SERVICES

Optical Services in Bunawan : 
- Ophthalmologists and qualified refractionists only should prescribe visual aic to the cases of refractive error. 
- All the optical shops in private sectors must be registered with the �Departmei of Private Clinics�, Ministry of Health. 
- Opticians, contact lens practitioners are issued certificate for practicing Oman by concerned authorities after assessing their qualifications an experience. 
- Opticians should attend training sessions and follow MOH guidelines fi prevention and management of eye problems especially refractive error ar communicable eye diseases. 
- Opticians should carry out health promotional activities related to eye care as to increase awareness about safe preventive practices and under� standard management of eye diseases. 
- Opticians should ensure that their clients whom they have given visual aic have understood the regimen for proper care of visual aids and eyes. 
- Opticians should refer all eye cases for ophthalmic opinion when needed. 
- Opticians must not prescribe any antibiotic and br steroid eye medications the patients. 
- Supervisory body would periodically visit these establishments for ensuring t high quality of optical services in these units. 
- Ministry of Health encourages private optical units to provide spectacles to t[ school students at subsidized rates. 
- Ministry of Health encourages private sector to establish manufacturing unit visual aids and their accessories in the Sultanate. 

PRIORITIZED  EYE DISEASE
CATARACT 
The situation analysis and management policies for the prioritized eye diseases are given in details in this chapter. 
1. Cataract: 
Cataract is a leading cause of blindness especially in the developing countries. It is mainly due to the aging process. In Oman 30% of the blind were estimated to be due to cataract. With the increase in the - Above 40 population in next two decades, cataract would be a major cause of blindness in Oman. Since it is a curable condition, Eye Health Care in the Sultanate promotes surgical management of cataract cases on priority basis. It has following objectives and strategies for reducing blindness related to cataract. 
Objectives: 
- To address all incident-blinding cataract cases by year 2000 and increase in coverage of non-blinding cataract cases by 5% every year. 
- To increase the cataract surgery rate in Oman from 1,500/million/year reported in 1998 to 3,000/million/year by the year 2010 and 4,500/million/year by the year 2020. 
Strategies: 
To achieve these objectives, all regions should adopt following strategies: 

To continue early detection of cataract cases at primary level. 
To strengthen services to increase cataract surgery rate.   

To promote activities for prevention of blindness due to cataract. 
To increase awareness of the community regarding cataract and uptake of cataract surgery at early stages. 
To ensure high quality of cataract surgery in the Sultanate. 
To encourage private sectors for the resource support and sharing the cataract surgery load. 
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To collaborate with international organization for technology transfer. 
To provide continuous medical education to the ophthalmologist for 
microsurgery and lens implantation surgery. 
To undertake operational research and surveys periodically to estimate the 
magnitude of cataract problem and address related issues. 

Standard Operating procedures:  At Primary level Health Institutions: 
Examine all eye cases to detect cataract and assess their visual status. 
If vision is less than 6/60 in an eye with cataract, the patient should be referred to the ophthalmologist for further investigations and management. If vision is more than 6/60 with cataract, they should explain the patient about possibility of developing cataract and need for intervention at later stage. 

Health care providers should take steps for prevention of blinding cataract in adults through health education. For the prevention of cataract in childhood, immunization against rubella and proper antenatal care and health education to avoid ocular trauma should be promoted. 
They should trace the defaulters i.e. blinding cataract cases refusing surgery and motivate them to undergo surgery. 
They should assist the Eye Health Care Master Trainers in screening of cataract cases in Cataract Fortnight project in their Wilayat. 
They should learn from the feedback sent by ophthalmologist and follow the case as suggested by ophthalmologist.