Research for Global Blindness Prevention:

Preface to the Research Agenda

On this page:

• International Council of Ophthalmology's Research Committee
  
  
• Dissemination and use
  
  
• Locus of investigation
  
  
• Caveats
  
  
• Terminology
  
  
• Appendix 1
  
  
• Appendix 2

March 14, 2003

International Council of Ophthalmology's Research Committee

Alfred Sommer, MD (Chair) (research@icoph.org)
Richard L. Abbott, MD
Allen Foster, MD
Serge Resnikoff, MD, PhD
Paul A. Sieving, MD, PhD
Hugh R. Taylor, MD
Bjorn M. Thylefors, MD
James M. Tielsch, MD
Sheila West, MD

This report emerged from the Committee's meeting in Baltimore (October 27-29, 2002). It was subsequently circulated to all members of the Committee and refined as suggestions warranted.

Dissemination and use

While the Research Committee was impaneled by the ICO and reports to it, the Committee took as its charge recommendations broadly relevant to those interested in advancing blindness prevention, including ICO and the NGO community.

It is the Committee's hope that this report will prove helpful to many individuals, organizations and institutions working toward our shared goal; and provide a useful starting point for those wishing to define the research agenda anew.

The Committee views its product as a "living document" that will change with future discoveries and input. To that end, the Committee recommends:

1. The Report be widely disseminated and placed on the ICO website
   
   
2. Be shared with other interested parties who may elect to place it on their websites as well, or hyperlink to its place on the ICO website
   
   
3. That a managed "chat room" be established on the ICO website that facilitates input, comments, and recommendations from interested individuals as a means of sharing information on ongoing projects that address key areas touched upon in this document in ways that encourage the continual growth and refinement of this report in an iterative process engaging the larger vision-research community.

This report is relevant to other ICO agendas, most specifically the International Clinical Guidelines ("operations research" provides evidence upon which guidelines are based).

The Educational Committee may recommend those skills needed to conduct relevant research.

This report also provides a basis for national, regional, and global support of vision research to support VISION 2020 and Vision for the Future, and the rationale for training vision scientists needed to carry out its agenda.

Locus of investigation:

Many relevant research opportunities are "generic" or "transnational," such as the basis of cataractogenesis or relative cost-effectiveness, safety and benefits of alternative intraocular lenses.

But the appropriate application of discoveries is local, and depends upon cultural, economic, and social conditions.

This means that the results of "generic" research will often provide only a partial answer; the full, appropriate solution requiring further operational research at the local level (whether these are States within India or regions of Africa).

Caveats:

This report was not meant to address all important eye health and vision-related research opportunities and needs, and is not an exhaustive presentation of all important opportunities.

Instead, it concentrates on those ocular diseases and conditions that cause the greatest vision disability in the largest number of individuals, particularly conditions being addressed in efforts to dramatically reduce unnecessary visual impairment and blindness among poor people, whether in the first or third world, urban or rural.

Terminology:

All issues identified in this report require urgent attention. However, the time it will take to complete these important research agendas differs greatly.

The following timeline realistically depicts the interval between formulating a research question, completing the investigation, and disseminating the results. This timeline is considerably longer than timelines used in framing programmatic goals.

Time	Duration
"Short"	1 to 10 years
"Medium"	11 to 20 years
"Long"	21 to 40 years

Appendix 1:

An attempt was made to characterize those ocular and visually disabling conditions most relevant to the goals of VISION 2020 and Vision for the Future by:

• their frequency (prevalence/incidence) in the population in 2002;
  
  
• the severity and frequency of the consequences of the condition and the degree to which current health systems have mitigated their impact;
  
  
• the degree to which existing technology is capable of preventing or remediating the problem if applied to the fullest extent possible;
  
  
• and the adequacy of local resources available for applying that technology.

These characteristics are ranked separately for "wealthy" (OECD) and "poor" countries; however, one must remember that few countries are homogenous in their application of health care.

Poor people in wealthy countries may lack adequate health services, while wealthy people in poor countries may have access to all the services they need.

It should be recognized as well that populations living in remote, rural areas are generally the least well served, yet the urban poor may, in many countries, suffer equivalent neglect.

Appendix 2:

A preliminary, generic description of major, complementary research avenues was presented to the ICO at its meeting in Sydney, Australia, April 2002.

This provided a starting point for the Committee's deliberations.

Next: General Introduction

Also see: Table of Contents of the Research Agenda for Global Blindness Prevention