Anjali Uniyal, B. Optom

Consultant Optometrist, Guru Nanak Eye Care Centre, Punjab, India

In mountains or in remote areas, where there is lack of basic life supporting facilities, no doubt there is also lack of basic medical facilities. In mountains, a small injury is considered as fatal,  and the one and only reason for it being fatal is the lack of basic medical facilities.  Not a single proper infrastructure is developed in the northern range (Shivalik range of outer Himalayas) of Uttarakhand, India. The purpose of this  blog is  to primarily raise awareness of the situation of public eye health in remote or mountain areas.

I am fully aware of the situation that even a small injury can immobilize a person and can make them dependent on another person, and this fact does not stop here due to improper transport facility and unavailability of resources paramedical staff, nursing staff and doctors.(1) It also plays a major role in the severity of illness. One hospital-based study reported that ocular injury is the fourth common cause of eye diseases (2.38%) (2) after refractive error, cataract, and conjunctivitis.

Ocular injury happens most of the time due to human-wildlife conflict.(3,4) As most hill districts of the state don’t have adequate health infrastructure, most of these cases are referred to other states for tertiary care.


Figure 1: Source – Times of India (5)

Figure 2: Leopard death cases in Uttarakhand in last 20 years (6)

Few years ago a case was reported of an incident that took place in a remote area of Uttarakhand in India where a woman was attacked by a bear while she was collecting wood to feed animals in the forest.(7) The woman  somehow managed to leave the area but at the cost of loosing both her eyes. The wild animal ripped out her eyes and she lost a pair of vital organ of her body in this brutal attack. Due to the  lack of emergency ocular facility in that area she was referred to tertiary medical centre which was around 400 kilometres away from the village to the nearest city of Dehradun, however, her eyes could not be saved and now she is living life of blind person. Another incident reported was a 65 year old man critically injured after being attacked by a bear in Chaugulu Tok village of Chamoli, Uttrakhand, India.(8) The bear gouged out the elderly man’s right eye leaving him with major injuries on his hand, head and face which again could have been treated on time if the area had better medical facilities.



Unfortunately, this became common for the people living in the areas,(9,10) they are not keen to visit forest but it’s their compulsion to be there as they need to arrange food for their animals, also they need to arrange wood for fire. What else can we do to solve the problem as health care professionals? One solution can be to create an infrastructure in the area which will help people can avail medical and eye-care facilities in emmergency. Another suggestion is to provide better transportation services as it takes around 7-8 hours from rural areas to reach the main city of Dehradun where the hospital is equipped with all tertiary care facilities. However, this journey can be delayed due to landslides or snow.

An important step has been taken by the state’s forest department. They came up with an animal deterrent spray to tackle the increasing animal attacks in the state, hoping these incidents can be tackled on time and no more life need to be lost in wilderness.(11)



1) (Last access 17March 2022; 12:00am AEDT)

2) Bharadwaj M, Singh LK, Dutt B. A hospital based eye health survey to see the pattern of eye diseases in Uttarakhand, India. Int J Res Med Sci. 2017 Jan 23;5(2):548-50.

3) Sanyal A, Rawat KA, Das S, Dvivedi S, Rajan M, Zaidi R. Are humans encroaching too much? man versus bear. International Surgery Journal. 2018 Feb 26;5(3):917-22.

4) Dvivedi S, Sood S, Mehrotra V, Dvivedi J. Injuries caused by the black Himalayan bear in the foothills of Garhwal, Himalayas. Tropical doctor. 2003 Apr;33(2):115-7.

5) (Last access 17March 2022; 11:50pm AEDT)

6) Meena, D & Baluni, D & Bisht, M & Pundir, D & Saklani, Akash. Human-wildlife conflict in Uttarakhand: Impact, opportunities, and ground level perspectives with mitigating strategies. Proceedings of the International Academy of Ecology and Environmental Sciences, 2021, 11(3): 84-102.

7) (Last access 17March 2022; 12:10am AEDT)

8) (Last access 17March 2022; 12:05am AEDT)

9) (Last access 17March 2022; 12:07am AEDT)

10) (Last access 17March 2022; 12:08am AEDT)

11) (Last access 17March 2022; 12:03am AEDT)