Vision 2020 Pg ophthalmology theory question
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Vision 2020 The Right to Sight ophthalmology PG theory answer goals strategies
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Vision 2020 : The Right to Sight
Definition / Launch
VISION 2020: The Right to Sight is a global initiative launched jointly by the WHO and the International Agency for the Prevention of Blindness (IAPB) on 18th February 1999, to eliminate avoidable blindness by the year 2020. Its distinguishing feature compared to earlier programmes is that it is founded on the concept of sight as a fundamental human right - recognition of this right by member countries acts as a catalyst for national prevention-of-blindness efforts (Park's Textbook of PSM, p. Vision 2020 section).
Objective
To assist member countries in developing sustainable systems that will enable them to eliminate avoidable blindness caused by:
- Cataract
- Refractive errors and low vision
- Childhood blindness (including xerophthalmia/Vitamin A deficiency)
- Trachoma and other causes of corneal blindness
- Glaucoma
- Diabetic retinopathy
(Park's PSM lists cataract, xerophthalmia and other causes of childhood blindness, refractive error/low vision, and trachoma/other corneal blindness as the original core targets; India's national plan of action additionally targets glaucoma and diabetic retinopathy.)
Three Core Strategies
VISION 2020 works through three integrated strategies:
- Disease control - targeted control of the priority blinding diseases listed above (cataract, refractive error, childhood blindness, corneal blindness/trachoma, glaucoma, diabetic retinopathy).
- Human resource development - training ophthalmologists, ophthalmic assistants/paramedics, and other eye care personnel; capacity building at all levels of the health system.
- Infrastructure and technology development / appropriate technology - strengthening and equipping eye care facilities so that services are sustainable, accessible, and affordable.
India's Plan of Action - Proposed Four-Tier Structure
Under Vision 2020, India (through the National Programme for Control of Blindness) developed a plan of action built on a pyramidal 4-tier eye care delivery structure, integrated with the general health system:
| Tier | Facility | Approx. numbers proposed |
|---|---|---|
| 1 | Centres of Excellence (tertiary care, super-specialty, training, research) | 20 |
| 2 | Training Centres (secondary/tertiary, medical college-linked) | 200 |
| 3 | Service Centres (secondary eye care - cataract surgery, basic ophthalmic services) | 2,000 |
| 4 | Vision Centres (primary eye care - screening, refraction, referral) | 20,000 |
This structure ensures a referral pyramid from community-level primary eye care (Vision Centres) up to specialized tertiary Centres of Excellence.
Supporting Components in India
- Eye donation and eye banking: Community education encourages voluntary eye donation, especially from terminally ill/accident victims. National Eye Donation Fortnight is observed from 25th August to 8th September every year. Gujarat, Tamil Nadu, Maharashtra, and Andhra Pradesh are leading states in eye donation activity.
- NGO/voluntary sector involvement: Organizations such as Lions International, Rotary International, and NSPB India conduct eye camps in remote rural and urban areas (under state guidelines) providing eye health education, screening, and surgical/rehabilitative services.
- Community health education, regular eye check-ups, and Vitamin A prophylaxis are built into the programme at all implementation levels.
- WHO assistance: intra-country fellowships (corneal transplantation, vitreo-retinal surgery, lasers, paediatric ophthalmology), childhood blindness surveys, district programme management training, and situational analysis of eye care infrastructure/human resources.
Follow-up: Global Eye Health Action Plan 2014-2019
Since the 2020 target was not fully met, WHO extended the effort through the Universal Eye Health: Global Action Plan 2014-2019, based on five principles:
- Universal access and equity
- Human rights
- Evidence-based practice
- Life-course approach
- Empowerment of persons with visual impairment
Target: 25% reduction in avoidable visual impairment by 2019 (from 2010 baseline).
Three national-level progress indicators: (1) prevalence and causes of visual impairment, (2) number of eye care personnel, (3) cataract surgical rate/output.
WHO estimated in 2010 that 285 million people were visually impaired, of whom 39 million were blind; controlling just cataract and refractive error could restore good sight to about two-thirds of the visually impaired. The plan emphasizes integrating eye care into primary health care and the broader NCD/health system framework (linking to diabetes, smoking, maternal/child health, safe water and sanitation, since most visual impairment is avoidable).
Note on Currency (for completeness in viva)
As the original 2020 target has now passed, IAPB/WHO have since moved toward newer frameworks (e.g., the World Report on Vision 2019 and subsequent integrated people-centred eye care strategies), but for PG theory purposes VISION 2020: The Right to Sight remains the standard textbook answer as given in Park's PSM.
Source: Park's Textbook of Preventive and Social Medicine - sections "Vision 2020: The Right to Sight" and "Universal Eye Health: A Global Action Plan 2014-2019."
Exam tip (how to structure this in the answer sheet)
Write it as: Definition → Launch/Year → Objective → 3 Strategies → Target diseases → 4-tier structure (with numbers) → Indian components (eye banking, NGOs) → conclude with Global Action Plan 2014-19 update. A labelled diagram of the 4-tier pyramid (Vision Centres → Service Centres → Training Centres → Centres of Excellence) fetches extra marks if you can draw it.
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