失明の変遷と失明予防対策　　外因から内因へ

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  • Prevention of blindness.

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I was told by Miss Kawamura in 1962 whether she should work forever without qualification. I conveyed the message to the committee of Japanese Oththalmological Society. That message triggered the creation of nationally qualified orthoptists in Japan. Ophthalmic service in Japan is given by 8500 ophthalmologists, 1500 orthoptists, 9000 ophthalmic medical assistants, 20000 opticians and nurses working with ophthalmologists. Eye diseases may be curable, as cataract, or preventable, as infectious diseases or ocular trauma, or cure or prevention still not possible as most genetic eye diseases. Rehabilitation of the patients is the only remaining mean of relieving the patients. The method of surgery of cataract is rapidly changing. Still, cataract is most important cause of blindness in developing countries, half of blind people by cataract. Blindness by diabetic retinopathy is preventable by prevention and strict control of diabetes, and photocoagulation and vitrectomy. Onchocerciasis, river blindness, is preventable by control of black flies and a new drug, ivermectin given once a year to the patients. The number of visually impaired in Japan is in 1987 10% less than the figure in 1980, whereras the number of other physically handicapped increased 20% at the same time.

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