male Female

    jan 84 43 41

    feb 113 48 65

    mar 63 40 23

    apr 15 10 5may 38 18 20

    jun 40 16 24

    jul 21 9 12

    aug 24 10 14

    sep 7 3 4

    oct 43 18 25

    nov 84 41 43

    dec 16 9 7

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    PETH-2009 Camp

    0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    100

    jan feb march total

    56

    15

    22

    93

    24

    8 9

    41

    32

    7

    13

    52

    Total operated patients Male Female

    Total operated

    patients Male Female

    jan 56 24 32

    feb 15 8 7march 22 9 13

    total 93 41 52

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    SINNER-2009 Camp

    89

    40

    84

    17

    230

    42

    13

    40

    3

    98

    47

    17

    44

    14

    122

    0

    50

    100

    150

    200

    250

    sep oct nov dec total

    Total operated patients

    Male

    Total operated patients Male Female

    sep 89 42 47

    oct 40 13 17

    nov 84 40 44dec 17 3 14

    total 230 98 122

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    IGATPURI-2010 Camp

    0

    10

    20

    30

    40

    50

    60

    feb march april total

    15

    38

    8

    59

    2

    20

    5

    27

    13

    18

    3

    32

    Total operated patients Male Female

    Total operated patients Male Female

    feb 15 2 13

    march 38 20 18

    april 8 5 3total 59 27 32

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    SURGANA & CHANDWAD-2010 CampTotal operated patients Male Female

    jan 9 5 4

    feb 11 5 6

    mar 10 7 3apr 9 4 5

    may 2 2 0

    jun 15 8 7

    jul 75 35 40

    aug 34 18 16

    sep 77 46 31

    total 242 130 112

    0

    50

    100

    150

    200

    250

    jan feb mar apr may jun jul aug sep total

    9 11 10 92

    15

    75

    34

    77

    242

    5 5 7 4 28

    35

    18

    46

    130

    4 6 3 5 07

    40

    16

    31

    112

    Total operated patients Male Female

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    Total no. of male operated Total no. of female operated

    43% 57%

    43%

    57%

    Total no. of male operated Total no. of female operated

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    1077

    8517

    Total no. of cataract surgeries done-1077 Total no. of patients examined-8517

    Total no. of cataract surgeries done-1077 Total no. of patients examined-8517

    1077 8517

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    Total no. of camps conducted by MVP

    Samaj Hospital in 2 years-150 Others

    150 5

    1505

    total no. of camps conducted by MVP Samaj Hospital in 2 years-150 others

    5

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    CONCLUSION

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    DR. POOJA KHARBANDA DOS 64TH ANNUAL CONFERENCE

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    DR. POOJA KHARBANDA DOS 64TH ANNUAL CONFERENCE

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    REFERENCES

    Community Eye Health Journal Vol. 11 to 23;

    1998 to 2010

    Clinical Ophthalmology Kanski

    Bulletine of the World Health Organztion, Vol. 1

    to 88; 194

    Jose R. Rathore AS, Sachdeva S. Community

    Opthalmology (Revised Indian) community Med

    2010; 35:365-8 .2010

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    THANK YOU

    EYES ARE THE DIVINE GIFT GIVEN BY GOD LETS JOIN HANDS IN TAKING CARE OF THEM

    DR. POOJA KHARBANDA

    M. S. OPHTHALMOLOGY

    S.R.

    NEW DELHI

    Sarvendriyam Pradhanam Vayanedrayam