Health Scan: Eye care pays off

Israel has emerged as a world leader in preventing avoidable blindness, reducing rates by over 56%.

By Judy Siegel-Itzkovich, The Jerusalem Post, 18.8.2013

Eighty percent of blindness world-wide is either preventable or treatable, according to the World Health Organization, but it remains a severe health concern across the globe, even in industrialized countries. Prof. Michael Belkin of the Goldschleger Eye Research Institute at Tel Aviv University’s Sackler Faculty of Medicine and Sheba Medical Center at Tel Hashomer says that other countries can learn from Israel’s approach to eye health.

Writing in the American Journal of Ophthalmology, Belkin said that in the past decade, rates of preventable blindness here have been cut by more than half – from 33.8 cases of blindness per 100,000 residents in 1999 to 14.8 in 2010. This improvement, found across all four main causes of avoidable blindness – age-related macular degeneration (AMD), glaucoma, diabetes and cataract – is unmatched anywhere else in the world, he reported. The secret is not only the innovative methods of treatment that were added to the basket of health services, but also good patient compliance with treatment regimens, including the correct use of prescribed medications. The health fund community clinics also offer programs, such as dedicated diabetes clinics, which promote early prevention and timely treatment for diabetes-related complications that can lead to blindness. Belkin noted that such programs save public and private health care money in the long term.

To evaluate the effectiveness of eye health care in Israel, Belkin and colleagues from TAU and Sheba conducted a statistical study measuring rates of blindness in individuals from 12 years through adulthood.
They discovered that Israel has emerged as a world leader in preventing avoidable blindness, reducing rates by over 56%. The rates of untreatable genetic causes of blindness remained steady over the same period. For example, AMD – one of the leading causes of blindness in the industrialized world – is treated with a drug therapy originally approved for colon cancer tumors. By diluting the drug to create smaller doses for the eye (an idea that originated in the US), it is possible to provide inexpensive therapy to thousands of patients.
From the public policy standpoint, Belkin wrote that the decline in blindness due to cataracts is due to a change in health care policy rather than any technical advance. Since the 1990s, patients have been able to choose their doctors privately for cataract surgery. This practically eliminated wait times for surgery and prevented the condition from growing worse over the long term.

Belkin believes that any country can adopt Israel’s strategies for reducing blindness. Although the initial costs can be daunting – such as the price of top-notch medications and setting up clinics – it’s “a good investment.

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