Early Blindness – Symptoms, Prevention & Cure, Dr. Soham Basak, Consultant, Cornea Department, Disha Eye Hospitals

Every year, Prevention of Blindness Week is observed from April 1- April 7. The week aims to raise awareness towards blind people and highlights the need for caring for one’s eyes. Leading doctors from Disha Eye Hospitals and Techno India Dama Hospital shares their insights on the symptoms, prevention cure, and dietary requirements for the prevention of blindness

The National Program for the Control of Blindness and Visual Impairment (NPCB-VI) is one of the most extensive government eye care programs worldwide. Which aims to provide comprehensive eye care at primary, secondary, and tertiary levels so that the prevalence of blindness may be reduced.

Blindness is the inability to perceive light and sight due to which one is not able to perform essential tasks. The definition varies for different countries and is graded as per the visual acuity in the better and worse eyes. Broadly it can be divided as low vision and blindness (WHO categories).

Medically, it is divided as avoidable blindness (preventable blindness and curable blindness) and incurable blindness. About 85% of blindness globally is avoidable.

Preventable blindness are those which can be prevented by treating the causative factor or taking adequate safety measures. For example – corneal blindness due to vitamin A deficiency, corneal ulcers; industrial and workplace blindness; diabetic retinopathy; retinopathy of prematurity.

Curable blindness needs medical and/or surgical treatment. Mostly it is synonymous with cataract blindness and refractive error blindness. Other diseases are glaucoma, corneal dystrophy, etc.

Incurable blindness is usually associated with birth defects where the structure of the eye is incomplete from birth; or genetic conditions for which unfortunately much treatment does not exist at present.

India has almost 2 crore blind population. According to the latest NPCB survey, the leading causes of blindness in India are – Cataract, Corneal opacity and complications of cataract surgery, glaucoma, diabetic retinopathy, other retinal diseases, and trauma/injury-related causes.

Early signs of blindness – a torchlight examination of the eyes of a newborn often reveals congenital birth defects. Usually, the parents notice these like white spots in the eye, abnormal shape of the eye, excess watering, child avoiding light, child not looking at faces or light sources, one or both eyes pointing at different sides.

At a school-going age, teachers often notice if a student is having difficulty looking at the board. It is always a good idea to cover each eye to check if the child can see equally with both eyes. Many times, if one eye is normal, the weaker eye is not noted by the child. This can lead to amblyopia – where the visual development of the eye remains incomplete. A simple pair of glasses used at the right time can easily prevent this complication.

Prevention of blindness depends on the cause of blindness.

1. Corneal ulcers in agriculture workers – use of safety goggles during farming work, visiting doctor if any vegetative matter enters the eye, not self-treating with random drops from the pharmacy.
2. Workplace injury – industrial safety goggles for workers involved in grinding, metal work, welding, etc.
3. Blindness due to refractive error (power of the eyes) – wearing spectacles, contact lenses, and refractive surgical options.
4. Cataract – a cataract surgery with implantation of artificial lens
5. Glaucoma – regular screening especially if family members have glaucoma and starting eye drops on time.
6. Diabetic retinopathy – good control of blood sugar, routine eye check-up every year to detect retinal involvement at the earliest
7. Retinopathy of prematurity – retina check-up of the newborn and subsequent treatment as advised.
8. Festival/ toys/ sports related – using fireworks, bow-arrow, danda-Gulli, holi colors, with caution. Protective headgear or eyewear in certain sports.
9. Vitamin A deficiency – nutritious diet in children, oral vitamin A supplements as per the immunization program.

For prevention of blindness, active roles must be played by different groups of people – ophthalmologists, paramedical ophthalmic assistants and optometrists, ASHA workers, Anganwadi workers, school teachers, government policy-makers, and NGOs.

IEC – Information Education and Communication is an important component of community eye health and blindness prevention. Public awareness campaigns (glaucoma week march, eye donation fortnight march, etc), television adverts, posters at public places are some of the ways by which we can reach the public about blindness prevention.

International bodies like WHO and the Vision 2020 program, the International Agency for the Prevention of Blindness (IAPB), International NGOs (Sight Savers, ORBIS, Lions, Rotary, etc) play an important role in teaching and training, advocacy, and facilitation of affordable treatment.

Not all are fortunate to have a preventable or treatable form of blindness. There are many blindness causes which are incurable – commonly birth defects, genetic disorders, end-stage of diseases like glaucoma, diabetic retinopathy; severe trauma, etc.

In these situations, there is an important role of special training. Low vision aids (specialized spectacles, digital assistance tools) may be beneficial to those with some faint vision. Otherwise, children can be enrolled in blind schools where Braille is taught, adults may be taught some form of vocational rehabilitation. Nowadays with voice input computers and artificial intelligence, there is a lot of scope for teaching and training in spite of blindness and visual impairment.

Parents and family members of those affected are encouraged to join support groups and contact special school/ training institutes so that the affected person can be benefitted.

A Healthy Food Habit Is An Influential Factor For A Crystal Clear Vision

Dr. Payel Kumar Roy,

Chief Clinical Dietician & Critical Care Nutritionist

Techno India DAMA Hospital

Can eyesight be improved with diet?

Eating more fruits and vegetables can help protect against eye disease and help your overall health.

7 Best Foods for Healthy Eyes AT A Glance

• Dark leafy greens. Dark leafy greens like spinach and other foods rich in vitamin C, like sweet potatoes, kale, carrots, turnips, butternut squash, and mustard greens may be helpful for slowing the progression of cataracts.
• Citrus fruits and berries.
• Nuts and seeds. Fish.
• Whole grains.
• Legumes.
• Many of the vitamins and antioxidants that improve eyesight naturally are found in common foods, including Carrots, kale, spinach, and collard greens (vitamin A and lutein) Liver (vitamin A), including cod liver oil. Swiss chard, zucchini

Natural treatments that could help blurry vision

1. Rest and recovery. Human eyes are sensitive and need rest just like the rest of your body, so make sure you’re getting enough decent sleep.
2. Lubricate the eyes.
3. Improve air quality.
4. Stop smoking.
5. Avoid allergens.
6. Take omega-3 fatty acids.
7. Protect your eyes.
8. Take vitamin A and brussel sprouts

There are certain foods which can make your vision more transparent and brighter

1. Spinach, as it contains a lot of beneficial vitamins and minerals that keep our eyes healthy.
2. Mangoes, as it contains a great amount of Vitamin E and great sources of Vitamin A, just like other bright-colored fruits.
3. Peanuts which are salty but healthy.
4. Apples.
5. Broccoli and
6. Carrots.

SPECIAL CASE – WHERE DIET PLAYS A VITAL ROLE

The Role of Diet in Glaucoma: 

Glaucoma is a major cause of irreversible blindness worldwide. Globally, it is estimated that 5.7 million people are visually impaired as a result of glaucoma

SPECIAL CASE – WHERE DIET PLAYS A VITAL ROLE

Alcohol – It has been shown that alcohol lowers IOP following acute ingestion in both glaucoma patients and healthy subjects. However, it is thought to be secondary to variable physiological changes such as a hyperosmotic effect exerted by alcohol, reduction of net water movement into the eye through vasopressin suppression and inhibition of secretory cells in the culinary processes.

Coffee – Coffee is a rich source of caffeine, a biologically active compound that exerts numerous physiological effects on the human body. Caffeine acts as a phosphodiesterase inhibitor which leads to an increase in intracellular cyclic adenosine monophosphate dehydrogenase, thereby stimulating aqueous humor production.

Tea – The nutritional value of tea is derived from its major constituents (i.e. polyphenols, caffeine, and minerals) Flavonoids, a major polyphenol in tea, are thought to play a role in glaucoma owing to their various physiological actions.