NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS
(1)
INTRODUCTION
National Programme for Control of Blindness [NPCB] was launched in the year
1976 as a 100% centrally sponsored programme with the goal of achieving a prevalence
rate of 0.3% of population by 2020. The strategy of the programme is :
•
To identify the curable blind in the State;
•
By Strengthening service delivery;
•
Developing human resources for eye care;
•
Promoting outreach activities and public awareness and
•
Developing institutional capacity.
The implementation of the programme was decentralized in 1994-95 with formation
of District Health Society in each district of the country . The Government of India has
been issuing guidelines from time to time to utilize the funds released to the District Health
Society in an effective and efficient manner. The District Health Society is expected to
enhance the coverage and improve quality of eye care services in the district.
Grant in Aid
The NPCB is funded by GOI. The funds will be released by the GOI to State
Blindness Control Society (or State Health & Family Welfare Society) Punjab. The funds
will be released by GOI based on the Annual Action Plan submitted. GOI will release
funds in two equal installment in a financial year, first installment will be I equivalent to
50% of the Plan budget. The second installment will however be released on basis of
progress made an expenditure incurred during the financial year. The funds provided to
State Health Society will be distributed to District Health Society as per requirement and
district plan of action. The following documents pertaining to the previous financial year by
30th June of the current financial year:
a) Statement on performance and expenditure
b) Audited Statement of Accounts
c) Utilization Certificate
d) State Annual Action Plan for the current financial year.
Procurement of Goods
The DBCS is permitted to procure consumable including the Drugs, Medical and
instruments required for ophthalmic surgery in Govt. facilitates which have been notified
as based hospital for eye care services. This may include DH,SDH including CHCs where
Eye Surgeons are posted.
The District Health Society will be required to constitute a purchase committee
comprising of CMO, district ophthalmic Surgeon, DPM and officer of the another deptt.
preferably having knowledge of procurement and financial procedures to procure the
items required by the District Health Society. The evaluation of the bids should not be
based on the criteria of lowest cost alone but the quality should also be considered .
Provision of spectacles : Students with refractive errors who cannot afford to pay
for spectacles would be borne by District Health society to the maximum upper limit of
Rs.200/-.
The price of spectacles must be fixed based on an
opened tender basis
ensuring quality of glasses as per specifications (English Glass) at a competitive price
Objectives of NPCB
1. To reduce the backlog of blindness through identification and treatment of blind
2. To develop Comprehensive eye care facilities in every district.
3. To develop human resources for providing eye care services.
4. To improve quality of service delivery.
5. To secure participation of Voluntary organizations/Pvt. Pract. in eye care
6. To enhance community awareness on eye care..
Activities
1.
100 percent achievement of Cataract operation of which 90% will be IOL and 10%
for simple cataract surgery 2009-10.
2.
Annual Eye check up of all incumbents of blind schools covering the visual acuity,
fundus examinations and other appreciate advance test required to assess
chances of visual restoration. Eye check up of applicants who desire to seek
admission in a blind school and issue of certificate of incurable blindness
recommending admission to a blind school. No person would be admitted to blind
school without this certificate. Eye check up of the incumbents of blind schools
including special investigation.
3.
Follow up of treated cases as per recommendation of ophthalmic board.
4.
Rehabilitation of incurable blind would be as per scheme of department of social
welfare.
5.
Low vision Aids to screen all school going children for refractive errors and provide
spectacles free of cost.
6.
As per approved PIP 2009-10 Ophthalmic Assistant @ Rs. 8000pm are being
recruited soon at district level.
7.
As per approved PIP 2009-10
5 Eye Cousellors @ Rs. 10,000 pm are being
recruited soon.
Financial Assistance
District Blindness Control Society would be empowered to use GOI grant released
under NPCB to meet expenses on the following:
1.
Eye Check up of incumbents of blind school including special investigations;
2.
Medical and/or surgical treatment of referred cases including medicine prescribed
after treatment/surgery.
3.
Low vision Aids and/or spectacles prescribed.
4.
TA/DA to members of the Board for travel relating to the scheme.
Focus in 2010-11
1. Eye collection centres to be established in all the districts of the State.
2. To achieve 100% target of cataract operations.
3. To provide following eye equipments at Sub Divisional Hospitals for effective eye care
services:
Slit Lamp, A-scan, operating Microscope, Keratometer, vision drum (Distant and
near) Trial Frame and Trial Set.
8. Strengthening of Vision Centers in all districts of the State.
(2) STRATEGY OF 11TH PLAN
Proposed pattern of assistants and strategy for 11th plan
a)
Keeping in view austerity measures and to avoid duplicity of work, State
Ophthalmic Cell has been merged with State Blindness Control Society. Due to
formation of National Rural Health Mission (NRHM), State Blindness Control
Society (SBCS) under NPCB has been further merged with State Health Society
under NRHM. District Blindness Control Society (DBCS) under NPCB has also
been merged with District Health Society under NRHM. Funds for implementation
of the programme would be released through State Health Societies in the form of
Grant in Aid.
b)
Increase in assistance for commodity to various facilities to increase their capacity
for treatment of all types of eye ailments.
c)
Facility for IOL implantation expanded upto Taluka level.
d)
Marginal increase in grant in aid to Eye Banks, Eye Donation Centres and NGOs
due to escalation of costs and to improve quality of services.
e)
In addition to cataract, assistance would also be provided for other eye diseases
liked Diabetic Retinopathy, Glaucoma Management, Laser Techniques, Corneal
Transplantation, Vitreoretinal Surgery, Treatment of Childhood blindness etc.
f)
Assistance for construction of dedicated Eye wards and Eye Operation Theatres in
North East States and few other states as per need.
g)
Assistance for appointment of ophthalmic manpower – ophthalmic surgeons,
ophthalmic Assistants and Eye Donation Counsellors on contractual basis.
h)
Assistance for involvement of Private Practitioners in sub-district, block and village
levels.
i)
Assistance for maintenance of ophthalmic equipments supplied under the
programme.
j)
Development of Mobile ophthalmic units with Tele-ophthalmology Network and
some fixed tele-models to cover difficult hilly terrains and difficult areas.
k)
Critical posts of 228 Eye Surgeons and 510 ophthalmic Assistants sanctioned
during the 9th plan and continued during 10th plan, would be integrated within the
State Plan in a phased manner during the current plan period.
l)
Strengthening of Management Information system.
m)
Intensification of IEC activities.
Strengthening/setting up of Regional Institutes of Ophthalmology
Non-recurring assistance upto Rs. 60 lakh for new RIOs and Rs. 40 lakh for
existing RIOs for providing ophthalmic equipments for developments of pediatric eye units/
low vision units/ retina units, audio visual aids and training infrastructure, IOL Surgery &
all other Sub specialties etc. List of equipment is as under :
1.
Operating Microscope with Assistant scope & Cornea attachments.
2.
A-scan Biometer
3.
Keratometer
4.
Slit Lamp
5.
Yag Laser
6.
Applanation Tonometer
7.
Auto Refractometer
8.
Vitrectomy Unit complete with endolaser photocoagulator
9.
Flash Autoclave
10. Automated Perimeter with field analyser
11. Phacoemulsifier
12. Double Frequency Yag Laser/Argon Green Laser
13. Fundus Fluoresce in Angiography
14. Streak Retinoscope
15. Tonometer (Schiotz)
16. Director Ophthalmoscope
17. Indirect Ophthalmoscope
18. Low vision Aid devices – High plus spectacles, Hand held magnifiers, Stand
magnifiers, Telescopes, Videomagnifires, Field Expanding devices, Absorptive
Lenses
19. B-Scan
20. Fundus Camera Digital
21. Teller visual acuity cards/Cardiff cards.
22. A set of trial lens box and trial frame including trial frame for children
23. 90 D lens, 78D lens, 20 D lens
24. Ishihara Colour Vision book
25. Synptophore
26. Tonopen
27. Worth 4 dot set with red and green glasses and rotating test durm
28. Loose prism set
29. Prism bar, Maddox wing, tangent scale
30. RAF under, Bagolini Glasses
31. Instruments for examination under general anesthesia
32. Cardiac monitor with defibrillator
33. Paediatric oculopasty surgery etc.
34. BP apparatus with paediatric etc.
35. Surgical sets for all subspecialties
36. Microsurgical instruments including SICS blades and phaco brobes
37. Instruments for management of ocular trauma, Keratoplasty set, instruments for lid
surgeries, instruments for enuculeation, entropion, Ectropion etc.
38. Vision Charts-Snellens/Logmar
39. Refraction Units
40. OCT( Optical Cohrence Tonography)
41. Air-Conditioners
42. Pulse-oxymeter
43. Generator
44. Surgical Sets for all sub specialties
45. Aut Kerato Refractometer
46. Laser/Argon and Yag with silt lamp delivery, indirect ophthalmoscope LIO,
endolaser
47. IOLs
48. Sutures 4-0,8-0,10-0
49. Gonioscope
50. Consumables for phaco surgery
51. SICSX
52. Paymen Capsulotomy Lens
53. Abraham Iridotomy Lens
54. Mainster Lens- Central Fundus
55. Maisnter Lens
56. Fluorescein strips
57. Schirmer Tear Test strips
58. Rose Bengal Strips
59. Lissamine Green Strips
60. Lander's Vitrectomy Lens set
61. Lander's Vitrectomy Lens set (Plano,videfield, biconcave)
62. Vitretomy Irrigating Lens set (Plano,widefield, biconcave
63. Silicon Oil injector
64. Intraocular Magnet (Titanium Handle)
65. Endocapsular Tension ring
66. Consumables for ophthalmic surgery (like viscoelastic, Ringer bactale etc.)
Strengthening of Medical Colleges
Non-recurring commodity assistance upto Rs. 40 lacs for providing ophthalmic
equipments as commodity assistance for development of paediatric eye units/ low vision
units/retina units. List of equipments is as under:
1. Operating Microscope with Assistant scope & Cornea attachments.
2. A-scan Biometer
3. Keratometer
4. Slit Lamp
5. Yag Laser
6. Applanation Tonometer
7. Auto Refractometer
8. Vitrectomy Unit complete with endolaser photocoagulator
9. Flash Autoclave
10. Automated Perimeter with field analyser
11. Phacoemulsifier
12. Double Frequency Yag Laser/Argon Green Laser
13. Fundus Fluoresce in Angiography
14. Streak Retinoscope
15. Tonometer (Schiotz)
16. Director Ophthalmoscope
Strengthening of District Hospital
Non-recurring
commodity assistance
upto
Rs.
20 lacs
for Ophthalmic
Equipments for IOL Surgery. List of Equipment is as under:
1. Operating Microscope
2. A-scan Biometer
3. Keratometer
4. Slit Lamp
5. Yag Laser
6. Applanation Tonometer
7. Auto Refractometer
8. Flash Autoclave
9. Streak Retinoscope
10. Tonometers (Schiotz)
11. Direct ophthalmoscope
Degradation of Sub-distt. Hosptial
Non-recurring commodity assistance upto Rs.5 lacs for ophthalmic equipments for
IOL Surgery. List of equipment is under:
1. Operating Microscope
2. A-scan Biometer
3. Keratometer
4. Slit Lamp
5. Auto Refractometer
6. Flash Autoclave
7. Streak Retinoscope
8. Tonometers (Schiotz)
9. Direct ophthalmoscope
Vision Centres at PHCs/ in Vol. Sector
Non-recurring assistance upto Rs. 50,000 for basic equipments, furniture and
fixtures, GIA to DECS would be used for Vision Centres at PHCs. For Voluntary Sector,
assistance would be provided as GIA. Details are as under1. Trial Lens
2. Trial Frames (Adult and Child)
3. Illuminated Vision Testing Drum
4. Plane mirror for retinoscopy
5. Streak Retinoscpe
6. Snellen & Near Vision Charts
7. Binomag/Magnifying Loupe
8. Tonometer (Schiotz)
9. Battery Operated Torch (2)
10. Lid speculum
11. Eplipation forceps
12. Foreign body spud and needle
13. Director Ophthalmoscope
14. Slit lamp (optional)
15. Vision Charts for preverbal children
Support to Eye Banks in Government/Voluntary Sector
Non-recurring assistance upto Rs. 15 lakh for equipments and furnishing towards
strengthening/developing eye bank by GOI. Details are as under1.
Slit Lamp Microscope
2.
Operating Microscope with camera attachment
3.
Specular Microscope
4.
Laminar Flow
5.
Serology Equipment
6.
Instruments for corneal excision and enucleation including containers
7.
Autoclave
8.
Keratoplasty instruments
9.
Transport facility (one 4 wheeler & One 2 wheeler)
10.
Refrigerator
11.
Computer & Accessories
12.
Telephone Line
13.
Air-Conditioner
14.
Renovation, Repair, Furniture & Fixtures
Support to Eye Donation Centres in Government/Voluntary Sector
Non-recurring Assistance upto
Rs. 1 lakh for strengthening/developing Eye
Donation Centre.
Recurring assistance of Rs. 1000 per pair of eyes collected towards honorarium
of
eye
bank
staff,
consumables
including
preservation
material
&
Media
transportation/travel cost/POL and Contingencies, Recurring GIA would be paid through
Affiliated Eye Bank.
(3) FINANCIAL & PHYSICAL STATUS
District wise details of Financial & Physical are attached as Annexure 'I' & 'II".
Performance of various Target given under this programme:Eye Care Services
Cataract
IOL implantation
School Children Screened
Refractive Errors
Spects Distributed
Teacher Trained
Eye Donation
Target
2009-10
1,80,000
1,62,000
3,50,000
21,000
6,300
4,000
800
Achievement
% age
1,67,770
1,59,645
5,28,000
33,817
10,803
5441
1280
93.2
98.5
151
161
171
136
160
Budget and Expenditure
In the year 2009-10 Grant in Aid of Rs. 2,82,42,000 was received from GOI
out of which 1,22,00,000 lac were distributed to District Blindness Control Society
according to their demand and further distributed to NGOs/Govt. Institutes (Annexure
'III').
(4) ACTION PLAN
1.
In the year 2009-10, 4 Yag Laser has been purchased & it has been written to S.P
Branch for installation in 4 District Hospitals.
2.
Under IEC activity an advertisement has been given in Regional News paper for
prevention of eyes on eve of festival and pamphlets has been published and
distributed in district. On 8th October, 2009 (World Eye Sight Day) work has been
done to aware public and 6 hoardings are being placed in Major Cities of the State
displaying message on mortuaries, cremation grounds, hospitals and other public
gathering places for Eye Donation of Eye Donation and Other Eye Diseases.
3.
With the help of Eye Banks out of which 3 are Govt. (Principal Medical college
Amritsar, Faridkot & Patiala) and 2 are Private ( Punorjot Eye Bank Regd. & Shri
Guru Harkrishan Charitable Trust, Sohana (Mohali) public awareness camp has
been organized for Eye Donation. To aware public regarding Eye diseases like
Glaucoma and Diabetic Retinopathy celebration was done by Punorjot Eye Bank
Society, Ludhiana on 12th March 2010.
4.
Equipments will be purchased by PHSC according to the demand received from
Govt. Medical College Amritsar (RIO) and Govt. Medical College, Patiala as per list
of equipments supplied by GOI.
5.
6 Batches of PMOAs were deputed for training held by Govt. of India at Chittarkut.
6.
Recurring GIA to District Health Society for NGOs for per performing free cataract
operation and other Intra-ocular Surgeries determined by following table:1.
2.
3.
4.
5.
6.
Drugs and consumable
Sutures
Spectacles
Transport/POL
Organization & Publicity
IOL, Viscoelastics
& additional Consumables
TOTAL
ECCE/IOL
200
50
125
100
75
200
SICS/PHACO
200
0
125
100
75
250
750
750
Grant-in-Aid for NGOs for management of other Eye Disease (other than
Cataract) like Diabetic Retinopathy, Glaucoma Management, Laser Techniques,
Corneal Transplantation, Vitreoretinal Surgery, Treatment of Childhood Blindness
etc. is Rs. 1000 per case.