The epidemiology of eye diseases is evolving, necessitating a rethinking of primary eye health care services with strong referral ties.
The WHO refers to the fundamental clinical treatment offered in outpatient clinics as “primary care.” If we apply this to eye care, we should refer to the clinical eye health services provided in institutions at the primary level as “primary eye care” (PEC). The goal of “primary eye health care” (PEHC), which includes disease prevention, promotion of good health, and the rehabilitation of the blind, should be expanded.
As the primary contributors to visual impairment might alter over time, PEHC must adapt to meet the population’s current demands for eye health. For instance, an estimated 500,000 children are predicted to go blind each year, the majority as a result of corneal scarring brought on by vitamin A deficiency, measles, and the use of dangerous conventional eye medications.
If the underlying causes could be addressed through Primary Health Care (PHC), such as safe water supplies to prevent diarrhoea, immunisation to prevent measles infection, promotion of food supplies and good nutrition, the availability of essential medications to reduce dependence on harmful traditional remedies, and maternal and child health, much of this blindness could be prevented. All of these procedures ought to be a part of basic eye care.
Below are the reasons that highlight the importance of primary eye care.
Preventable and Treatable Causes of Blindness
There are numerous eye conditions that, if caught early enough, can be treated to avoid blindness (e.g., trichiasis from trachoma, early diabetic retinopathy). Other medical disorders, including cataracts, may be treated surgically to restore vision.
According to estimates, ten million individuals, mostly women, are at risk of developing trachomatous trichiasis and going blind. To save them from going blind, these folks need to be located and operated on locally. People with trichiasis typically come from remote, underdeveloped rural areas, thus surgery performed in a clinic setting is unlikely to address the requirement.
In Western nations, diabetic retinopathy is a significant contributor to working-age blindness that may be avoidable. Many localities have screening programmes run by properly trained individuals to identify and send people who need photocoagulation to avert blindness. An estimated 13.5 million people globally are thought to have primary open-angle glaucoma; it is important to identify these people and refer them for care to avert blindness. Therefore, primary eye care is crucial in all societies and everywhere in the world.
Around 20 million of the projected 38 million blind people suffer from cataract blindness, a condition that can be surgically treated to restore vision. Primary eye care is responsible for identifying and referring those in need of cataract surgery.
Eye Diseases Requiring Treatment
In many nations, eye diseases (such as conjunctivitis, mild trauma, watery eyes, etc.) are among the most prevalent health issues that primary-level healthcare providers are approached with.
These healthcare professionals must be able to examine the eyes, diagnose conditions that they can successfully treat on their own, and identify which eye diseases they should refer for a more thorough examination, diagnosis, and treatment. This is a crucial component of primary eye care because a poor diagnosis can delay the administration of the appropriate therapy, which may have unfavourable long-term effects. Workers at the primary level should be able to recognise and treat infections like conjunctivitis, know when to start treating patients and refer them (for example, for corneal ulcers), and know which conditions should be referred to.
Wrapping Up
As a result, primary eye care encompasses a wide range of procedures that can be carried out in the community or at the foundational level of medical treatment. In all societies and geographical locations, primary eye care is a crucial foundation for the prevention of blindness. Without basic eye care, only patients who visit secondary and tertiary clinics would receive diagnoses and treatments, and preventative efforts will be minimal.
It may involve a variety of worker cadres, many of whom already have a wide range of obligations. One of the problems and obstacles to the efficient and comprehensive implementation of basic healthcare is this. The training demands of these cadres must also be taken into account if they are to function as integrated primary eye care providers. Effective primary eye care cannot exist in a vacuum. The secondary and tertiary levels of eye care, which have facilities and staff that are more particularly trained in the treatment of ocular illnesses, must have excellent referral mechanisms and good communication.
