Lok Sabha Question No. 839 (UNSTARRED), answered on 2018-12-14
Subject: Vision Damage
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PINAKI MISRA

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 839 TO BE ANSWERED ON 14 TH DECEMBER, 2018

## VISION DAMAGE

## 839. SHRI PINAKI MISRA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  there  could  be  a  permanent damage  to  the  vision  in  the  patients  of dengue, chikungunya and bacterial infections like typhoid and rickettsia and if so, the details thereof;
- (b) whether the possibility of damage to the vision can be ruled out through early detection and treatment of the above said infections; and
- (c) if so, the steps taken by the Governm nt for its early detection and control nationwide?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEA LTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

(a) to (b): Permanent  Vision  loss  from  infectious  diseases  like  dengue,  chikungunya typhoid and rickettsia is very rare. The causes for vision loss may be related to hemo instability,  hematopoietic  disturbances,  immune  related  or  direct  organismal  invasion; ast  of these being the least common.

Ophthalmic manifestations in patients with vision loss in the presence of these inf include endophthalmitis, panophthalmitis (secondary to transfusion, intravenous therapy), hemorrhage, pre - retinal and in tra - retinal hemorrhage (secondary to low platelet count), retinit and micro - infarcts (usually immune mediated).

All  of  these  diseases  are  primarily  non - ocular,  multi - systemic  disorders  and  hence systemic diagnosis is already available at the time of pre sentation to the eye specialist.

Management primarily depends on adequate monitoring of systemic features (like blo pressure, blood counts, hematuria, pyrexia, pulse, respiratory rate, neurological alter and conservative treatment.

Role of  antiviral  agents  is  poorly  established  in  dengue  and  chikungunya  while  spe antibacterial therapy is curative in patients with typhoid and reckettsia (e.g. doxycycli typhus). Management of vision loss also remains conservative in dengue a nd chikungunya.

(c): Government  of  India  has  taken  the  following  steps  for  diseases  like  Dengue  a Chikungunya under the National Vector Borne Disease Control Programme (NVBDCP):

- Free  diagnostic  facilities  through  Sentinel  Surveillance  Hospitals  (SSHs)  and Referral laboratories (ARLs) identified across the country. Test kits are supplied free of cost.
- Guidelines  on  case  management  were  developed  and  shared  with  the  sta tes  for  wider circulation.
- Training is imparted to the doctors on case management.
- Monitoring and supervision for early case detection and prevention and control thr reviews and video conference at higher level.
- Advisories are issued to sensitize the S tates.
- IEC/BCC  activities  to  disseminate  knowledge  for  prevention  and  control  throug advocacy meetings, review, electronic and print media.

Further, comprehensive eye care services are also provided by the government fre cost  at  primary,  secon dary  and  tertiary  centres  across  all  States/  UTs  under  the  Natio Programme for Control of Blindness and Visual Impairment (NPCBVI).