Al-Shifa Trust                          Al-Shifa Centrefor Cummunity Opthlmology (ACCO)

                                                               Activities

There are three levels of prevention of blindness. The primary level of prevention is meant to stop a blinding disease from occurring through measures like health education and creating awareness about disease and its prevention (Health Promotion). The secondary level is to prevent the disease from causing blindness through detection at an earlier stage while the tertiary
level of prevention is aimed at restoration of useful sight following blindness by means of surgery, medicine or low vision
devices. ACCO is endeavoring to fight against blindness at these three levels.


Level 1:
Eye Health Promotion
(Primary Level).		 ACCO has prepared booklets, slides, pamphlets and posters about the detection and prevention of all the major blinding diseases in Pakistan in both English and Urdu languages. Similar information is being disseminated through various radio and television programmes. Apart from eye health education, primary eye care training is also being imparted to various levels of health workers, community workers and social workers including teachers and others. These voluntary and integrated eye workers are playing very useful role in fighting against blindness at both primary and secondary levels. So far ACCO has distributed about 90,000 pamphlets/booklets and trained more than 8,000 voluntary, integrated and essential eye workers.
Level 2: Preventive Screening/Case Detection (Secondary Level) ACCO is running two different PROGRAMMES. The first one is for prevention of childhood blindness. We are carrying out screening of both the school age and pre-school age children for potentially blinding diseases like refractive error, squint, cataract, glaucoma and vitamin A deficiency. So far we have screened about one and a half million school going children and about 25,000 children below the age of five. We have found that 3-5% of the children are having defective vision and most of them can be helped with glasses. The other screening program is aimed at prevention of diabetes related blindness which is going to feature as one of the major causes of blindness in near future. So far about 60,000 people above 40 years have been screened for potentially blinding diabetes. About 10% were found to have diabetes and one out of those ten suffering from diabetes were at risk of becoming blind.
Level 3: Curative activities (Tertiary Level) Cataract is the major cause of blindness in Pakistan & worldwide. We need to do about 2300 cataract operations per million population per year as against that of 1100 being currently performed in Pakistan. Cost, inaccessible or poor quality eye services and lack of awareness are the major obstacles. To counter these barriers in order to remove this cataract backlog, ACCO has adopted a unique strategy of carrying out screening of the patients for cataract in areas 150-200 km away, followed by transport of those patients selected for surgery to base hospital Al-Shifa on the same day. The patients are operated the next day free of cost and sent home. So far we have screened and treated more than 300,000 patients, out of which about 19,000 have undergone cataract operations free of cost. Simultaneously we are holding cataract surgical camps in far flung areas of the country and neighboring countries. Apart from cataract we are also treating the patients at community level for trachoma, eye infection of the newborn and vitamin A deficiency through provision of essential medicines.