1. Gender and Eye Health World Sight Day 2009

2. 2/3 of the Blind in the World are Women 80% of Blindness is Avoidable

3. World-wide Gender Disparity Women are key income producers and in raising children Young girls care for infants, tend to remain within villages Women are caregivers –In treating women, we treat many children, elderly, women and men

4. Gender Disparities Women live longer/age- related diseases –AMD –Cataracts Reasons other than Age –Dry eye, trachoma, auto- immune diseases –Access to care ½ that of men unoperated cataract adult/child –Poor access to follow up

5. Trachoma Women bear ~75% of trachoma- related blindness –role in community- work in fields, child rearing –contact with children who harbor chlamydia Women are less likely to have access to care for trichiasis

6. Trachoma Chlamydia trachomatis infection –antibiotics Repeated infections and scarring of palpebral conjunctiva

7. Trachoma Entropion and trichiasis –surgery Corneal opacification from irritating lashes

8. Trachoma - Solutions Awareness –Education (SAFE), involve family in decision –Key informants –Female-female communication Access –Antibiotics to reach males and females equally; multiple approaches –Bring surgery to the community Acceptance –Involve local leaders –Teach surgical approach, assure competent surgeons for both genders

9. North Carolina Initiative Sandy Barnhart –Barriers to eye health in Randolph County, NC –Qualitative approaches (focus groups, surveys) –Quantitative (local health department statistics, Center for Disease Control)

10. Randolph County Median income (2002) - $23,629 ($27,785) High School dropout – 6.3% vs. 4.9% Bachelor's degree – 11% vs. 22% Births to mothers who smoke – 18% vs. 14% Low birth weight infants more than in state which is 13.6% of live births (US rate-12.7%)

11. Opportunities for Ophthalmologists World-wide –Organizations (Carter Center, ORBIS, etc.) US –Education (smoking, BMI, diabetes, toxocara) –Vision 2020 initiative to eradicate avoidable blindness by 2020 –Data collection (little data on eye health and gender at county level) –Barriers differ regionally

12. Communication is a Key

13. References http://www.womenseyehealth.org/ educational/educational.htm http://www.who.int/topics/blindnes s/en/ http://www.preventblindness.org/ http://www.seva.org/ http://www.iefusa.org http://www.aao.org/ http://VISION2020.org Praveen@aravind.org kcco@kcmc.ac.tz rpkandel@wlink.com.np Maggie@seva.ca suzgilbert@earthlink.net