Global perspective to ENT

Question 1

Define health according to WHO

Answer 1

“ Health is a state of complete physical, mental & social wellbeing & not merely the absence of disease or infirmity” (WHO definition of Health)

Question 2

What is the leading cause of blindness globally?

Answer 2

Cataracts

Question 3

What is the leading cause of visual impairment globally?

Answer 3

Uncorrected refractive errors

Question 4

What is the 2nd leading cause of visual impairment and blindness globally?

Answer 4

Glaucoma

Question 5

What is the 4th leading cause of blindness globally?

Answer 5

Corneal Opacity / Scarring

Question 6

Why is glaucoma such an issue globally?

Answer 6

– Treatable with lifelong eye drops – access to drops, aren’t able to store these safely
– Complications of poor hygiene with drop insertion leading to loss of confidence in treatment

Question 7

Describe trachoma

Answer 7

– Bacterial infection due to face-washing with dirty water, sharing linen & flies (Chlamydia trachomatis)
– Malnutrition (vit A deficiency) predisposes
– Leads to granulation of inner eyelid
– Eyelids turn inwards causing scratching of cornea
– Treatment is SAFE (Surgery, antibiotics, facewashing, environmental)

Question 8

How is trachoma treated?

Answer 8

– Treatment is SAFE (Surgery, antibiotics, facewashing, environmental)

Question 9

Describe River Blindness (Onchocerciasis)

Answer 9

– Riverside areas: transmitted by blackfly
– Larvae causes eye lesions, inflammation & scarring
– Annual dose Ivermectine

Question 10

How is River Blindness (Onchocerciasis) treated?

Answer 10

Annual dose Ivermectine

Question 11

What are the main causes of childhood blindness in developing countries?

Answer 11

Lesions in eyes e.g. tumours (more industrialised)
Vitamin A deficiency
Corneal scars - measles, traditional cures, rubella cataracts

Question 12

How can avoidable blindness be prevented?

Answer 12

– Hygiene, sanitation, clean water
– Improved access to eye care
– Improved nutrition

Question 13

How can we try and reduce avoidable blindness?

Answer 13

– Awareness & education
– Target nutrition & hygiene
– Community education for earlier referral
– Eye surgery camps & mobile cataract tem
– Improved facilities & access
– Vaccination programmes
– VISION 2020

Question 14

Define disabling hearing loss

Answer 14

• Hearing loss greater than 40dB in adults

Question 15

What % of cases of disabling hearing loss are avoidable?

Answer 15

half of cases (50%)

Question 16

How can hearing loss be targeted globally?

Answer 16

– Immunisations (measles, mumps, rubella, meningitis)
– Antenatal care & rubella immunisations
– Education
– Hygiene & clean water
– Health & safety legislation regarding PPE/noise
– Early detection & intervention
– Social support
– Simple aids

Question 17

What is the 2nd leading cause of death globally?

Answer 17

Stroke