Arcuate field defect akin to glaucoma is seen in?

Posterior cerebral artery infarct

A multivariate analysis was conducted to examine the relationship between risk of developing blindness and age. The results are shown in the table below. Which of the following is true?

>80 y age group has the strongest association with blindness risk

60-69 y age group shows statistically significant association with blindness

<50 y age group serves as the reference category

50-59 y age group has the highest odds ratio for blindness risk

What does a visual acuity test primarily assess?

Ability to recognize shapes and details

Ability to differentiate colors

Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?

Syringing and probing of the nasolacrimal duct

Pan retinal photocoagulation for diabetic retinopathy

What is the definition of blindness according to WHO?

Visual acuity of less than 3/60 in the better eye

Visual acuity of less than 10/60 in the better eye

Visual acuity of less than 20/60 in the better eye

Visual acuity of less than 6/60 in the better eye

Regarding Chlamydia infection of the eyes, true statements include the following except:

Inclusion conjunctivitis is an acute ocular infection caused by sexually transmitted C. trachomatis strains (usually serovars D through K)

Acute inclusion conjunctivitis typically presents with mucopurulent discharge

Preventable Blindness for INI-CET: High-Yield Ophthalmology Lessons

Intro & Scope - Defining Darkness

Defines visual loss magnitude & impact. Preventable blindness is a key public health issue.
WHO Blindness: Best Corrected Visual Acuity (BCVA) <3/60 or visual field <10° in better eye.
WHO Categories (better eye): Severe VI (BCVA <6/60-3/60), Moderate VI (BCVA <6/18-6/60).
India (NPCB) Blindness: <6/60 (or <1/60 / Counting Fingers at 1m) or field ≤20° in better eye.

⭐ India's blindness prevalence (≥50 yrs) is 0.36% (NBVIS 2015-19).

Major Causes - Preventable Villains

Cause	Key Impact / At-Risk Group	Core Prevention / Community Strategy
Cataract	Leading cause; age-related opacity	Mass screening, high-volume quality cataract surgery (SICS, Phaco)
Refractive Errors	School children, adults; blurred vision	School eye health programs, vision screening, affordable spectacles
Vitamin A Deficiency	Children < 5 yrs; Xerophthalmia (XN, X1B)	Vit A prophylaxis (1 lakh IU <1yr, 2 lakh IU 1-6yr q 6mo), dietary diversification
Trachoma	Endemic areas; Chlamydia trachomatis; Cicatricial disease (TT)	WHO SAFE strategy (Surgery for TT, Antibiotics, Facial cleanliness, Environmental change)
Glaucoma	"Silent thief"; ↑IOP, optic neuropathy	Opportunistic screening, awareness, early diagnosis, lifelong management
Diabetic Retinopathy	Long-standing diabetes; neovascularization	Regular dilated fundus exam (annual), strict glycemic & BP control, laser photocoagulation

⭐ Cataract is the leading cause of blindness and visual impairment in India, accounting for over 60% of cases. Most of this is surgically curable.

National Efforts - India's Vision Quest

National Programme for Control of Blindness & Visual Impairment (NPCBVI):
- Launched 1976. Current goal: reduce blindness prevalence to 0.3% by 2025.
- Key Target: Cataract Surgery Rate (CSR) of 600/lakh population/year (or 6000/million).
- Key components:
  - Free cataract operations.
  - School eye screening (refractive errors).
  - Management of other causes (Diabetic Retinopathy, Glaucoma, Corneal Blindness).
  - Eye banking & donation.
  - Information, Education, Communication (IEC); Human Resource Development (HRD) & Infrastructure strengthening.
Vision 2020: The Right to Sight - India:
- Global WHO-IAPB initiative adopted by India to eliminate avoidable blindness.
- Pillars: Disease control (cataract, RE, childhood blindness, DR, glaucoma), HRD, infrastructure development, advocacy.

⭐ The National Programme for Control of Blindness (NPCB) was launched by India in 1976.

Screening & Action - Detect & Deflect

Goal: Early detection & timely intervention to prevent blindness.
Key Actions:
- Active (camps) & passive (opportunistic) case finding.
- Robust referral system (Primary → Tertiary care).
- Community health education on eye care.

Screening Priorities:

Area	Target Group	Conditions Screened	Critical Action Thresholds (Examples)
School Eye Health	School children	Refractive errors, Vit. A deficiency, squint, amblyopia	VA < 6/9, any Bitot's spot
Diabetic Retinopathy	Known diabetics	Diabetic Retinopathy (DR), CSME	Any DR (referral), Mod. NPDR for ophthalmologist review
Childhood Blindness	Infants, <5 yrs	Congenital cataract, ROP (preterm <34wks, <1700g)	Leukocoria, absent red reflex, ROP Zone I or Stage 3
Glaucoma (opportunistic)	Adults >40 yrs	Glaucoma	IOP >21 mmHg, CDR >0.5, suspicious optic disc

Community Referral Flowchart:

⭐ ASHA's Role (NPCBVI): Creating awareness, identifying common eye problems (cataract, refractive errors), mobilizing community for screening camps, facilitating referrals, and ensuring treatment compliance (e.g., post-cataract surgery).

High‑Yield Points - ⚡ Biggest Takeaways

Cataract: Leading cause of preventable blindness in India.

Refractive Errors: Second most common cause of avoidable visual impairment.

Vitamin A Deficiency: Major cause of childhood blindness; Bitot's spots are a key sign.

Trachoma: Control via SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement).

Glaucoma: Early detection is vital to prevent irreversible blindness.

Diabetic Retinopathy: Preventable with good glycemic control and regular screening.

NPCBVI Target: Reduce blindness prevalence in India to 0.3% by 2025.

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