It is very important to sensitize everyone regarding the needs of people with irreversible visual impairment and this book is well designed to raise awareness among medical professionals and the general community. It gives a roadmap to optimize vision care and deal with challenges. I am particularly happy that the book lays equal emphasis on rehabilitation of people with blindness and low vision.

One of the first benefits of the book I foresee will be that it can spur introduction of Management of Vision Impairment as a subject in the Medical and Optometry Colleges. Secondary, the book will be an invaluable guide and handbook for practitioners, clinicians, social workers and NGO administrators working in the field of vision impairment.

The Editor and Contributors have taken good care to give pictorial explanations, examples, practical tips and guidelines that make the book useful to professionals and at the same time, comprehensible to lay persons.

Sightsavers is happy to be associated with the book and we wish it all success.

In the first place, at least as far as the developing world is concerned, treating vision impairment had low motivation because of certain reasons as under.

Eye care specialists were not able to spare the large time spans needed to treat vision impairment cases whereas twice to three times of effort, counseling and evaluation times are required per vision impairment client as compared to general eye patients. Some eye care specialists especially optometrists do take up this area and emerge as vision impairment clinicians. But this tribe is small and they too may not find the profession remunerative as a private practice.

As far as hospitals go, the private commercial ones find treatment of vision impairment unremunerative and cost in-effective and the government run hospitals are swamped with routine eye treatment. It was therefore a handful of major corporate eye hospitals that took treatment of vision impairment as a cultivated discipline depending on overseas contributions for the activity.

On the clients' side, there was helplessness as well as lack of awareness of the advances being made elsewhere in the West. The tendency was to accept the situation and demand nothing. A few clients who do seek medical treatment go through a cycle of high expectations, disappointment and despair. Satisfaction levels are typically low, even in case of clients who are given the best care and time. This in turn led to an alround despondency for the clients and low job satisfaction for specialists who spend time for management of vision impairment.

Even medical colleges and teaching hospitals had side-lined vision impairment. They, as well as the funding agencies do know that the population needing vision impairment attention is huge but action was limited to sympathy, admitting that the problem is severe and special. The problem is relegated as a social problem to be addressed by special mechanisms and NonGovernmental Organizations (NGOs). With this background, proper place for this subject is not given in the curricula and even adequate university books did not take birth. Some low key treatment is however given to the subject in the general ophthalmology Textbooks. With sparse attention given to the subject in the syllabus and examinations, 7an eye specialist emerging out of a medical college could not know much about low vision and vision rehabilitation. This field did not count for much as a specialization in the postgraduate levels.

It is therefore no wonder that we have a society where as far as management of vision impairment is concerned; facilities and even awareness are scarce. It is practically a situation of vacuum, knowingly endured by medical education in general and in most eye care hospitals. Only some students, professors and some enlightened hospital managements are now taking to management of vision impairment in a serious fashion. Even if this seriousness comes due to pressure from the government and international charitable organizations, it will still be a welcome development.

The starting point for rectifying this situation is in addressing the syllabi of medical colleges in creating training material. This book attempts to fill the vacuum mentioned above and help to install Management of Vision Impairment as a compulsory subject in the curricula in the medical colleges. The book also intends to be a ready handbook for practitioners whether they are in the Eye Care Hospitals or in the NGOs. May their tribe increase!

This book is the combined effort of several contributors and they welcome feedback, queries, suggestions and critiques about the book.

MS Raju is the recipient of the 2009 BJ Modi award for outstanding service to the disabled, awarded by the National Society for Equal opportunities for Handicapped, India.

Apart from being the editor and general editorial contributor for all chapters, he is the core contributor for the chapters on Technologies, Education, Rehabilitation, Coping and seven of the eight appendices in the book.

In this book, we are principally concerned with nomenclature relating to vision or visual impairment. For its terminology, we adopted the latest recommendations of International Classification of Diseases (ICD-10).

Our readers may make a note of the following adaptations. Those interested in deeper study may browse http://www.who.int/classifications/apps/icd/icd10online.