Department of Vitreo-Retinal Services, Pushpagiri Vitreo-Retinal Institute, West Marredpally, Secunderabad, Telangana, India.
Indian J Ophthalmol. 2019 Jun;67(6):726-731. doi: 10.4103/ijo.IJO_700_18.
Many of the causes of childhood blindness are avoidable, being either preventable or treatable. Retinopathy of prematurity (ROP) remains one of the most preventable causes of childhood blindness worldwide. Currently, India is facing the third epidemic of ROP. In India, the health system involving the mother and child health services needs to be strengthened with a policy to cover the existing inadequacies in neonatal care and implementation of program covering newborn, especially premature. The access, availability, and affordability of services related to the care of premature babies need strengthening in India. ROP-trained ophthalmologists and neonatal care pediatricians and a professional togetherness is a big issue. Inadequacies in awareness of ROP among the parents, health care workers, counsellors add up to the problem. Community-based health workers such as Accredited Social Health Activist are a good dependable force in India and are needed to be trained in awareness and establishing a proper identification for prompt referral. ROP prevention needs a multidisciplinary team approach. ROP management stands as a good example of all the strategies for prevention, which includes primary prevention (improving obstetric and neonatal care), secondary prevention (screening and treatment programs), and tertiary prevention (treating complications and rehabilitation to reduce disability). Given its demographic and cultural diversity, India faces numerous challenges, with significant rural-urban, poor-rich, gender, socioeconomic, and regional differences. So, we need to gear up to face the present challenge of the third epidemic of ROP and prevent ROP-related childhood blindness as it is the need of the hour.
许多儿童失明的原因是可以避免的,因为这些原因既可以预防也可以治疗。早产儿视网膜病变(ROP)仍然是全球范围内可预防的儿童失明的最主要原因之一。目前,印度正面临着 ROP 的第三次流行。在印度,涉及母婴保健服务的卫生系统需要得到加强,制定一项政策来覆盖新生儿护理方面现有的不足之处,并实施涵盖新生儿,尤其是早产儿的计划。印度需要加强与早产儿护理相关的服务的可及性、可获得性和可负担性。在印度,接受过 ROP 培训的眼科医生和新生儿科儿科医生以及专业人员的合作是一个大问题。父母、医护人员、咨询人员对 ROP 的认识不足也是问题之一。在印度,像认证社会卫生活动家这样的社区卫生工作者是一支可靠的力量,需要对他们进行培训,以提高认识并建立适当的识别机制,以便及时转诊。ROP 的预防需要多学科团队方法。ROP 的管理是所有预防策略的一个很好的例子,包括初级预防(改善产科和新生儿护理)、二级预防(筛查和治疗计划)和三级预防(治疗并发症和康复以减少残疾)。由于印度的人口和文化多样性,它面临着许多挑战,存在显著的城乡、贫富、性别、社会经济和地区差异。因此,我们需要做好准备,迎接第三次 ROP 流行带来的挑战,防止 ROP 相关的儿童失明,因为这是当前的迫切需要。