Correlation Between Poverty and Blindness, Research Paper Example

Introduction

Poverty can be explained at different levels, such as at the community level, individual, family, or household.  Basically poverty levels are considered based on employment status, income level, costs, land ownership, consumption, and housing, types of services that are offered, such as education, development, healthcare, as well as psychological and social services.  With all of the factors in mind, poverty can therefore be thought of as the lack of opportunities or services available to the public that could enhance the quality of life for an individual.   In addition, disabilities are also reported as a factor of “poor people”.  Studies have found that up to 20 percent of poor people residing in underdeveloped countries are affected with a disability.  In fact, visual disabilities are documented as number six out of the seven categories of disabilities impacting the quality of life and life expectancy for individuals in developing countries.  Other studies have suggested that blindness is a direct factor of poverty.  In addition, blindness is correlated with resulting in financial insecurity.  Studies have also found that the blindness is much higher in lower income countries than industrialized countries, with more than 75% of the global blindness being both preventable and treatable.  Although there has been correlations linked to poverty and blindness, there is a lack of sufficient data to firmly correlated poverty and blindness.  (Gilbert et al., 2007)  The current paper discusses the conditions that are most responsible for global blindness, as well as their correlation with poverty.  In addition, the paper focuses on the prevention and treatment of these diseases, which could lead to a decrease in the global blindness problem.

The three main causes of avoidable blindness, which are also responsible for more than 70% of global blindness, are cataract, trachoma, and glaucoma.  Cataracts result in the loss of normal transparency due to the opacity of the crystalline lens in the eye.  In fact, out of the three main causes, cataracts are responsible for more than half of the blindness globally. Trachoma is condition that causes blindness and is estimated to affect 15 percent of the global blindness.  The cause of trachoma is through the infection with Chlamydia trachomatis.  Reoccurring eye infections lead to trichiasis, which further results in corneal blindness. Glaucoma is a disease that is responsible for over 13 percent of the worldwide blindness.  Glaucoma is considered as a group of conditions that are characterized with atrophy of the optic disc, visual field loss, and increased intra-ocular pressure.  These diseases can either be treated or prevented, depending on the type; however, these conditions are more common in areas with socio-economic issues or problems, such as the lack of basic needs for healthcare and lack of healthy sanitary conditions.  (Roodhooft, 2002)  In addition, the impact of a disability of the economic status of an individual is overwhelming.  The causes of the disability have had major effects on employment status, education, health, social well-being, and poverty alleviation.  It has been suggested that these individuals could increase their quality of life if their issue of disability, such as blindness, was fixed.  With vision correctness, these individuals would be able to find employment and have the ability to care for themselves and their family.  As observed in Table 1, the dimensions of eye disability and poverty are detailed.  Vision impairment is known to force people to remain and fall deeper into poverty.  (Jaggernath et al., 2014)  The current paper discusses each of the conditions in respect to their etiology, prevention, and treatment and how these factors are correlated with blindness from these conditions and poverty.

Blindness Diseases

Cataracts

Cataracts can be considered a universal cause of blindness.  Cataracts are caused from the clouding of the lens of the eye, which affects vision.  Cataracts are mostly common in the elderly.  In fact, over half of Americans have developed a cataract or have had cataract surgery by the age of 80.  Cataracts an occur in one of both eyes and have common symptoms such as, blurred visions, color visualization problems, problems with glares or lighting, the lack of ability to see well at night, double vision, and changes in eye glass prescriptions.  Cataracts develop at a slow pace and therefore, the change in glasses and lighting can alleviate the symptoms; however, in order to correct the problem, the removal of the cloudy lens with the replacement of an artificial lens is required.  (NIH, 2015)

Studies have linked age with the increase in cataract occurrences.  In addition, studies have shown that cataracts increase with age in developing countries, at an earlier age compared to already developed countries.  For instance, cataracts were found to occur 14 years earlier in India compared to the United States.  The study found that 82% of residents in India exhibited significant cataracts between the ages of 75-83 years of age; whereas, in the United States, only 46% of people in that age group exhibited a history of cataracts.  In addition, studies have indicated that there is a continuing growth of cataract incidences and it is estimated that the number of people with cataracts will double over the next 20 years.  (Byran and Tyler, 2001)

The etiology of age-associated cataract is not fully understood; however, an association of a genetic component has been suggested. Genetic relationships have been correlated with approximately two thirds of cortical cataracts.  Based on genetics, nothing can be done in order to prevent a cataract; however, other factors, such as exposure to ultraviolet-B or UV-V rays has been known to be a risk factor.  In addition, the condition of diabetes and the intake of corticosteroids are also associated with disease occurrence. Other studies have shown that extreme malnutrition is common in individuals with cataracts.  Also, other diseases, such as cholera (severe diarrhea) have been associated with people with cataracts.  In the United States, an increase in the body mass index seems to be a risk factor to developing cataracts.  (Byran and Tyler, 2001)

Currently there are studies in development into the use of antioxidant vitamin supplements and the reduction of cataracts; however, the effectiveness of this preventative measure is not known.  The reduction of the risk of the development of cataracts is associated with UV-B radiation exposure and smoking.  Studies suggest that the reduction of UV-B rays and the decrease in smoking can help decrease the risk factors for the development of cataracts.  In developed countries, such as the United States, education and politics have helped as an effective measure in the reduction of cataracts due to the continuing awareness of sun exposure effects and smoking effects.  (Byran and Tyler, 2001)

The treatment and cure for cataracts is surgery.  The problem with this resolution is that it is not available to everyone and depending on where it is available, the outcomes are different.  There are many challenges that arise from treatment such as, at what stage in cataract development should the surgery occur, how it is performed and how it is paid for.  For the most part, when someone is completely blind, this is not when a surgery would be performed.  Usually, there is a measurement conducted on the visual acuity of the individual.  In developed countries, the threshold at which an individual is considered for surgery decreased with the increase in safer surgeries and better rehabilitation procedures.  In addition, in developed countries the demands of good vision have increased in the retired in order for a better quality of life.  The threshold for developed countries is considered 6/9 or less in order to receive the surgery. This decrease in the threshold has increased the number of people in countries, such as the United States, Australia, and the United Kingdom.  In fact, cataract surgery is the highest ophthalmic procedure in certain areas.  Not only for societal issues, but for issues concerning important factors such as the workforce and drivers licenses.  (Byran and Tyler, 2001)

Cataract surgery criteria have been that of a debate.  Who should get a surgery and the threshold to that of which it is chosen varies with the situation and individual as there are different levels of visual disruption.  For instance, how does this visual impairment affect their normal life habits or ability to work or thrive day to day.  These are the considerations that are made for these surgeries.  Relating the condition to a visual disability is usually assessed.  Although there have been advances in the number of treatments and the assessment of who needs the treatment.  The real problem persists in who has access to these treatment options.  The major challenges for cataract surgeries lie in the developing countries.  In developing countries there is a lack of doctors, facilities, and eye care practices.  In addition, the level of professionalism and health care benefits varies considerably, which in turn puts a constraint on who can receive this type of surgery.  For instance, in a developing country, most of the patients in need of cataract surgery live away from the larger cities that have surgery centers and capabilities of this type of surgery; however, it is also known that these centers lack the funding, maintenance, and accessibility to the right medical equipment and medications, as well as surgeons capable of performing this specific surgery.  In order to grasp the overall effect of how these countries lack the necessary people and equipment, in Africa it has been indicated that there are only about 500 ophthalmologists.  There are millions of residents in Africa.  In addition, most of these doctors are unavailable to the general public and are only found in the major cities.   It has also been found that general doctors that are available to the general public do not have the detailed knowledge or expertise to conduct the correct testing or evaluation on vision problems.  (Byran and Tyler, 2001)

Other research has found that patients do not utilize the cataract surgical services that are available to them.  In one study, it was found that Kenyans were offered a free cataract extraction and only 70% of the people underwent the surgery.  In same study, only 62% of the people from Nepal underwent the surgery.  It has been suggested that the lack of willingness to undergo the surgery in developing countries is due to the lack of knowledge of the outcome or the lack of trust to the medial field.  In addition, fear of becoming completely blind or traditional religious beliefs may deter people from undergoing a medical surgery.  Other facts are the inability to get to the surgery and the distance to the surgery.  When services are not freely available to people, the major reason for the lack of cataract surgery is the cost of the service.  In developing countries, the medical care or funds that are given to medical care are usually prioritized differently and to other types of medical needs, basic needs of the communities.  Therefore, most likely the only people who undergo cataract surgery in the developing countries are those that can afford it.  (Byran and Tyler, 2001)

In a similar study on cataract surgery and poverty levels, participants were analyzed for household level and surgical coverage.  It was found that blindness was significantly greater in poor groups and in poor households.  In addition, it was found that poor participants exhibited lower rates of cataract surgery, resulting in blindness.  It was also found that the poor participants underwent less than optimal surgery (without the intraocular lens implantation), which resulted in higher blindness rates due to the lack of correction.  In addition, spectacle coverage was also low in poor households and in women.  (Gilbert et al., 2007)

In order to further show the correlation between poverty and blindness, a group of researchers conducted a study in Kenya, Bangladesh and the Philippines in order to test and see if blindness was a cause of poverty itself.  The researchers in this study suggest that poverty and blindness are in fact linked, with poverty being the factor predisposing the people to blindness through the inability to maintain or find employment, or by the cost of the treatment.   The basis of this study was to show how cataract surgery is limiting financially and when people cannot afford such a surgery, blindness leads to poverty.  The study showed that the visually impaired individuals from cataracts were significantly poor, less productive, and had a less quality of life compared to normal vision individuals in Kenya, Bangladesh and the Philippines.  In addition, the results of the study found that one year after cataract surgery the self-rated wealth of individuals improved in Kenya and the Philippines.  The data from this study highly suggest an apparent correlation between poverty and cataracts.  Other factors that were found in this study support the cost of the surgery as a main issue of why poorer people do not undergo the surgery, which results in blindness.  These factors therefore suggest the role of poverty in blindness.  (Polak et al., 2010)

Since poverty shows a correlation to blindness in regards to cataract occurrences, the debate leads to how to fix the issue and implement a strategy to help developing countries with this problem.  One solution is to implement industries in this area to increase the economy and open up the ability for the people to obtain jobs and help afford such surgeries.  One organization, the Fred Hollows Foundation, incorporation a manufacturing company in Nepal.  The communities in this area have benefited from the production of lens manufactured from the company, and have become more educated and capable of affording necessary surgeries.  (Byran and Tyler, 2001)

Trachoma

Trachoma is a bacterial infection caused by the bacteria, Chlamydia trachomatis, which impacts the eyes.  The bacteria in this condition spread via contact those through direct contact with an infected person via the eyes, nose or throat.  Therefore, trachoma can be highly contagious and usually affects both eyes.  The initial symptoms of trachoma start with irritation and itching of both of the eyes.  Those who do not get treated for this condition can result in full blindness.  The important issue with this disease in regard to blindness is that it is preventable.  Even though this disease is preventable, the World Health Organization (WHO) has estimated that approximately eight million people are visually impaired by infection with this disease.  In addition, it has been indicated that over 84 million people are in need of receiving treatment worldwide for this infection.  Most of these people are indicated as from poorer areas or from developing countries.  In addition, some of these people are children.  (Mayo Clinic, 2015)  In addition, the 2014 indication of the global at risk population was estimated at 232 million.  Further review found that the concentration of cases of trachoma is located with 14 different countries.  (ITI, 2015)

If trachoma is treated during the early stages of the disease, when the mild symptoms, such as irritation and mild discharge are present, further complications can be prevented from occurring; however, if the disease goes untreated and continues to progress, the individual’s symptoms will worsen.  The identification of active trachoma is found through the presence of follicles which are located on the tarsal conjunctiva of the eye.  In order to assess active trachoma, the World Health Organization (WHO) has created a grading system, as seen in Table 2.  The first two signs of the disease looks for the follicles; whereas, the inflammation indications look for severe disease.  (Wright et al., 2007)  After disease progression, the individual will start to develop symptoms such as, light sensitivity, eye pain, and blurred vision.  (Mayo Clinic, 2015)  The interesting observation about trachoma is that the infections of trachoma can develop in early childhood and with repeated infections leave a scar, which in turn can eventually lead to blindness.  Research has found that the poor are the people suffering from this condition due to the limited access to water and good sanitation.  Also, due to the highly contagious transfer of the disease, it can occur in clusters of groups and infect multiple people and families.  (ITI, 2015)

Since the disease is highly contagious, trachoma has been known to decrease the economic status of entire communities in developing countries.  Families infected with this disease remain in poverty and the disease and long-term effects continue on to the next generations.  The cost of trachoma has reached over billions of dollars per year.  In addition, the blindness that occurs from trachoma occurs in adults who are the working people of the family, deterring them from the ability to care for them or their families.  It is also noted that women are more likely to contract trichiasis.  In these developing countries, women are the primary caregivers of the home and therefore are unable to care for the household and her family members.  This not only affects the family, but affects the children as daughters, for instance, are taken from education in order to take on the motherly duties.  (ITI, 2015)

Public health interventions have been established in order to help with the global epidemic of trachoma and blindness.  It has been referred to as the SAFE strategy.  The strategy includes treatment for people in these developing countries with trachoma epidemics.  The treatment includes antibiotic treatment using Zithromax and the help in improvements to access to clean water and better sanitation.  Clean water and better sanitation are the first steps and crucial factors to eliminating the cause of blindness from trachoma.  (Light for the World, 2015)

Programs have been implemented in 2015 in affected countries with trachoma in order to help eliminate the disease.  The goal is for elimination by the year 2020.  The program is built upon five main principles for the fight in the elimination.  The principles are as follows: urgency for action and scale-up, accountable ownership by countries so they can integrate actions into the national health services, integration so that trachoma focused efforts are aligned with activities, eye care and development strategies, efficient, coordinated partnerships with all stakeholders, and tailored interventions to meet local needs and context  (Light of the World, 2015).  The purpose of this program is to not only decrease poverty and blindness levels, but help with the societal changes that are occurring with people that have vision loss or blindness.  For instance, it has been found that people living with blindness and in poverty are secluded from society in addition to the large economic affect that is occurring within a family and community from this disease.  In addition, the community economic costs are extremely high from this condition.  It is estimated that there are billions of dollars lost from the trachoma.  Although it will be costly to eliminate the disease, in the long run, human factors and the economy will prosper.  For instance, Light of the World indicates that if the disease were eliminated in Africa, the economy would increase up to 30 percent in its’ annual productivity, not to mention the enormous impact it would have on people.  (Light for the World, 2015)

The progression of trachoma is a very painful condition and can result in death of the individual.  In addition, about one-third of the patients with this condition develop corneal opacity.  In order to management patients that have developed trichiasis, surgical intervention is necessary.  Also, there is such a lag time between the transmission in children to the development of trichiasis from trachoma in adults, that even with the elimination of the disease, surgeries would be necessary for children with active trachoma today when they develop into adults.  There have been numerous surgeries to help with trichiasis; however, this type of surgery does not correct vision impairment.  In addition, the surgery must be performed directly after diagnosis in order for a good outcome to occur.  It seems that people are reluctant to undergo this type of surgery.  Different factors have been assumed for this reluctance, such as the high recurrence rates after the surgery.  It has been found that trichiasis recurrences are extremely high at a rate of 60% after three years post-surgery.  (Wright et al., 2009)

Another form of treatment, as mentioned previously, is antibiotics.  Antibiotics are used to decrease the outbreak of the bacteria within the area.  In addition, it is suggested that hygiene changes or behavior should occur in order to decrease recurrence.  It has been recommended that members of the community with high incidences of trachoma receive oral doses of antibiotics (azithromycin (20mg/kg up to 1g) annually for at least three years.  The antibiotic treatment has been found to have a low resistance and with a good side-effect.  Other data has shown that treatment of antibiotics at two times per year in areas where trachoma is 50 percent or more has reduced the presence of the infectious bacteria.  (Wright et al., 2009)

Glaucoma

Glaucoma is a condition that affects the optic nerve.  The optic nerve transmits the images to the brain and is composed of numerous fibers.  If damage occurs to the optic nerve fibers, blind spots can occur.  Therefore, if the entire optic nerve is damaged or destroyed, the results are blindness.  It is therefore crucial for early detection and treatment of this condition in order to prevent blindness from occurring.  In the United States, glaucoma is the leading cause to blindness, especially in the elderly.  However, with early treatment, loss of vision can be prevented.  (The American Academy of Ophthalmology, 2002)

Within the eye there is a clear liquid, called the aqueous humor, which circulates inside the front part of the eye. Small amounts of liquid are consistently produced in order to flow through the eye and out of the eye in order to maintain a specific level of pressure.   If there is a problem with the drainage of the eye, pressure increases and damages the optic nerve.  There are different types of glaucoma, such as chronic open-angle glaucoma and closed angle glaucoma.  Symptoms of glaucoma include the following: blurred vision, severe eye pain, and headaches, rainbow-colored halos around lights, and nausea and vomiting.  There are many risk factors for glaucoma such as age, elevated eye pressure, family history of glaucoma, African ancestry, nearsightedness, past eye injuries, and diabetes.  Physicians usually review these factors and determine if treatment is needed or monitoring is necessary.  In addition, the detection of glaucoma usually occurs through regular eye examinations and glaucoma screenings.  (The American Academy of Ophthalmology, 2002)

A typical glaucoma patient is usually thought of by eye care physicians as an older African-American patient, as they are high risk patients.  In fact, African Americans comprise around 75% of the glaucoma patients in the United States.  (Swanson, 2014)  However, glaucoma is considered the third main cause of blindness globally and research is pointing towards poverty as the cause.  For instance, in Ethiopia, glaucoma is the fifth cause of blindness that could have been prevented with treatment and prevention.  The factors in Ethiopia and other developing counties is due to the nature of the disease and the inability or inaccessibility to eye care, as well as the low level of awareness or education of the disease in the community.  In fact, health care professionals in these areas have a low level of understanding of this disease.  (Faal, 2012)

In Africa, the government has acknowledged that there is a major lack of trained ophthalmologists needed in order to diagnose and treat glaucoma.  In addition, it has been acknowledged that there is no type of public awareness service or program available to the communities in Africa that teach the people about the disease and their options, as well as help with the training of doctors who are capable of performing this type of service.  The government is aware that these two issues are pertinent in order to help decrease the number of glaucoma cases within Africa.  The need for a market for mediations for glaucoma in Africa is also an issue.  With the lack of these resources, people are unable to obtain the correct medications they need in order to treat glaucoma.  (Faal, 2012)

In other studies, glaucoma was found in developing countries in Asia to be significantly higher than in the United States.  (Figure 1)  This study found that women were at a high predisposition to glaucoma compared to males.  This can correlate to poverty areas as well, where cultures do not allow women to receive healthcare.  Further research found that in Indian and other developing countries, that only about half of the cases of glaucoma were treated.  The reason for the lack of treatment is again linked to a lower socioeconomic status and a decrease in the education level.  (Grehn and Stamper, 2006)

Ocular Hypertension Treatment has proven successful in glaucoma patients; however, these studies do not apply to developing countries.  It is suggested that intervention in developing countries would be the best means of treatment and prevention for glaucoma.  Other treatments, such as surgery are conducted in order to treat glaucoma; however, these have higher risks associated with it and are harder to manage, especially for people in developing countries with the inability to make it to treatment centers.  (Grehn and Stamper, 2006)

Overall Impact of Eye Health on Economic Status

It has been observed that there is a higher risk for becoming blind for individuals who come from a lower socio-economic grade than people in better socio-economic situations.  Poorer countries are faced with a higher disadvantage and are more likely to develop conditions such as trachoma or have the inability to get treated or prevent other diseases or conditions leading to blindness.  Once there is vision impairment in the already low economic society, this puts further burden on individuals; therefore, vision loss can have severe impacts on people’s lives.  Vision has been indicated to be a critical factor in the role of society and quality of life; therefore, the inability to see negatively impacts the function and quality of life of an individual.   (Jaggernath et al., 2009)  Studies have specifically found that vision impairment or blinded has restricted the ability of an individual to perform daily tasks and maintain an independence they once had.  In addition, people who develop blindness also develop other health conditions such as stress and depression. (Lamouroux et al., 2009)

One of the major factors in the increase in treatable and preventable vision impairments is the inability of people in developing countries to access the healthcare that they need or require.  Research suggests that eye services in particular have issues that range from gender inequality, lower socio-economic status, low income status, low employment levels, and cost problems.  In regard to gender inequality, women in these countries may be prohibited from obtaining vision services or correcting their vision problems.  These instances are usually related to culture contexts and beliefs where the people do not believe in obtaining or undergoing these types of procedures or services.  In some cultures, it is even believed that a supernatural power is the cause of the condition and they must use holistic types of methods to try and cure or treat the problem. (Jaggernath et al., 2014)

Other issues concerning the lack of accessibility for people in developing countries is the lack of available resources, such as facilities or doctors.  The lack of facilities is a major problem.  This not only includes the lack of the actual facility itself, but the lack of the necessary health staff or physicians who are qualified to treat and prevent vision conditions.  In addition, in these developing countries, the knowledge and technology is not available to the facilities that are present.  With that being said, the poor are prevented from receiving the quality services that they should in order to fix or prevent vision impairment.  (Jaggernath et al., 2014)

Knowledge of vision impairment in developing country cultures is also an issue.  Some communities lack the knowledge of health.  For instance, poor households found in these countries do not know how to read and are not educated, and therefore, are not knowledgeable about these conditions, the causes, and the options in regard to prevention and treatment.  Some people think that the development of blindness is part of the aging process and that there is nothing that can be done to correct it.  (Jaggernath et al., 2014)  One study found the subjects indicated that fear from the surgery itself for correcting vision was a deterrent itself.  (Gooding, 2006)

One important factor to the cause of blindness is an environmental factor, such as sanitation.  Part of the WHO goal in their SAFE strategy for trachoma, in particular, was to incorporate measures that help increase cleaner environment in order to decrease the bacteria in the community.  These environmental factors were all linked to poverty conditions, such as unsafe water supply, feces disposal, animal pens within a human household, etc.  These types of issues are currently being addressed in order to help the communities obtain a better environment.  Education programs to be incorporated into the SAFE program include help with cleaning water, refuse dumps, relocation of animal pens, as well as educating the public on the need for such changes.  One study found that high fly densities were associated with trachoma outbreaks.  In the study, it was indicated that high flu densities and fly contact with feces were associated with high levels of trachoma in children.  (Wright et al., 2009)

Government policy is an important factor that needs to be considered for the impact of vision impairment from poverty.  One proven implementation has been observed in India.  For instance, India was the first country to implement a national program to decrease and control the occurrence of blindness.  The country was more focused on cataract prevention and control; however, the effort from the government led to the improvement of the skills for the ophthalmologists in India.  Other programs were established in order to help with control. For instance, China has approximately 300 doctors per 100,000 people, which is higher than other industrialized countries.  However, this does not help with improvement to vision.  When comparing India versus China, India has a much lower doctor to person ratio, but they perform more cataract surgeries per year than China.  (Grehn and Stamper, 2006)  In Africa, there is a huge doctor to person ratio in addition to the lack of the ability to train personnel.  For instance, in Africa there is an average of one eye physician per one million people in the Sub-Saharan region of Africa.  In addition, there are only a handful of facilities that provide optometric training for doctors.  To obtain a better idea of the ratio in Africa, there are only about 2,500 optometrists that are capable of providing eye health care services to a population of over 44 million in South Africa.  This is compared to a developed country, such as the United Kingdom where the ration is one doctor for every 5,200 people.  (Naidoo, 2007)

Other concerns for developing countries are related to the pharmaceutical industry.  Most countries do not have access to the necessary drugs that they need in order to treat many diseases, to include vision impairment diseases.  There is inaccessibility to drugs and this is due to the international patent system.  It has been indicated that the World Trade Organization’s Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement deters access for the poor people to proper medication.  A solution to this problem has been recognized as the need for the development of domestic manufacturing.  For instance, India has built their own pharmaceutical industry through domestic firms and has become a leading industry in generic versions of already patented drugs.  Although they are leader in the development, subsequent patent regimes in 2005 are transforming the industry to return the big firms.  Therefore, it must be recognized that there is a need for access to these drugs and patents.  (Grehn and Stamper, 2006)

Conclusion

As mentioned above, poverty can be explained at different levels, such as at the community level, individual, family, or household.  Basically, poverty levels are considered based on employment status, income level, costs, land ownership, consumption, and housing, types of services that are offered, such as education, development, healthcare, as well as psychological and social services.  Poverty and blindness are highly correlated and have been found to be a lethal condition or combination.  Although there has been correlations linked to poverty and blindness, there is a lack of sufficient data to firmly correlated poverty and blindness.  Research has found, however, that there are three main causes of avoidable blindness, which are also responsible for more than 70% of global blindness, are cataract, trachoma, and glaucoma.  In addition, research has suggested that the increase for global blindness is positively linked to poverty.

Most people who become blind are already in a low economic status and therefore, become even lower or cannot transition out of that status.  Poverty is therefore linked to blinding eye diseases such as cataracts, trachoma, and glaucoma.  Given that this is a global issue, it is up to organizations such as the World Health Organization (WHO) to help in awareness and prevention programs.  Governmental programs need to address the numerous barriers in regard to global eye health and strategies to help the poor prevent and treat vision impairment conditions.  These barriers include the clinical knowledge and financial barriers.  There is also an essential need for doctors, facilities and equipment.  There are millions of residents in these developing countries, with only limiting numbers of doctors or trained physicians capable of performing such surgeries.

In order to decrease blindness globally, the issues of poverty must be addressed, as well as government programs that help educate, assist and provide access for their communities to the essential health care services they need.   The economic and political realization and necessary measures must be met.  Strategies must be implemented that promote governance among the poor and those stricken in poverty.  Two researchers provided a great statement to illustrate the need for addressing poverty and blindness: “Genetic factors aside, diseases like blindness and nutritional influences on cataract can be eradicated with improvement in socio-economic development. Similarly, trachoma, a blinding disease associated with poverty and inadequate sanitation, can also be controlled with economic improvements.  However, it is less convincing that pure economic development will have a significant effect on the rates of onchocerciasis, unless fly eradication or control programs are considered to be a part of economic development.  Similarly, glaucoma is a worldwide problem in all populations that requires more complex intervention strategies and will probably not change dramatically with economic development (Naidoo, 2007)”.

References

The American Academy of Ophthalmology.  (2002). Retrieved from: http://www.azglaucomaspecialists.com/glaucoma.pdf

Faal, H. (2012).  Community Eye Health Journal. 79 & 80(25): 41-84.

Garry, B. and Taylor, H.  (2001).  Cataract blindness – challenges for the 21st century. Bulletin of the World Health Organization. 79: 249–256.

Gilbert, CE., Shah, SP, Jadoon, MZ, Bourne, R., Dineen, B., Khan, MA., Johnson, GA., Khan, 32 (2007). Poverty and blindness in Pakistan: results from the Pakistan national blindness and visual impairment survey.  BMJ. 336(7634): 29–32.

Gooding, K. (2006) Poverty and Blindness: A Survey of the Literature. Sightsavers. International Programme Development. Unit. http://www.sightsavers.org

Grehn, F. and Stamper, R.  (2006).  Glaucoma.  Essentials in Opthalmology.  Retrieved from: http://www.researchgate.net/profile/Murray_Johnstone/publication/226655993_A_New_Model_Describes_an_Aqueous_Outflow_Pump_and_Explores_Causes_of_Pump_Failure_in_Glaucoma/links/0deec51f86825799d2000000.pdf

ITI.  (2015).  The World’s Leading Cause of Preventable Blindness. What is trachoma? Retrieved from: http://www.trachoma.org/world%E2%80%99s-leading-cause-preventable-blindness

Jaggernath, J., Overland, L., Ramson, P. Kovia, V., Fai, V., Kovin, C., Naidoo, S. (2014). Poverty and Eye. Health.  (6):1849-1860.

Kuper, H., Polack, S., Mathenge, W., Eusebio, C., Wadud, Z., Rashid, M., Foster, A.  (2010).

Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh.

Lamoureux, E., Fenwick, E., Moore, K., Klaic, M., Borschmann, K. and Hill, K. (2009) Impact of the Severity of Distance and Near-Vision Impairment on Depression and Vision-Specific Quality of Life in Older People Living in Residential Care. Investigative Ophthalmology and Visual Science, 50, 4103-4109. http://dx.doi.org/10.1167/iovs.08-3294

Light for the World. (2015).  Poverty Affects Eye Health.  Retrieved from: http://www.light-for-the-world.org/uploads/media/Vision_Development_01_2013.pdf

Mayo Clinic.  (2015).  Trachoma.  Retrieved from: Mayoclinic.org

Naidoo, K. (2007).  Poverty and blindness in Africa.  Clin. Exp. Optom. 90(6):415-421 NIH.  (2015).  Cataract.  Retrieved on 5/6/15 from: http://www.nlm.nih.gov/medlineplus/cataract.html

Roodhooft, JMJ.  (2002).  Leading Causes of Blindness Worldwide.  Bull. Soc. belge Ophtalmol., 283: 19-25.

Swanson, M. (2014).  The Changing and Challenging Epidemiology of Glaucoma.  Review of Optometry.   Retrieved from: http://www.reviewofoptometry.com/content/c/49437/dnnprintmode/true/?skinsrc=%5Bl%5Dskins/ro2009/pageprint&containersrc=%5Bl%5Dcontainers/ro2009/simple

Wright, H., Turner, A., Taylor, AC.  (2007).  Trachoma and poverty: unnecessary blindness further disadvantages the poorest people in the poorest countries.  Clinical and Experimental Optometry.  90(6):422-428.