Describe eye health education and community participation.

Principles of Eye Health Education

• Most blindness IN INDIA IS treatable, and the people WHO have IT DO not come. Health education exists to close that gap, and its target is the belief that poor vision is an inevitable part of ageing about which nothing can be done — which is the commonest single barrier to uptake
• The messages that matter, in order of practical value: cataract blindness is curable by an operation, and one need not wait until it is "ripe"; spectacles do not weaken the eyes; a squinting child needs examining, not waiting; diabetics must have their eyes examined even when vision is normal; never put oil, honey, breast milk or plant juice into an injured eye; irrigate a chemical injury at once; and eye donation does not disfigure the face or delay the funeral
• Correcting harmful practices is as important as promoting good ones — traditional eye remedies instilled into injured eyes cause corneal ulceration and blindness; couching, the traditional displacement of the cataractous lens into the vitreous, still occurs in some regions and causes glaucoma and blindness; and self-medication with over-the-counter steroid drops causes glaucoma and fungal keratitis

Community Participation

• Community participation means the community shares in identifying the problem, planning and delivering the response, rather than merely receiving a service designed elsewhere. Its practical value is that it produces uptake that no amount of provision can generate
• Who to involve — the panchayat and local leaders, whose endorsement legitimises a camp; ASHAs, anganwadi workers and self-help groups, who know who in the village cannot see; school teachers, who screen and who influence parents; religious leaders, particularly for eye donation, where a statement from within the faith removes an objection no doctor can; employers and trade groups; and successfully treated patients as advocates
• What the community can actually do — identify and list those with poor vision; motivate and accompany them, which addresses the escort barrier directly; arrange transport; provide a venue; contribute to costs or arrange local funding; and follow up those who were operated and those who were referred
• The escort and transport contributions are the most valuable, because they remove the barrier that free surgery alone cannot: a blind elderly person cannot travel alone, and the escort is a wage-earner losing a day
• Sustainability requires more than enthusiasm — train and support local workers rather than using them once; give feedback to the community about results.