'Status of Child Eye Health in India' Launched on World Sight Day

During the Vision 2020 World Sight Day Event, attended by key stakeholders in eye care, Dr. GN Rao, Founder, Chairman, LV Prasad Eye Institute, formally launched Orbis's 'Status of Child Eye Health in India: A Comprehensive Report'. It was an honor for Orbis to have the report launched by such a renowned name in the eye care landscape.

List of key attendees:

• Guest of Honor: Dr. Promila Gupta, Principal Consultant NPCB&VI, MoHFW, Government of India
• Chief Guest: Dr GN Rao, Founder, Chairman, LV Prasad Eye Institute
• Dr Rishi Raj Borah, Country Director, Orbis India
• Mr. Thulasiraj, Executive Director-LAICO
• Mr. RN Mohanty President, Vision 2020 INDIA
• Mr. Phanindrababu Nukella, CEO-Vision 2020 INDIA

An estimated 1 in 1000 children between 0-15 years are blind in India. Did you know 270,000 children in India are blind? This is the largest number of blind children in any one country.

The Status of Child Eye Health in India: A Comprehensive Report is released at a crucial time as Orbis completes its 20 years. But the Orbis anniversary also coincides with the final year of Vision 2020 global initiative which makes it all the more important to steer the conversation to eye care with special focus on children’s eye care in India.

About 90% of visually impaired people live in low and middle-income countries. Almost 85% of blindness is attributed to avoidable causes, increasing the emphasis on advocacy, human resource development, infrastructure, technology development and partnerships for blindness prevention and control.

The magnitude of ailments in terms of the scale and occurrence in the Indian context is higher for conditions like refractive error, amblyopia and other common eye conditions like conjunctivitis and redness in the eye compared to conditions like childhood cataract, retinoblastoma and color vision deficiency.

The economic burden of childhood blindness is more pronounced in developing countries in comparison to developed countries. Studies have shown that developing countries have 12 to 15 blind children for every 10,000 children, compared to 3 or 4 blind children per 10,000 children in developed countries.

A running theme in the report is that the acceptability of eye healthcare within communities which need it the most is directly connected to the level of awareness and accessibility of eye care among the individuals.

Based on the stipulates of the NPCB and NRHM, different states of India have adopted different approach to address the issue of child eyecare in India. The current eye healthcare delivery system is hinged on coordination between the not-for-profit sector and the government. Government support can be accessed in two forms. First, government aids training institutions, enabling greater number of people to be trained through monetary assistance. Second, it assists in the form of cost sharing and reimbursement services rendered. NGO sector relies on government in areas of advocacy, reimbursement, subsidized costs for surgeries or spectacles, where the standard operating procedures of the government come in handy.

In both India and Nepal, more than 60% of cataract surgeries is performed by the NGO sector which only accounts for a third of all ophthalmologists, thereby reiterating the fact that efficiency increases output.

Orbis is known for establishing pediatric ophthalmology and have contributed to effectively managing pediatric eye related anomalies. Sightsavers is focused on multi-sectoral engagements; Operation Eyesight Universal focuses on community-based vision centers and rehabilitation. Aravind Eye Care has worked in providing pediatric ophthalmology based solutions, and RP Centre is the biggest residential program that has been involved in training students in pediatric ophthalmology. Organizations like Christoffel-Blind Mission and Sightsavers have succeeded in a coordinated resource sharing approach towards eye healthcare.

There is a need to merge efforts of NGOs with that of the government initiatives for healthcare such as Rashtriya Bal Swasthya Karyakram, Janani suraksha yojana which are especially targeted programs for childhood development. Finding the place for eye care in these programs would open new avenues for enhancing children’s eye care and addressing the problem of childhood blindness.

The report and its findings show that there is a need for not just NGOs, INGOs and eye hospital collaborations to address childhood blindness in India but an amalgamation of efforts by the government sector, non-profits, social sector and the private sectors with corporate social responsibility programs in the country.

Since about 80% of blindness is avoidable, evidence shows that treating and preventing blindness provides some of the largest returns on investment (RoI) compared with other health interventions. The limited need for infrastructure, low treatment costs, and relatively high potential for cost recovery for interventions such as cataract surgery, make interventions in eye care a compelling investment.

Orbis's India Childhood Blindness Initiative is the flagship program of Orbis, which was started in 2002, initially focused on identifying tertiary level eye hospitals where Child Eye Centers could be established.

Orbis has successfully established 33 children’s eye care centers across 17 states in India. The availability of pediatric ophthalmology service care was 1 for 400 million in India in 2000 and with Orbis’s contribution it has improved to 1 for 20 million across these states.

The REACH (Refractive Error Among Children) program functions across 15 districts of India to fight the problem of Refractive error. Orbis has also worked in the areas of eye banking, diabetic retinopathy and quality assurance, by developing the Quality Resource Center which supports eye care facilities across India and internationally.

While Orbis has achieved a lot in its 20 years in India. Given the current status of child eye health, it has found that there are many other areas of focus for it to branch out to.

Through our vision planning, we have come to the conclusion that India will benefit from Simulation in Eye Health and Orbis will introduce initiatives to establish Ophthalmic Simulation Centers and also create a cadre of trainers in ophthalmic simulation.

We will strengthen regional resource centers which will serve the need for ophthalmic and para-ophthalmic education providing access to quality ophthalmic training in major regions of the country.

We also hope to build further collaborations with allied stakeholders develop research studies for policy influence and advocacy for quality eye care.