OFTALMOLOGI KOMUNITAS

Dr. Prima Maya Sari, SpM

Community ophthalmology


Synonyms
= Public health ophthalmology
= Preventive eye care
= Preventive Ophthalmology
Oftalmologi komunitas adalah salah satu
subspesialisasi dalam bidang Ilmu Kesehatan
Mata yang mengkhususkan pada pelayanan
kesehatan masyarakat untuk masalah-
masalah kesehatan mata.
Community ophthalmology
The Aim : To provide the
Ophthalmologic services to a whole
group or sub group of people which
benefit the largest number of
people in the community at
affordable cost in identifying and
preventing sight threatening ocular
conditions
Community ophthalmology
This is a new field.
New concept for many countries yet.
Difficult to get it moving.

Future doctor has a great
responsibility in developing this field
Curative ophthalmology
Remain at the center of all activities
Community Ophthalmology does not
dilute its importance
Focus is only changed from individual
to community
What are the major differences in curative
& preventive medicine ?
Goals

Target

Diagnosis


Therapy



Results


Treatment & cure

Single patient

Physical
examination.


Drugs / Surgery



Limited to
individuals


Prevention of disease

Population/community

Health survey
(Community Diagnosis)

Health education
improved sanitation,
Hygiene, Immunization
etc
Prevention of disease
Improvement of quality
of life in community
Curative Preventive
Public health
principles


Applied to
ophthalmology


Activities in community
Prevent Blindness


Reduce the disability
caused by poor vision


Main Aims of
Community
Ophthalmology
Summary of Activities
Fact finding surveys / Research /Screening
/Clinical care / Health education /Referral
/Follow up/ Improvement of basic needs etc.
Activities in Community
Therefore community ophthalmology can
be explained as a discipline where

The traditional care applied to an
individual patient is diverted to a
population with a prominence placed on
preventive aspects
Who is a community eye
specialist
Ophthalmologist

With Knowledge on
Community
organization, need,
structure,&
epidemiological
principals, bio-
statistics,
managerial and
communication
skills
Community
physician

With basic clinical
Aspects of
Ophthalmology
Role depend on the
local needs
of a country
Major duties
1) Designing and planning of fact finding
surveys.

2) Planning primary eye care programs.
- Screening
- Health education
- Training
- Promoting community participation
Major duties
3) Organizing community screening,
preventive & curative programmes
- Eye camps
- Surgical camps

4) Research in to eye diseases.

5) Co-ordination of activities and promoting to
implement policies for prevention purposes.

WHO activity on prevention of
blindness (PBL)
PBL Programme was established in 1978.


At the beginning
The number of blindness in the world
Not known

Task force was appointed.
- Surveys
- According to international
classification of diseases
1CD 10


Obtained more epidemiological details.

BDB (Blindness Data Bank)
WHO Global data bank on blindness
- Collection and dissemination of data.
How to arrange a preventive eye
care programmes

Let us learn the activities involved
and man power needed.

Activity
Primary prevention
In the community
through Primary
Health Care(PHC)

Secondary
prevention
Identify and treat in
the community
Primary health care
workers
Volunteers(Trained)

P.H.Workers
General physicians
Community
Ophthalmologist.
Person
Identify and refer
for Treatment


Diagnose and
treatment or
Diagnose and
refer
PEC Workers
Optometrists
General physicians.

PEC Workers.
General physicians
Community
Ophthalmologist
Activity Person
Activity

PEC Workers To identify ocular
diseases or systemic
diseases that cause
ocular problems.

Work in the community

Prevent visual disability and blindness.
WHO Guidelines for primary
eye care
1. Conditions to be recognized and treated by
a trained primary eye care worker

Conjunctivitis and lid infections
- Acute conjunctivitis
- Ophthalmia neonatorum
- Trachoma
- Allergic & Irritative conjunctivitis
- Lid lesions chalazion
Trauma
- Sub conjunctival hemorrhages

- Blunt trauma

Blinding Malnutrition
2. Conditions to be recognized and
referred after treatment has been
initiated.

Corneal ulcers
Lacerating or perforating injuries of the
eye ball
Lid lacerations
Entropion / Trichiasis
Burns - Chemical
- Thermal

3. Conditions that should be recognized
and referred for treatment.

Painful red eye with visual loss

Cataract

Ptergium

Visual loss < 6/18 in either eye
Integration of PEC in to PHC
PEC should not be planned
separately from PHC which is
considered the mother system that
carry the goals of PEC to the
community by integration
THANK YOU....