The Thai Journal of Ophthalmology
The Opthalmological Society of Thailand

Official Publication of the Royal College of Ophthalmologist and Ophthalmological Society of Thailand

Current Status of Thai National Programe for Prevention of Blindness

Nisit Leelawongs, MD.
Department of Ophthalmology, St. Louis Hospital

The Thai programme of blindness prevention took its beginning in 1977. Crash programmes within the Ministry of Public Health were made with the aim to strengthen eye care at the inter mediary level. A small group of ophthalmologist from rural service, calling themselves the "Ophthalmic Cell" met and took initiative. This action was voluntary and although receiving no concrete com mitment from the authorities, however was sup ported by several Eye Institutes. Then the rural eye units, each of which was staffed by one sur geon and two 6-month-trained nurses, were orga nized and were soon to increase rapidly in num bers.

The situation changed in 1982, when a Na tional Board was first formulated, and the "Ophthalmic Cell" become the central co-ordinating body of multidisciplinary composition. Activities in this phase were introducing of primary eye care into the community levels.

A nation wide survey, carried out in 1983, identified major causes of blindness as well as mag nitude of the national problems. Further expan sion of primary eye care and strengthening of se condary eye care were made in accordance with other major activities of the Fifth National 5-year Socio-Economic Development Plan. Great thank to the successful 'Primary Health Care" in this country, it facilitated of very effective and effi cient on the effort of integration primary eye care into the primary health care scheme. In this phase a number of significant activities were also introduced. The institute of Public Health Ophthalmo logy, established at Korat, provided wider Oppor tunity for training, services and research. Also various eye sectors made contributions in parallel with the Institute on the National Programme Specialized eye care was found already covering over 50 provinces with referral networks to which outreached communities could have access to cata ract and glaucoma care. The outlook of Thai programme had never before held so spectacular and magnificent. The success of primary eye care gave a huge potential for a great leap foward the phase to follow.

Common to many countries in this region, cataract has been identified as a leading cause of blindness and has had a great concern to all sectors, and at all levels of health care providers. However, a strong belief prevailed that, answer must be found in the primary health care with a strong eye component integrated. It must be based on the spirit of self-reliance and self-determination, and avoiding of new inputs and foreign aids as well. With 200,000 cases of blindding cataract, the Ophthalmic Cell has developed provincial plans to intervene in mass on the premise that, it is part of primary health care scheme with eye sectors playing supplementary role.

After a long preparation, three provinces Buri ram, Korat and Tak were selected for a pilot study in 1986. A district of 100,000 population in each province, was chosen and carried out with their own plan. However, it consisted of collecting base-line data. Mass screening and referral were carried out at the primary level. Surgery was sub sequently performed in mass at the eye unit. Follow-up was done at primary level. Spectacles were provided at an affordable price. This pilot study has successfully convinced all sectors that this programme can now be fostered and extend ed into other provincial areas. The national programme, has eventually stepped into a new phase. to fight against cataract in the whole Kingdom.


Recently, a large scale operation covering 50 provinces will be implemented, it is a tribute to His Majesty the King on the occasion of his 60th birthday this year. Preparation is now well underway. However, to eye sectors, the overall plan is cataract service development of long-term basis. The target
is given that 60,000 cataract could have been operated annually by 1996. There is a long way ahead for the Thai Programme, however, light is now seen infront to lead us to "Eye Health For All'.

Thai J Ophthalmol 1987; 1(1): 1