Eyeworld

EW MEETING REPORTER 142 Reporting from the All India Ophthalmological Society, February 16–19, 2017, Jaipur, India Vision 2020 India Since the Vision 2020 global ini- tiative was launched by the World Health Organization (WHO) in 1999, the paradigm for preventing blindness around the world has shifted. For instance, said Promila Gupta, MD, New Delhi, India, im- provements in pediatric healthcare in India have lowered the mortal- ity rate for premature infants; this in turn has had the unfortunate downside of an increasing number of cases of retinopathy of prematuri- ty (ROP). In response to this shifting para- digm, the goal is now a 25% reduc- tion in the prevalence of avoidable visual impairment from the baseline in 2010 by 2019. Dr. Gupta discussed the strat- egies and approaches currently being adopted by India's National Programme for Control of Blindness (NPCB) to achieve Vision 2020's goals at a symposium on the global initiative in India held Saturday. Visual impairment includes both blindness and low vision, with blindness defined as visual acuity of worse than 3/60 or correspond- ing visual field loss to less than 10º in the better eye, moderate visual impairment set at less than 6/18 but better than 6/60, and severe visual impairment in between. Therefore, to achieve this goal following these WHO definitions, degeneration and other diseases. Having identified these causes of blindness, the WHO launched Vision 2020, a global initiative to eliminate blindness from prevent- able causes by 2020. Dr. Taylor described the three components of the initiative: effec- tive disease control, human resource development, and infrastructure development. He then described the great strides being made toward the objective of Vision 2020, with, for instance, the dramatic increase in cataract surgical rate in India and the 42% drop in the prevalence of global blindness from 1990 to 2010. In 2013, the WHO initiated its Global Action Plan, which aims to achieve a 25% reduction in avoid- able visual impairment by 2019. Dr. Taylor, who is current president of the International Council of Ophthalmology, has always been concerned with global blindness, repeating this advocacy at every international, national, and regional ophthalmology meeting he attends. The ICO itself continues its work by helping raise the standards of ophthalmology around the world, collaborating with various oph- thalmology societies to achieve the objectives set forth by the WHO. "The ICO is working hard to support national and regional oph- thalmic societies to build a better world for all to see," he said. The bottom line, he said, is that ultimately, the use of amniotic membrane in ophthalmology may just be "something to do rather than something that does." For his second President's Guest Lecture, Dr. Dua was asked to revisit one of the most significant contri- butions to ophthalmic knowledge, what may very well be his prime leg- acy: the pre-Descemet's layer, more popularly known as Dua's layer. In addition to eloquently retell- ing the narrative and revisiting the controversies surrounding his iden- tification of Dua's layer—by which he reshaped our very image of the eye—Dr. Dua discussed the clinical and surgical significance of the layer, including its role in acute hydrops in keratoconus and how it can be used to make deep anterior lamellar keratoplasty (DALK) safer. Dua's layer, he said, can be used to support Descemet's membrane, making it easier to handle and un- fold during a Descemet's membrane endothelial keratoplasty (DMEK)-like DALK procedure. And it isn't over: Dr. Dua said they have begun research on Dua's layer in the context of glaucoma, posterior corneal curvature, and biomechanics. Global perspective on blindness The September 2016 issue of Na- tional Geographic featured a bold pronouncement: "The End of Blind- ness." The feature article, said Hugh Taylor, MD, Melbourne, Australia, celebrated advances in gene thera- py, retinal implants, and stem cell therapy. There was, he said, a short, passing mention of cataract toward the end of the article; no mention at all of refractive issues. Dr. Taylor offered a more earth- bound, pragmatic perspective in his President's Guest Lecture Friday morning on "The Latest Develop- ments and Advances in Prevention of Blindness, A Global Perspective." He reiterated the four major causes of blindness identified by the World Health Organization (WHO) back in 1994: Cataract and refractive errors; trachoma, vitamin A deficiency, and onchocerciasis; diabetic retinopathy and glaucoma; age-related macular March 2017 continued on page 144 View videos from AIOS 2017 EWrePlay.org Amar Agarwal, MD, Chennai, India, shows a technique for gluing an IOL to sclera in the case of a dislocated sutured IOL.

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