The role of education in controlling corneal blindness

healthcareCorneal blindness is estimated to be the second most prevalent cause of blindness in many less developed countries – and the condition is preventable. The  only treatment is a cornea transplant, but supply of donated corneas is far, far less than the demand.

One of the ways to prevent corneal blindness, it has been argued, is through education, to help mitigate some of the main causes of developing the disease. This includes public health education focusing on prevention, and around the importance of seeking the appropriate eye care as early as possible, which is crucial for the early detection and management of corneal conditions.

According to the World Health Organisation (WHO), prevention programmes in developing countries must include widespread immunisations, the regular distribution of high-dose vitamin A capsules to children at risk, nutritional education for families, and dietary fortification for populations with poor nutrition.

WHO explains that the populations most at risk and affected are the poorest communities, where other diseases such as trachoma are epidemic, causing public health programmes to become overwhelmed by the vast number of diseases causing and contributing to corneal blindness.

Education around corneal blindness also involves eye care providers, including cornea specialists, optometrists, technicians, nursing staff and staff for eye banking, in order to improve accessibility to eye care. This is particularly important in areas where the availability of expertise to manage corneal disease is lacking.

Educating providers will help allow cornea care to reach remote rural areas, and also help to establish a network of cornea care provides that can serve as a helpful referral model.

And in the community, the WHO has stated that another area for cornea blindness prevention-related education is practitioners of traditional eye medicines, who it says are an “important risk factor for corneal blindness in many developing countries”. Traditional medicine often harm the eye, rather than relieve pain or improve eyesight.

Research has found that 26% of childhood blindness in Malawi was associated with the use of these medicines, while 25% of corneal ulcers were associated with the use of traditional eye medicines. These traditional medicines are often contaminated, and provide a vehicle for the spread of germs.

Research into traditional healers in Malawi found that most TEM consisted of dried plant material crushed into a powder and dissolved into non-sterile water solutions. These medications offer a way to introduce bacteria into eyes that are already affected by injury or infection, and worsening the patient’s condition.

WHO says that educating traditional healers and getting their cooperation in directing patients to appropriate health care facilities is a first step in preventing complications leading to blindness from the use of traditional medicines.

Medical facilities treating those with corneal blindness, such as the Tej Kohli Cornea Institute, and experts including the institute’s May Griffith, regularly speak out about the issues hindering progress made to reduce and eliminate cases of preventable corneal blindness. For Tej Kohli, India and other nations severely affected by corneal blindness stand to massively benefit from widespread education efforts.

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