France

Visual impairment constitutes a major public health problem in France, as while childhood management of the problem responds to children’s particular needs, the situation is less satisfactory for adults, in particular regarding the elderly. Currently, more than 1 million visually impaired people are likely to receive a comprehensive cure, treatment or rehabilitation.

Denis Brillard, a former Director at the OPC, describes the experience of the OPC in Africa related to French public eye health programmes. Diabetic retinopathy and poor vision are discussed.


Low vision

Low vision generates disability and dependence, leading to a diminished quality of life. The main cause is the link between eye diseases and age. Low vision thus presents a public health problem when taking into account the growing number of elderly people.

Thanks to our experience in Africa of public health project design and visual health development, the OPC has been interested for several years in the management of visually impaired patients. Objective for patients : to safeguard and improve quality of life thanks to a comprehensive health care plan of rehabilitation and adaptation for low vision, provided by ocular health staff, both medical and paramedical, optics practitioners, and community health workers.

It’s as a result that, with the help of Denis Brillard and Jean-François Ceccon, a project to create a city hospital for the management of visual impairment in the Ile de France region was developed with the orthoptic services managers from 5 Parisian hospitals (Hôtel Dieu, Lariboisière, Pitié Salpêtrière, XVXX, Institution nationale des Invalides) and 4 optics brands (Lissac, Optic 2000, Europtical, Krys). The standardised test files have been established. ’The French Association for Low Vision Professionals’ and the Valentin Haüy Association (a French association providing services for the blind and visually impaired) were participating, as well as ARS Ile de France. The necessary readjustment of the OPC regarding its original assignments brought the director of programmes to suggest the management of this project, taking into account the progression of works, by the Institute of Vision, directed by Professor José Sahel. The initial contacts made by Denis Brillard and Jean-François Ceccon enabled the transfer of the project in September 2011. Of course, the door at the Institute of Vision is always open for the OPC.

Nature of work Impaired vision
- Development of treatment programmes for visually impaired patients by means of health networks between town and hospital
Work commenced 2006
Geographical areas concerned Ile-de-France
Partners : Network of Orthoptists in the following hospitals :
- Hôtel-Dieu
- hôpital Lariboisière
- hôpital de la Pitié-Salpetrière
- Centre hospitalier national d’ ophtalmologie des XV-XX
Projects -Recommendations of good assessment practices (2009)
- Strengthening and expansion of our network with the hospitals of Paris(2010)

Diabetic Retinopathy

The Organisation for the Prevention of Blindness (OPC), in collaboration with the Valentin Haüy Association and the OPHDIAT network of the AP-HP, have participated in the creation and the equipping of diabetic retinopathy screening centres. Since 2006, 17 centres have been equipped in the Parisian region and across the country.

Nature of work Diagnosis of diabetic retinopathy
- Provision of equipment for the detection of diabetic retinopathy by telediagnosis
Work commenced 2006
Geographical areas concerned Centres and networks for screening for diabetic retinopathy
- Ile-de-France (12 sites),
- Provence-Alpes-Côtes d’azur,
- Languedoc-Roussillon,
- Pays de Loire,
- Poitou-Charentes
Partners : -Association Valentin Haüy
- Welfare services–Hôpitaux de Paris
- Welfare services–Hôpitaux de Marseille
- Regional University Hospital of Nice
- Regional University Hospital of Montpellier
- Regional University Hospital of d’Angers
- Regional University Hospital of La Rochelle
Achievements 2008 The diagnostic centres attached to the secure network AP-HP (OPHDIAT network) screened 12,452 people.
Projects 2009 -Create a network in the Mid-Pyrénées region of France
- Reinforce partnership with diabetic resources to better inform people

Project : FRANCOPHONE PUBLIC HEALTH OPHTHALMOLOGY COURSE The first two sessions were held in Rabat, Morocco

Start of OPC’s work : 2004

Nature of Work : Public Health Francophone Ophthalmology course (our training programmes continue)

Partners :
- SightFirst
- Université Mohammed V, Souissi à Rabat
- Université Victor Segalen, Bordeaux 2 (ISPED)

Achievements : 2 courses held (2004 et 2007), 58 participants

Projects 2010 : Organisation of a third course
- Modify the training of the inter-university diploma (Rabat-Bordeaux 2)