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Cataract blindness poses major public health threat

UNB, Dhaka
The other day 56-year-old Maheb Hossain, living in Baganbari slums at Kafrul in the city, felt that he couldn't see around clearly.
With his eyesight dimming day-by-day, he became unable in five years' time to continue his small vegetable shop on the slum footpath.
Last December, an eye camp of Dhaka Urban Eye Care Project, a project of Sightsavers International, Bangladesh detected cataract (Chhani) in both of his eyes. His eyes were operated upon for free, and he got his eyesight back at 6/12 vision.
A total of 12,382 people underwent operation free of cost and got their eyesight back. They were picked from a total of 57,428 eye patients examined from July 2005 to December 2007.
But there is a great concern that though such cataract problem is completely avoidable blindness, it is one of the major public health problems in the country for many reasons.
The Dhaka Urban Care Project observed some barriers to operating cataract. These are lack of awareness, financial constraints, social taboos, dependence on traditional healers, fear of operation, distance of clinics, transport problems, less care about eyesight, etc.
Prof Dr ASM Kamal Uddin, director of Elamia Eye Hospital, country's oldest and largest eye hospital, said cataract problem E completely curable if someone undergoes a surgery.
“But, in most cases, it E not done in the country for a lack of awareness and family supports in old age, financial constraints, and distance of communications from the hospital."
Quoting a national blindness and low vision survey, Project Manager of the Dhaka Urban Eye Care Project M Nurun Nabi said an estimated 50,400 adult cataract patienE are there in Dhaka, and the number E on the up--with 10,000 new cases per year. In Dhaka, a total of 3,600 are blind children -- 1,200 with cataract--and the rate of increase is alarming, he added.
A government's National Eye Care operational plan (revised) (2005-2010) said presently about 7.5 million people aged 30 and above in the country are blind besides about 40,000 blind children
And about 5 million people, including children, suffer from refractive error while 250,000 adulE arevictimsoflowvEion.
It also says that nearly 80 percent of this blindness is of cataract victims, which E avoidable or treatable through simple and cost-effective surgical intervention.
The plan warns that the number of blind population, it is feared, will be doubled by the year 2020 if no intervention E initiated immediately. The blindness is treated as the burden in society, both from economic and social point of view. The estimated cost of blindness in Bangladesh E about Tk 20,000 crore that is calculated on the basE of the wage loss of the blind persons.
World Health Organisation (WHO) observes the major cause of blindness E cataract, which E curable.
According to the National Blindness and Low Vision Survey of Bangladesh (1999-2000), the largest nationwide survey ever done, cataract E the major cause of bilateral blindness (79.6 percent) and low vision (74.2 percent) amongst Bangladeshi adults in all areas across the country.
The survey found un-operated cataract as the main cause of blindness and low vEion prevalent in elderly persons, in women, in illiterate individuak, in predominantly
rural areas, in unemployed or inactive workers and, amongst employed males, in those who were manual workers.
A document of Community Eye Care and Research Centre (CECRC), a local NGO of Rangpur, said, “Government and private initiatives could only perform 65,000 surgeries yearly from 2000 up to 2002, thus raking the cataract surgical coverage (CSR) only up to 500 per year per million of population,” it added.
CECRC also warned that every year the backlog of cataract is increasing substantially due to the gap between need and current level of performance.
According to medical dictionary definition, cataract is a clouding of the lens of the eye. The normally clear aspirin-sized lens of the eye starts to become cloudy. The result is much like smearing grease over the lens of a camera. It impairs normal vision.
Medical science indicates variety of reasons for cataract formation, including long-term ultraviolet exposure, exposure to radiation, secondary effects of diseases such as diabetes, hypertension and advanced age.