The Problem: The causes of blindness in Bangladesh and Sylhet

It is estimated that in Sylhet today:

• 59,605 people are blind
• 75% are blinded by cataracts
• Around 9,000 new cases of cataract blindness occur every year
• 350,000 adults and 130,000 children suffer from severe visual impairment which could be easily corrected with glasses.

Cataract is a clouding of the eye's lens. There is no single cause of cataract. A number of risk factors, such as vitamin A deficiency, dehydration, smoking and diabetes, seem to have an impact.

Childhood blindness – there are 40,000 blind children in Bangladesh, 12,000 blind through cataract.  Of all the blind children, nine out of ten are either born blind or become blind before their sixth birthday.

Other causes of blindness in Bangladesh are:

Refractive error is an eye disorder meaning the shape of the eye does not bend light correctly, resulting in a blurred image. It includes short- and long-sightedness. The disorder can be simply diagnosed, measured and corrected with spectacles.

Diabetic Retinopathy is caused by damage to the small blood vessels in the retina at the back of the eye as a result of diabetes. Laser treatment can reduce leaking from retinal blood vessels and this treatment is most effective at preserving sight if the retinopathy is detected and treated early.

Glaucoma is when the optic nerve that carries images from the eye to the brain is damaged. This is caused by clogged drainage channels within the eye. Glaucoma is often associated with ageing, though it is not confined to the elderly. In Bangladesh glaucoma is treated either with eye drops or through surgery.

Blindness and poverty – a deadly combination

In Bangladesh, more than 58 million people (2010 estimate CIA Factbook) live below the international poverty line, without access to even the most basic of services.

Levels of extreme poverty remain high at 12 - 13% (or 20 million people). These people survive on less than $1.25 per day (World Bank), suffer from chronic hunger and malnutrition are highly prone to many types of diseases, have inadequate shelter and are therefore particularly vulnerable to recurring natural disasters.

For someone living in poverty in Bangladesh, the impact of blindness can be extremely serious.  Restoring sight to people is not just about giving them the opportunity to see.  If someone is unable to work, they could be at risk of not being able to properly support their families, both physically and financially.  The stigma often attached to blindness can mean that visually impaired people risk being ostracised or cast out of their communities, putting them at further risk. 

Childhood blindness

Over 50% of children who become blind die within two years of becoming blind. This is mainly due to systemic medical complications of the condition causing blindness, for example, vitamin A deficiency or measles. The chance of mortality is also higher in children who are blind as they may have reduced access to food and other basic resources, including treatment if they fall ill. This is partly because parents may have more difficulty in caring for their blind children, and also because, when resources are limited, families may not give an equal share to a disabled child perceived as unable to provide for the family in the future.