National Programme for Control of Blindness (NPCB)

What is Blindness?

According to WHO definition of blindness- “Visual acuity of less than 3/60 (snellen) or its equivalent, and
for non specialised personnel it is further described as “Inability to count fingers in daylight at a distance of 3 meters.

National Programme for Control of Blindness (NPCB) in India :-

Table of Contents

India has 6 million blind out of 36 million blind present in the world.
Definition of blind:
- Inability of a person to count fingers from a distance of 6 meters or 20 feet (Technical Definition) or Vision 6/18 or less, with the best possible spectacle correction

Cataract (62.6%)
Refractive Error (19.70%).
Corneal blindness (0.90%)
Glaucoma (5.80%)
Surgical Complication (1.20%)
Posterior Capsular Opacification 10.90%)
Posterior Segment Disorder (4.70%)

To reduce the backlog of blindness through identification and treatment of blind at primary, secondary and tertiary levels.
Develop and strengthen the strategy of NPCB for “Eye Health and prevention of visual impairment through provision of comprehensive eye care services and quality service delivery.
Stengthening and upgradation various sub-specialities of ophthalmology.
To enhance community awareness on eye care and lay stress on preventive measures.
Strengthening the existing and developing additional human resources and infrastructure facilities for providing high quality comprehensive Eye Care in all Districts of the country.
Increase and expand research for prevention of blindness and visual impairment.
To secure participation of Voluntary Organisations/ Private Practitioners in eye Care.

The four proaged strategy of the programme :

To make the National Blindness Control Programme more comprehensive by strengthening services for other causes of blindness like corneal blindness (requiring transplantation), refractive errors in school going children, treating other causes of blindness like glaucoma.
To shift from eye camp approach to a fixed facility surgical approach and from conventional surgery to IOL implantation for better quality of post operation vision in operation patients.
To expand the World Bank project activities like constructions of dedicated eye operation theatres, eye wards at district level, training of eye surgeons, modern cataract surgery, and other eye surgery and supply of ophthalmic equipment, etc. to the whole country.
To enhance the coverage of eye care services in tribal and other under served areas through identification of bilateral blind patients, preparation of villages wise blind register and giving preference to bilateral blind patients for cataract surgery.

An ophthalmologist performing a Cataract surgery

Cataract Operation: To strengthen eye care services by additional input and improving the efficiency at different levels. Intra-ocular Lenses (IOLs) implantation has increased in many states with the assistance of World Bank.
Involvement of NGOs: The voluntary organisations are encouraged to organise eye camps in remote rural, urban areas along with District Health Organisation. NGOs are playing a significant role in cataract surgeries.
Civil Works construction of eye wards, operation theatres, and dark rooms were under taken in 7 states under the World Bank assisted project.
Training: Imparting training to eye surgeons both as trainers and as surgeons who will be implementing IOL. PHC medical officer, Ophthalmic assistant, Ophthalmic health workers.
Commodity assistant: Commodities like suture and IOLs, Indirect Ophthalmoscopes, Slit lamps
, Keratometers, A-scan Biometers, Yag Lasers are procure centrally and distributed to states.
Information Education and Communication: Posters, video spots, radio jingles, etc. in all regional languages.
Management Information System: Software is developed to facilitate data completion in medical colleges.
Monitoring and Evaluation.

Launched by the World Health Organization and a Task Force of International Non-governmental Organization to combat the gigantic problem of blindness in the world.
It was launched in Geneva on February 18, 1999 .
Vision 2020 envisages collaboration between governments, World Health Organization, International agency for the Prevention of Blindness, funding agencies, international, non-governmental and private organisations that collaborate with the World Health Organization in the prevention and control of blindness.
Globally, five conditions have been identified for immediate attention for achieving the goals of Vision 2020.
They are:
- Cataract
- Trachoma
- Onchocerciasis
- Childhood blindness
- Refractive Errors and Low Vision.
These conditions have been chosen on the basis of their contribution to the burden of blindness and the feasibility and affordability of interventions to control them.
Five basic strategies to combat blindness :-
- Disease prevention and control
- Training of personnel
- Strengthening the existing eye care infrastructure
- Use of appropriate and affordable technology
- Mobilization of resources
Vision 2020 will serve as a common platform to facilitate a focused and coordinated functioning of all the partner in eliminating avoidable blindness by the year 2020.

The mission of the vision 2020 Global Initiative is to eliminate the main causes of all preventable and treatable blindness as a public health issue by the year 2020.

Raise the profile, among the key audiences, of the causes of avoidable blindness and the solutions that will help to eliminate the problem.
Identify and secure the necessary resources around the world in order to provide an increased level of prevention and treatment programmes.
Facilitate the planning, development and implementation of the three core Vision 2020 strategies by National Programmes.

Disease control: Facilitate the implementation of specific programmes to control and treat the major causes of blindness
Human resource development: support training of ophthalmologists and other eye care personnel to provide eye care.
Infrastructure and appropriate technology development: assist to improve infrastructure and technology to make eye care more available and accessible.