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When we talk about disability, it seems that we refer to a disabled person in all aspects of life, however, such an assumption is not entirely true, and over the last decades, people with some type of disability have been demonstrating it.

In the world, there are different types of disability: physical, sensory, intellectual, psychic, visceral, multiple disabilities.

The reasons that can cause this type of limitation are.

Causes before birth (prenatal); it is a hereditary or congenital visual limitation

Causes during birth (perinatal); It is a limitation acquired at birth.

Causes after birth; this is a limitation acquired throughout life and can be caused by trauma, disease or old age.

People with visual disabilities have long strived to convince the world that despite their condition, they are an active part of society and through their activities in the different fields where they have the opportunity to carry out some function, they have shown that they can contribute as much as the rest of the general population, although historically they have been ignored and denigrated.

Until the second half of the twentieth century, it was difficult for societies to recognize that people with disabilities have the same capabilities, needs, and interests as the rest of the population and there was discriminatory treatment towards them in different important aspects of life.

Gradually the treatment and recognition of their dignity, individual autonomy, non-discrimination, respect for diversity, inclusion and full and effective participation in society, has been so important that laws have been created in their favor, what has allowed improving and even regulating the treatment towards them, since through these, their rights as citizens and productive individuals have been established. All this has allowed the participation of these people in the workplace, in culture, sports, recreational activities and the improvement of their overall health, inserting them as active and useful members of society.

In 2012, the commemoration of the National Day of the Blind Person was decreed for every October 15, where people with visual disabilities are taken into consideration, so they can in society, be seen and treated normally, without disqualifications, and with the aim of raising awareness in society about the needs and characteristics of these visually impaired people, through educational campaigns, conferences, seminars and any other means, as well as to make known the use of technical aids such as the white canes and the guide dogs.

In this way, the country joins other nations in the world that are interested in encouraging their citizens to recognize people with visual disabilities as individuals with the same rights as the rest of the members of society, valued and inserted into the productive process of the country. Where the main causes of blindness or visual impairment are highlighted along with their prevention treatment is promoted.

In Costa Rica, there are more than 18 thousand people who suffer from blindness and more than 279 thousand with some visual impairment due to untreated cataract and diabetes mellitus.

The World Health Organization (WHO), in 2013 approved the global initiative “Universal Eye Health” for a period of 5 years from 2014 to this year 2019. This plan seeks to prevent avoidable blindness and visual disabilities. Costa Rica, as a member country of the Pan American Health Organization, is committed to carrying out actions to improve national indexes regarding visual disabilities and blindness going into the future.

According to the Rapid Evaluation of Avoidable Blindness, carried out by the Costa Rican Social Security Fund in 2015, it was found that untreated cataract in people over 50 represents the leading cause of blindness in Costa Rica (52.1%). The prevalence of low functional vision in people over 50 years, understood as the categories of blindness, severe visual impairment, of the untreatable or irreversible cause, was estimated at 2.5% of the population.

Chronic diseases such as diabetes, whose prevalence is 22% is another great challenge since its evolution affects vision due to retinopathy and an annual ophthalmologic revision is required in patients with diabetes, to avoid serious consequences.

The prevalence of diabetic retinopathy of any grade in patients older than 50 years is estimated at 50.8%, proliferative diabetic retinopathy is 1.6% and the prevalence of diabetic maculopathy that threatens vision among diabetics older than 50 years is estimated at 1.1% of according to Evaluation of Avoidable Blindness studies.

Blindness not only affects the quality of life of the person but increases their dependence, reduces social participation and influences economically by decreasing employment opportunities.

The country has pledged to follow up on the indicated data and to carry out the necessary actions with the National Committee for the Prevention of Blindness and Avoidable Visual Impairments, it is an inter-institutional group with social participation, which is responsible for promoting the visual health in the country and mobilize the different national entities to achieve the proposed objective of reducing blindness and avoidable visual impairments.

There is currently an action plan established by the Pan American Health Organization Directing Council that proposes a series of measures to address this problem, which will represent a challenge in the future due to the population increase, its longevity and the greater demand for attention that will fall upon Health Services.

To reduce avoidable visual disability and guarantee access to rehabilitation services, the plan proposes the following:

* Create and maintain human resources that are distributed equally to address the problem

* Strengthen the organizational capacity of public ophthalmology services to provide efficient, affordable and high-quality services for the entire population.

* Strengthen the primary eye care system for early detection and refer people over 50 with visual impairment.

* Increase the coverage of cataract surgery to all segments of the population and compliance with standards and quality.

* Formulate programs to improve the quality of neonatal care, prevention, detection and treatment of retinopathy in prematurity.

* Detect and treat uncorrected refractive defects in school children and adolescents through effective screening and management programs.

It is important to remember that: “The recognition of people with disabilities goes with seeing everything created by God as a symbol of life and therefore has a value that emerges from human sensitivity itself.”

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