SA eye specialists do free cataract operations during Eye Care Awareness Week from 8 to 12 October

They hope to improve on the 2006 campaign when ophthalmologists screened 1884 patients and performed cataract surgery on 1336 patients of all ages at both public and private hospitals and clinics countrywide.

This year, eye specialists (ophthalmologists) will focus their attention on the prevention of childhood blindness in support of World Sight Day on 11 October. The theme for World Sight Day 2007, is `Vision for Children' and forms part of "Vision 2020 – The Right to Sight, a collaboration between the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness to promote the prevention of childhood blindness.

Accurate statistics are not available but it is estimated that there are more than 21 000 blind children in South Africa. According to global statistics, 50% of childhood blindness is avoidable.

The Ophthalmological Society of South Africa (OSSA), the representative association for eye specialists, says many cases of childhood blindness can be prevented through appropriate public health interventions, screening programmes and access to well-equipped and well-staffed paediatric ophthalmology centres.

International statistics indicate that 500 000 children across the world lose their eyesight every year, which amounts to one new case every minute. Dr Harold König, President of OSSA, explains that there are many causes of childhood blindness, which requires a variety of interventions.

`The causes of childhood blindness in South Africa, like elsewhere in the world, are varied. A study of children in schools for the visually impaired has shown that retinal diseases account for nearly 40% of childhood blindness, optic nerve abnormalities account for 15% and corneal scarring for 11%.

`For South Africa to contribute meaningfully to the ambitious goals of Vision 2020 of eradicating preventable blindness, we must have enough specialist units around the country that have the equipment and expertise to deal with these conditions. Paediatric ophthalmology is a highly specialised field that requires a multidisciplinary team consisting of paediatric ophthalmologists, paediatric anaesthetists, refractionists and contact lens practitioners, orthoptists and low vision therapists. We must continue to train and retrain people with these skills,' König said.

According to OSSA, some of the more important strategies necessary to deal with childhood blindness include:

Programmes to prevent corneal scarring in children . Measures include prevention of eye infections in newborn babies by routine treatment at birth with topical antibiotic ointment, measles immunisation programmes and ensuring adequate dietary Vitamin A in women of childbearing age and young children.
Screening programmes for retinopathy of prematurity , a disorder that can affect the developing retina of premature infants weighing less than 1500g and which could lead to blindness. High risk babies should be examined at about six week of age by ophthalmologists with appropriate experience. Laser treatment at the correct time dramatically reduces the incidence of blindness in these babies.
Rubella immunisation and genetic counselling to reduce Glaucoma, an eye disease that involves damage to the optic nerve.

Children with dyslexia and other learning disorders should also be assessed by an ophthalmologist to rule out significant refractive errors, focussing deficiencies, eye muscle imbalances and motor fusion deficiencies.

`There is no good scientific evidence that eye exercises, visual training, "neurological organisational training" or tinted or coloured spectacles can treat dyslexia and other learning disorders. These claims are often based on anecdotal information or poorly controlled studies,' says Prof Tony Murray of the University of Cape Town.

According to a recent review in the Journal of Paediatric Ophthalmology and Strabismus convergence insufficiency (weakness of the muscles that turn the eyes inwards) was the only condition where eye exercises have proven to be beneficial. Evidence have shown that exercises had no effect on eye movement disorders, amblyopia, myopia (short sightedness), accommodation disorders, learning disabilities, stereoacuity, sports vision and motion sickness.

Dyslexia and learning disorders are best treated by a multidisciplinary team consisting of the paediatrician, educational specialist, occupational therapist, psychologist and others, including ear, nose and throat (ENT) specialists and audiologists.

Prof Murray recommends that parents take their children for routine screening tests at specific stages of their development to identify abnormalities that cause blindness and amblyopia. These stages are:

- Preterm – screening for retinopathy of prematurity
- Newborn babies – screening for congenital cataract, glaucoma and other disorders
- Preschool period – screening for strabismus (squint), anisometropia (difference in refractive error between the two eyes), hypermetropia (far-sightedness) and other amblyogenic factors
- Primary school – screening for refractive errors (near-sightedness, far-sightedness and astigmatism).

Murray says it is important to recognise that the brain is an integral part of the visual system. Any abnormalities should be identified as early as possible, while the brain is still developing synaptic connections. Failure to treat certain eye conditions in time will result in permanent loss of vision - a condition called 'amblyopia'. Many of the conditions that result in amblyopia are not detectable without an ophthalmic examination by a suitably trained professional.

König advises parents to contact their local ophthalmologist or eye clinic if they have concerns about the visual development of their children. Failure to do so may result in problems being detected too late for effective sight-restoring therapy.

Visit OSSA's website at www.ossa.co.za for more information on eye diseases and conditions and to find an ophthalmologist in your area.

Issued by the Ophthalmological Society of South Africa in the interest of Vision 2020 – The Right to Sight.

General Enquiries: Magda Naudé on 082 452 5878