A Global Public Health Perspective: Facilitating Access to Assistive Technology.

Clinicians should not overlook vulnerable populations with limited access to assistive technology (AT), the importance of collaboration in multidisciplinary teams, advocacy for enabling environments, and supportive health systems. Resources, a model of care, and recommendations can assist clinicians in contributing to changing attitudes, expanding knowledge, and improving the lives of many.The increasing availability of innovative advances in AT can immeasurably enhance the quality of life of people with disabilities.

The Use of Key Informant Method for Identifying Children with Blindness and Severe Visual Impairment in Developing Countries.

Purpose: An estimated 19 million children are visually impaired; of these, 1.4 million are irreversibly blind. A key challenge is to identify them early in life to benefit maximally from visual rehabilitation, and/or treatment.

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach.

Background: The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective.

Measuring vision-specific quality of life among adults in Fiji.

Purpose: To evaluate an 18-item vision-specific quality-of-life questionnaire designed for use with adults in Fiji.

Methods: Participants in a population-based cross-sectional survey selected by multistage random sampling from those aged ≥40 years living on Fiji's main island had distance and near visual acuity measured. Those with presenting vision impairment (<6/18) and/or presbyopia ( View Article and Find Full Text PDF

Improving access to eye health services in rural Timor-Leste.

Context: Delivering eye health services to people in rural areas, especially in fragile, post-conflict countries, is a major challenge. This article reports on the implementation and evaluation of an innovative district-based outreach service. The main project partners were the Timor-Leste Ministry of Health and an international non-government organization, with assistance from a local non-government organization.

Population-based study of self-reported ocular trauma in Fiji.

Background: To characterize causes, risk factors and outcomes for ocular trauma among adults aged ≥40 years in Fiji.

Design: Population-based cross-sectional survey; multistage cluster random sampling.

Participants: 1381 (= 73.

The impact of reduced distance and near vision on the quality of life of adults in Timor-Leste.

Purpose: To determine the independent, relative, and combined impact of reduced distance and near vision on the vision-specific quality of life (VS QOL) of adults in Timor-Leste.

Design: A population-based cross-sectional eye health survey was conducted in urban and rural areas in Timor-Leste.

Participants: Participants were 40 years or older.

Developing a competency-based curriculum for eye care managers in Sub-Saharan Africa.

Introduction: There are insufficient healthcare providers to supply eye care services to the millions of people living with visual impairment in developing countries. Eye care providers may supply more efficient and effective services if supported by skilled managers. To help produce skilled managers, appropriate competencies for eye care managers in Sub-Saharan Africa were included in the curriculum for the Postgraduate Diploma in Community Eye Health course (PGDCEH) at the University of Cape Town.

Monitoring and evaluation of refractive error and presbyopia for Vision 2020.

Purpose: To develop output and outcome indicators for the correction of refractive error and presbyopia to a level comparable with those advocated by Vision 2020 for cataract.

Methods: World Health Organization, Vision 2020 and published eye care intervention literature were searched to find evidence of best practice. This information was used to construct a suite of indicators for monitoring the correction of refractive error and presbyopia.

Clinical observations of biofouling on PEO coated silicone hydrogel contact lenses.

Silicone hydrogel contact lenses, which have been a major advance in the field of vision correction, require surface modification or coatings for comfort and biocompatibility. While current coatings show adequate clinical performance, advanced coatings may improve the biocompatibility of contact lenses further by reducing biofouling and related adverse clinical events. Here, we have produced coatings on Lotrafilcon A contact lenses by deposition of a thin film of allylamine plasma polymer (ALAPP) as a reactive interlayer for the high density grafting of poly(ethylene oxide) dialdehyde (PEO(ALD)(2)), which had previously shown complete resistance to protein adsorption in vitro.

Stated and actual willingness to pay for spectacles in Timor-Leste.

Purpose: To conduct a survey of willingness to pay for ready-made spectacles in the low-resource country of Timor-Leste, and, uniquely, subsequent validation with actual payment information.

Methods: A systematic random sampling strategy was used to apply a binary with follow-up stated willingness to pay methodology. Findings were validated by comparing the amount declared willing to pay with the actual price paid at a subsequent visit.

Applying standards to readymade spectacles used in low-resource countries.

Purpose: To test the applicability of standards of appearance, construction, optical quality and performance, and durability proposed for readymade spectacles to be used by eye care programs in low-resource countries.

Methods: Orders of readymade spectacles were procured from three suppliers by an eye care program in Timor-Leste. Feedback regarding quality was given to one supplier before placing subsequent orders.

Mid-level cadre providing eye care in the context of Vision 2020.

The contribution of the mid-level cadre of eye care providers is an essential component of the Vision 2020: The Right To Sight initiative, to eliminate avoidable blindness by 2020. However, for the past 20 years the functions of this cadre have not been definitively outlined, or universally accepted. Consequently, the competencies they require to provide high quality comprehensive eye care have not been established.

Education of eye health professionals to meet the needs of the Pacific.

Vision impairment has significant impact on quality of life and substantial economic consequences. Yet, in the Pacific Islands, as in other low resource settings, it is predominantly caused by chronic conditions that can be treated or prevented. A whole of health approach is required to rectify this, and must include an increase in workforce capacity, both in size and effectiveness, by providing competency-based education for eye care professionals.

Public sector refraction and spectacle dispensing in low-resource countries of the Western Pacific.

Background: Given that uncorrected refractive error is a frequent cause of vision impairment, and that there is a high unmet need for spectacles, an appraisal of public sector arrangements for the correction of refractive error was conducted in eight Pacific Island countries.

Methods: Mixed methods (questionnaire and semi-structured interviews) were used to collect information from eye care personnel (from Fiji, Papua New Guinea, Solomon Islands, Vanuatu, Cook Islands, Samoa, Tonga and Tuvalu) attending a regional eye health workshop in 2005.

Results: Fiji, Tonga and Vanuatu had Vision 2020 eye care plans that included refraction services, but not spectacle provision.

Spectacles in Fiji: need, acquisition, use and willingness to pay.

Background: Little information is available regarding the perceived need, previous acquisition, use and willingness to pay for spectacles in Fiji, on which to base spectacle provision services.

Methods: Using a rapid appraisal technique, semi-structured interviews were conducted with 174 urban and rural households in Fiji's Central Province to assist in planning eye-care services.

Results: Problems with distance and/or near vision comprised 85.

Development and validation of a vision-specific quality-of-life questionnaire for Timor-Leste.

Purpose: To develop and determine the reliability and validity of a vision-specific quality-of-life instrument (TL-VSQOL) designed to assess the impact of distance and near vision impairment in adults living in Timor-Leste.

Methods: A vision-specific quality-of-life questionnaire was developed, piloted, and administered to 704 Timorese aged >or=40 years during a population-based eye health rapid assessment. Rasch analysis was performed on the data of 457 participants with presenting near vision worse than N8 (78.

Evaluation of the first 5 years of a national eye health programme in Vanuatu.

Purpose: To evaluate against its objectives the achievements of the first 5 years of a national eye health programme in Vanuatu.

Methods: Programme clinical activity data were collated from surgical logs, clinic and outreach reports, and patient register books. Cataract surgical outcomes were retrieved from monitoring software.