National Programme for Control of Blindness and Visual Impairment

Background

National Programme for Control of Blindness was launched in the year 1976 with the goal to reduce the prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02, prevalence of blindness is estimated to be 1.1%.  Rapid Survey on Avoidable Blindness conducted under NPCB during 2006-07 showed reduction in the prevalence of blindness from 1.1% (2001-02) to 1% (2006-07). Various activities/initiatives undertaken during the Five Year Plans under NPCB were targeted towards achieving the goal of reducing the prevalence of blindness to 0.3% by the year 2020. The National Blindness Survey (2015-19) has shown reduction in the prevalence of blindness from 1% (2007) to 0.36% (2019).

In the beginning it was a 100% Centrally Sponsored scheme. From 12th FYP it is 60:40 in all States/UTs and 90:10 in hilly states and all NE States. Nomenclature of the programme was also changed from National Programme for Control of Blindness to National Programme for Control of Blindness & Visual Impairment (NPCBVI) in 2017.

Main causes of blindness

1. Cataract (66.2 %)
2. Corneal opacity (7.4%)
3. Cataract surgical complications (7.2%)
4. Posterior segment disorders excluding DR and ARMD (5.9%) and
5. Glaucoma (5.5%). 

Goal

Under the National Health Policy (NHP), the target is to reduce the prevalence of blindness to 0.25% by 2025.

Major activities under the Programme

1. Primary eye care services

• Preventive and promotive eye care services: under comprehensive primary health care Health and Wellness Centres (HWC) are providing preventive and promotive eye care services.
•  IEC activities for promotion and preventive eye care and eye donation.

2. Secondary eye care services

•  Cataract surgeries: Reduction in the backlog of cataract by performing cataract surgeries in Governmental, Non-Governmental Eye Hospitals and private practitioners.
•  Screening for Refractive errors and Distribution of free Spectacles: Screening of Children for identification and treatment refractive errors and distribution of spectacles to those who are suffering from refractive errors through school eye screening programme.
• Distribution of free spectacles to old persons suffering from presbyopia to enable them for undertaking near work as a new initiative under the programme.
• Management of Visual impairment: The programme is now geared to take care of all categories of visual impairment including low vision cases. Apart from cataract, now the focus of the programme is on treatment and management of other eye diseases like glaucoma, diabetic retinopathy, vitreo retinal diseases, Corneal blindness and childhood blindness.
• Use of Mobile Ophthalmic Units and Tele- ophthalmology network to expand coverage and reach of the programme in disadvantaged and hard to reach areas.
• Eye banking Services: Strengthening of eye banking services and collection of donated eyes.

3. Tertiary Eye care Services:

Under the tertiary care component of NPCB&VI

• Grant in Aid for strengthening of Regional Institute of Ophthalmology and Medical Colleges to provide super-speciality eye care services 
• Hands on Training of Govt. Eye Surgeons for upgradation of their clinical and surgical skills.
• IEC campaigns
• Research and surveys

4. Infrastructure Development and Capacity building

• Grant in Aid for strengthening of eye care units at primary and secondary level.
• Training of Paramedical Ophthalmic Assistant and Eye donation counsellors.

5. Newer Initiatives/ Focus Areas under the program

• Revision of NPCBVI guidelines to provide Comprehensive eye health care through AB- Health and Wellness Centers
• “Standards of eye banking in India 2020” have been launched for improvement in eye donation, collection, processing, and maintenance of quality standards, equitable distribution of scarce corneal tissue, strengthening of institutional capacity for corneal transplantation, community awareness and
  training of health personnel.
• Development of a network of eye banks and eye donation centres and linked with medical colleges and RIOs to promote collection and timely utilization of donated eyes in a transparent manner
• Focus on other causes of Visual impairment, besides Cataract, treatment/management of other eye diseases like Diabetic retinopathy (DR), Retinopathy of prematurity (ROP). Corneal Blindness and glaucoma has been increased. DR screening and glaucoma clinics have been made integral part at district and sub-district hospitals.
• In order to achieve elimination of trachoma by the year 2020 as per WHO global action plan, surveillance, case detection and treatment of Trachoma trichiasis (TT) is being executed which will be followed by TT only survey in all previously trachoma endemic districts.
• Issuing of COVID 19 guidelines to all stakeholders for safe ophthalmology practices to minimize and avoid the spread of COVID 19 in eye care facilities.
   Setting up of super-specialty clinics for all major eye diseases including diabetic retinopathy, glaucoma, retinopathy of prematurity etc. in state level hospitals and medical colleges all over the country.
• Linkage of tele-ophthalmology centres at PHC/ Vision centres with super-specialty eye hospitals to ensure delivery of best possible diagnosis and treatment for eye diseases, especially in hilly terrains and difficult areas.

Source: National Programme for Control of Blindness & Visual Impairment (NPCBVI)