Ophtalmology Community

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    OFTALMOLOGI KOMUNITAS

    Dr. Prima Maya Sari, SpM

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    Community ophthalmology

    Synonyms

    = Public health ophthalmology

    = Preventive eye care

    = Preventive Ophthalmology

    Oftalmologi komunitas adalah salah satu

    subspesialisasi dalam bidang Ilmu Kesehatan

    Mata yang mengkhususkan pada pelayanan

    kesehatan masyarakat untuk masalah-masalah kesehatan mata.

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    Community ophthalmology

    The Aim : To provide theOphthalmologic services to a wholegroup or sub group of people whichbenefit the largest number ofpeople in the community at

    affordable cost in identifying andpreventing sight threatening ocularconditions

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    Community ophthalmology

    This is a new field.

    New concept for many countries yet.Difficult to get it moving.

    Future doctor has a great

    responsibility in developing this field

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    Curative ophthalmology

    Remain at the center of all activities

    Community Ophthalmology does notdilute its importance

    Focus is only changed from individual

    to community

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    What are the major differences in curative

    & preventive medicine ?

    Goals

    Target

    Diagnosis

    Therapy

    Results

    Treatment & cure

    Single patient

    Physical

    examination.

    Drugs / Surgery

    Limited toindividuals

    Prevention of disease

    Population/community

    Health survey(Community Diagnosis)

    Health education

    improved sanitation,Hygiene, Immunization

    etc

    Prevention of disease

    Improvement of quality

    of life in community

    Curative Preventive

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    Public health

    principles

    Applied to

    ophthalmology

    Activities in community

    Prevent Blindness Reduce the disability

    caused by poor vision

    Main Aims of

    Community

    Ophthalmology

    Summary of Activities

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    Fact finding surveys / Research /Screening

    /Clinical care / Health education /Referral

    /Follow up/ Improvement of basic needs etc.

    Activities in Community

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    Therefore community ophthalmology can

    be explained as a discipline where

    The traditional care applied to an

    individual patient is diverted to a

    population with a prominence placed on

    preventive aspects

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    Who is a community eye

    specialist

    Ophthalmologist

    With Knowledge on

    Communityorganization, need,

    structure,&epidemiological

    principals, bio-statistics,

    managerial andcommunication

    skills

    Community

    physician

    With basic clinicalAspects of

    Ophthalmology

    Role depend on the

    local needs

    of a country

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    Major duties

    1) Designing and planning of fact finding

    surveys.

    2) Planning primary eye care programs.

    - Screening

    - Health education- Training

    - Promoting community participation

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    Major duties

    3) Organizing community screening,

    preventive & curative programmes

    - Eye camps

    - Surgical camps

    4) Research in to eye diseases.

    5) Co-ordination of activities and promoting to

    implement policies for prevention purposes.

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    WHO activity on prevention of

    blindness (PBL)

    PBL Programme was established in 1978.

    At the beginning

    The number of blindness in the world

    Not known

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    Task force was appointed.

    - Surveys

    - According to internationalclassification of diseases1CD10

    Obtained more epidemiological details.

    BDB (Blindness Data Bank)WHO Global data bank on blindness

    - Collection and dissemination of data.

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    How to arrange a preventive eye

    care programmes

    Let us learn the activities involved

    and man power needed.

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    Activity

    Primary prevention

    In the community

    through PrimaryHealth Care(PHC)

    Secondary

    prevention

    Identify and treat in

    the community

    Primary health care

    workers

    Volunteers(Trained)

    P.H.Workers

    General physiciansCommunity

    Ophthalmologist.

    Person

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    Identify and refer

    for Treatment

    Diagnose and

    treatment orDiagnose and

    refer

    PEC Workers

    Optometrists

    General physicians.

    PEC Workers.

    General physiciansCommunity

    Ophthalmologist

    Activity Person

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    Activity

    PEC Workers To identify ocular

    diseases or systemic

    diseases that causeocular problems.

    Work in the community

    Prevent visual disability and blindness.

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    WHO Guidelines for primary

    eye care1. Conditions to be recognized and treated by

    a trained primary eye care worker

    Conjunctivitis and lid infections

    - Acute conjunctivitis

    - Ophthalmia neonatorum

    - Trachoma

    - Allergic & Irritative conjunctivitis

    - Lid lesionschalazion

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    Trauma- Sub conjunctival hemorrhages

    - Blunt trauma

    Blinding Malnutrition

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    2. Conditions to be recognized andreferred after treatment has been

    initiated.

    Corneal ulcers

    Lacerating or perforating injuries of theeye ball

    Lid lacerations

    Entropion / Trichiasis

    Burns - Chemical

    - Thermal

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    3. Conditions that should be recognizedand referred for treatment.

    Painful red eye with visual loss

    Cataract

    Ptergium

    Visual loss < 6/18 in either eye

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    Integration of PEC in to PHC

    PEC should not be planned

    separately from PHC which isconsidered the mother system that

    carry the goals of PEC to the

    community by integration

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    THANK YOU....