Centre turns blind eye to eye care

The poor state of eye care in the country is not only a health concern, but also a major economic concern.

There are 13 crore visually challenged people in India because of uncorrected refractive error, revealed a WHO report published in 2008. The same report also found that the loss of productivity caused by eye problems costs the country $23 billion dollars (approximately Rs1,17,750 crore) annually.

The problem stems from lack of qualified optometrists.
"In India, the eye care market is potentially worth $30 billion (approximately Rs 1,53,586 crore). Private eye care providers have to realise that they have to invest in the training of quality optometrists to tap the full potential of the market," said Professor Brien Holden, one of the authors of the report.

"And, if there are enough quality optometrists, it will not only will it help the millions of people suffering from eye problems, but also benefit the economy," added Holden, who was recently in the country to help set up India Vision Institute to train quality optometrists.

According to a study conducted by Country Family Health and Development Research Service Foundation, there were only 11,000 optometrists in the country in 2007. The figure has now increased to 21,000, but the ratio of optometrists to population is still poor.

Optometry is fast gaining popularity as a profession in the country, observed Dr Harshvardhan Golpade, a consultant anterior segment surgeon at Fortis Hospital.

“It's a relatively comfortable profession as there are not many emergency surgeries. As the surgeries are not time consuming, you can end up doing several in one day," he said.
But, there is another hurdle: Most optometrists prefer to practise in cities.

The ratio of optometrists to population is 1:25,000 (1 optometrist for every 25,000 people) in urban areas, which is significantly better than the ratio in rural areas - 1:2,50,000. Compare this to the ratio of optometrists to population in first world countries such as Australia and the US (1:6000) and the magnitude of the problem begins to emerge.

"The Indian government has to step in and provide incentives to optometrists to work in rural areas," suggested Holden.
Dr TP Lahane, dean of Grant Medical College at JJ Hospital, observed that lack of personnel is not the only problem in rural areas. "The technology and infrastructure in government hospitals and NGO-run centres in rural areas are not very advanced. Most of the NGOs that get funding from the government to perform eye surgeries are concentrated in the urban centres. The government should ensure that they fund NGOs established in rural areas," he said.

Besides lack of infrastructure, there is also a lack of awareness about eye problems, said Elizabeth Kurien, director of India region of Sightsavers, an international eye care organisation).
“Most people think that blindness, low vision and cataract affect mostly the elderly and it cannot be reversed. This leads to the public health centres largely lacking an eye care professional, be it an ophthalmologist, an optometrist or a mid-level personnel."
But, the ground reality is almost opposite.

According to a study published in The Indian Journal of Opthalmology, there are around 2 lakh visually challenged children in India and most of these cases could have been avoided if there was adequate eye health services.
Another study revealed that 60,000 children lose sight every year due to Vitamin A deficiency. “The government needs to develop sustainable eye health services as part of general healthcare within the public healthcare system," said Kurien.