A Critical Challenge for Ophthalmology: Enhancing Training To Meet the Need for Eye Care International Council of Ophthalmology/ International Federation of Ophthalmological Societies

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 2 Unmet Public Need for Eye Care Worldwide at least 161 million people are severely visually impaired:Worldwide at least 161 million people are severely visually impaired: –37 million blind –124 million with low vision Burden of blindness greatest in the least developed regions of the globe.Burden of blindness greatest in the least developed regions of the globe. Global vision loss is certain to increase, particularly in developing countries, due to population growth and aging, unless concerted action is taken.Global vision loss is certain to increase, particularly in developing countries, due to population growth and aging, unless concerted action is taken.

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 3 Global Distribution of Blindness (by Cause, 2002 WHO Data) Cataract 47 % Trachoma 4 % Glaucoma12% Onchocerciasis -1 % Other 13 % Age Related Macular Degeneration 9% Childhood blindness 4% Diabetic Retinopathy 5% Corneal scar 5%

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 4 Key Issues Related to Training Particularly in developing countries: Not enough ophthalmologists and other eye care providers to provide the care neededNot enough ophthalmologists and other eye care providers to provide the care needed Mal-distribution: Lack of providers where most neededMal-distribution: Lack of providers where most needed Not enough training programsNot enough training programs Existing training programs not focused on public needs, e.g., for community eye healthExisting training programs not focused on public needs, e.g., for community eye health Lack of infrastructure and professional development for those who are trainedLack of infrastructure and professional development for those who are trained

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 5 Challenge for Ophthalmology To provide LEADERSHIP for training the ophthalmologists and other personnel needed to meet the public need for eye careTo provide LEADERSHIP for training the ophthalmologists and other personnel needed to meet the public need for eye care Long-term goals:Long-term goals: –Increase access to quality eye care worldwide –Prevent avoidable blindness and visual loss –Preserve and restore vision

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 6 What the ICO Asks Societies To Do Work with national VISION 2020 programs and others involved with eye careWork with national VISION 2020 programs and others involved with eye care Assess the needs for ophthalmologists and other providers in your countryAssess the needs for ophthalmologists and other providers in your country Evaluate existing training programsEvaluate existing training programs Define what needs to be done to improve and expand trainingDefine what needs to be done to improve and expand training Advocate for funding and other support to do itAdvocate for funding and other support to do it

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 7 VISION 2020: The Right To Sight Global initiative to eliminate avoidable blindness by the year 2020Global initiative to eliminate avoidable blindness by the year 2020 Partnership launched in 1999, led by International Agency for the Prevention of Blindness (IAPB) and WHOPartnership launched in 1999, led by International Agency for the Prevention of Blindness (IAPB) and WHO VISION 2020 implementation plans being defined at regional, national and provincial/district levelsVISION 2020 implementation plans being defined at regional, national and provincial/district levels Three core strategies:Three core strategies: –Disease control –Infrastructure development –Human resources development

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 8 Resources for Enhancing Training VISION 2020 Human Resources Working GroupVISION 2020 Human Resources Working Group Corporate and private supportCorporate and private support ICO/IFOS:ICO/IFOS: –Curricula for training of residents, medical students and allied personnel –Pilot project to enhance residency training in Nigeria –ICO Courses for Residency Program Directors –ICO Basic and Clinical Assessments –IFOS/ICO International Fellowship –ICO International Clinical Guidelines

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 9 Background: ICO/IFOS In 1857 in Brussels, 150 ophthalmologists from 24 countries met in the first International Congress of OphthalmologyIn 1857 in Brussels, 150 ophthalmologists from 24 countries met in the first International Congress of Ophthalmology International Council of Ophthalmology (ICO) founded in 1927 in Scheveningen, HollandInternational Council of Ophthalmology (ICO) founded in 1927 in Scheveningen, Holland International Federation of Ophthalmological Societies (IFOS) founded in 1933 in Madrid, SpainInternational Federation of Ophthalmological Societies (IFOS) founded in 1933 in Madrid, Spain IFOS represents and serves associations of ophthalmologists around the worldIFOS represents and serves associations of ophthalmologists around the world ICO is the executive body of IFOSICO is the executive body of IFOS

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 10 Background: ICO/IFOS ICO Primary Commitments: 1. Enhance ophthalmic education 2. Support communication and collaboration among ophthalmologic societies and ophthalmologists 3. Advocate for preservation of vision 4. Define proposed clinical guidelines and standards 5. Stimulate research to eradicate preventable vision loss

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 11 Resources: ICO Ophthalmic Education Curricula for residents, medical students, allied health and CMECurricula for residents, medical students, allied health and CME Pilot project to enhance residency training in NigeriaPilot project to enhance residency training in Nigeria Courses for residency program directorsCourses for residency program directors ICO Basic and Clinical AssessmentsICO Basic and Clinical Assessments IFOS/ICO International FellowshipIFOS/ICO International Fellowship ICO International Clinical GuidelinesICO International Clinical Guidelines World Ophthalmology CongressWorld Ophthalmology Congress Atlas of Ophthalmology - atlasofophthalmology.com (endorsed by the ICO)Atlas of Ophthalmology - atlasofophthalmology.com (endorsed by the ICO)atlasofophthalmology.com

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 12 Resources: ICO Curricula ICO international task forces have defined principles and guidelines for curricula for :ICO international task forces have defined principles and guidelines for curricula for : –Ophthalmology residency education –Medical student education in ophthalmology –Allied ophthalmic personnel training –Ophthalmology continuing education Intended to be adapted by ophthalmologic societies and training programsIntended to be adapted by ophthalmologic societies and training programs Can be downloaded from be downloaded from

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 13 Resources: Pilot Project in Nigeria Initiative of ICO and Ophthalmological Society of Nigeria (OSN) to improve residency training: Six regional residency resource centers with Internet accessSix regional residency resource centers with Internet access OSN has defined a Vision for the Future – Nigeria and established an OSN FoundationOSN has defined a Vision for the Future – Nigeria and established an OSN Foundation “Twinning” with All India Ophthalmologic Society and work with Aravind Eye Care System“Twinning” with All India Ophthalmologic Society and work with Aravind Eye Care System Creating high-quality training center in IbadanCreating high-quality training center in Ibadan Evaluation of impact on patient careEvaluation of impact on patient care

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 14 Conclusion There are critical public needs for eye care not being met, resulting in avoidable blindness and loss of visionThere are critical public needs for eye care not being met, resulting in avoidable blindness and loss of vision Not enough ophthalmologists or other eye care providers being trained and insufficient training programsNot enough ophthalmologists or other eye care providers being trained and insufficient training programs The ICO asks ophthalmologic societies to take the lead in defining how to enhance training to meet public needsThe ICO asks ophthalmologic societies to take the lead in defining how to enhance training to meet public needs Lots resources available to help you do that, particularly from the ICOLots resources available to help you do that, particularly from the ICO Thank you for considering this opportunity and challengeThank you for considering this opportunity and challenge We look forward to working with you to improve trainingWe look forward to working with you to improve training

International Council of Ophthalmology/ International Federation of Ophthalmological Societies 15 To Contact the ICO: Bruce E. Spivey, MD, President International Council of Ophthalmology 945 Green Street San Francisco, California, USA Fax: (+1) Web: