Blindness from diabetic retinopathy
The prevalence of diabetes among adults in Latin America and the Caribbean varies among countries. It is estimated that approximately 50% of diabetics are unaware they have the condition. More than 75% of patients who have had diabetes mellitus for more than 20 years will have some form of diabetic retinopathy. After 15 years of diabetes, approximately 2% of people become blind, and about 10% develop severe visual handicap.
The prevalence of Diabetes mellitus affecting persons 40-84 of African descent in Barbados is high, with 18% of the population giving a diabetes history predominantly of older-onset. In the Barbados Eye Study 30% of persons with diabetes had diabetic retinopathy and 1% had proliferative diabetic retinopathy.
Evidence-based treatment is available to reduce significantly the risks for blindness and for moderate vision loss. Clinical studies spanning more than 30 years have shown that appropriate treatment can reduce the risks by more than 90%.
What needs to be done?
- Perform situation analysis of management of diabetic retinopathy in the Region as base for planning and advocacy.
- Integrate the prevention of blindness strategies in the national diabetes programs, and ensure that they are incorporated into non- communicable chronic diseases programs.
Blindness in premature babies
In Latin America and the Caribbean an estimated 42,000 babies with birth weight of less than 1,500 gm. require screening for R Retinopathy of the premature babies and 4.300 need treatment every year, untreated 50% of these babies will become blind.
Prevention of blindness due to ROP is planned in three levels.
Primary prevention: reduce the incidence of ROP through improved pre and neonatal care. This includes good antenatal care, good obstetric care, and meticulous neonatal care, particularly with respect to oxygenation - vital role of nurses. Follow up of preterm babies, screening babies at risk - neonatologists or neonatal nurses should identify babies to be examined.
Secondary prevention: early identification of severe cases of ROP by regular examination by a skilled ophthalmologist of premature babies in neonatal care and timely treatment of those with "high risk" ROP
Tertiary prevention: restore useful vision in children with retinal complications through vitreoretinal surgery (stage 4 ROP, not for stage 5) and or offer rehabilitation.
What needs to be done?
- Improve coverage and quality of Retinopathy of Prematurity (ROP) Programs.
- Improve quality of information on neonatal care.
- Increase public awareness and education in ROP and other prematurity health.