Prevention of Blindness and Visual Impairment

Guidelines for disease control

The development of technical guidelines is based on consultations with Members of the WHO Expert Advisory Panel on Trachoma and Prevention of Blindness, and with a network of 20 WHO Collaborating Centres around the world. When available, specific experience acquired in countries is taken into account.

The WHO technical guidelines focus on public health problems, in terms of blinding diseases globally, and where there is potential for intervention, either for prevention of disease or its complications, or for restoring sight. Many of the technical guidelines are published in the non-serial WHO publications, which can be obtained through the online book shop.

Trachoma is an infectious eye disease that causes blindness; it is prevalent in many poor rural communities. The World Health Organization has set the year 2020 as the target for global elimination of trachoma as a public health problem.

To reach this target, the SAFE strategy (Surgery for trichiasis, Antibiotics to treat Chlamydia trachomatis infection, and Facial cleanliness and Environmental improvement to reduce transmission of C. trachomatis from one person to another) is recommended for districts and communities with endemic disease.

This guide has been written for managers of national and district trachoma control programmes. It sets out, step-by-step, what is needed to assess the magnitude and extent of the trachoma problem in the area and how to plan, implement, monitor and evaluate a programme to control, and ultimately eliminate, trachoma.

Templates for a number of forms recommended for use in a programme can be found in the annex. To allow adaptation of the forms for use in a specific programme, electronic versions are available on the CD-ROM that accompanies this guide. The CD-ROM also contains an antibiotic requirement estimator, a template budget and a generic evaluation manual.

Two versions of this guide are available:The trainer s version includes the guide, with a set of 30 slides and the CD-ROM. The learner's version contains the guide with the CD-ROM.

WHO Consulation on Public Health Management of chronic eye Diseases

The Action Plan for the Prevention of Avoidable Blindness and Visual Impairment 2009-2013, Objective 2, Task 59 requires the WHO Secretariat to review the evidence relevant to the public health strategies for the management of the major chronic eye diseases. In order to achieve this task, a meeting of experts was called in WHO on September 19th, 2011 to review the work already done in workshops, meetings and thematic papers on the individual diseases. The meeting reviewed the existing guidelines and discussed the best approach for the effective management of chronic eye diseases in a public health framework for different development settings. The meeting was the technical preamble to the development of a WHO Technical Report Series in which the different options for managing the main chronic eye diseases will be presented for the use of decision makers, NGO managers, health care providers, patients associations. In anticipation of the completed document, we are posting on this page the notes from the meeting, the main addresses of the experts and of the WHO.


Diabetic retinopathy is undoubtedly an important and growing cause of blindness worldwide; there are no accurate epidemiological data available as yet, but it is likely that diabetes with retinopathy is the most common cause of severe visual loss in the working-age population of developed countries.


Glaucoma is recognized to be a major cause of blindness globally, probably affecting more than 5 million people, which corresponds to 13.5% of world blindness. Whereas the congenital form of glaucoma is a rare condition, the angle-closure and open angle ("simple") glaucomas are increasingly common in relation to aging of populations, but with different geographical/racial distributions. The importance of secondary glaucoma is often related to the underlying disease, and therefore difficult to assess in terms of visual loss.


Onchocerciasis or "river blindness" is a particular cause of blindness in some 27 countries across the African continent, and in a few Latin American countries. The disease has been successfully controlled or is in the process of being so, in 11 West African countries through the Onchocerciasis Control Programme (OCP).

Vitamin A deficiency/xerophthalmia

Blinding malnutrition (xerophthalmia/ keratomalacia) is the leading cause of childhood blindness in the world. It is estimated that each year approximately 500 000 children go blind, and 70% of those due to vitamin A deficiency.


Conjunctivitis of the newborn: prevention and treatment at the primary health care level, 1986,(English, French, Russian, Spanish), ISBN 92 4 156088 6

Guide to trachoma control C.R.Dawson, B.R.Jones & M.L.Tarizzo, 1981,(English, French, Russian), ISBN 92 4 154157 1

Management of cataract in primary health care services, 1996, Second edition (English), ISBN 92 4 154499 6

Prevention of childhood blindness 1992,(English, French, Spanish), ISBN 92 4 156151 3

The provision of spectacles at low cost, 1987,(English, French, Spanish), ISBN 92 4 156108 4

Vitamin A deficency and its consequences: A field guide to detection and control, A.Sommer, 1995, Third edition (English, French, Spanish), ISBN 92 4 154478 3