Roles and Responsibilities of Optometrists in India

Swarnalakshmi M. R, M.Optom

Assistant Professor, Avinashilingam Institute for Home Science and Higher Education for Women, India

Blindness and vision impairment remain significant public health issues in India. Cataract and uncorrected refractive error are the leading causes of blindness in India^.(1) Despite the fact that vision impairment is avoidable, the majority of the world’s population becomes blind. According to WHO estimates, approximately 94 million people have visual impairment due to cataracts, while 88.4 million have visual impairment due to refractive errors. India is the first country in the world to implement a blindness control program that focuses on a model to address blinding eye disease and initiate a public-funded program for the control of blindness as a national priority health problem.⁽²⁾

Definition of World Council of Optometry (WCO)⁽³⁾

Optometry is a healthcare profession that is autonomous, educated and regulated (licensed/registered) and optometrists are the primary healthcare practitioners of the eye and visual system, who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/diagnosis, and management of disease in the eye and the rehabilitation of conditions of the visual system.

In India: Optometrists who have completed four years of training are qualified to assess and prescribe:⁽¹⁾

• Comprehensive eye examination, including a detailed history, vision check, refraction, pupillary examination, extra ocular muscle assessment, cover test, IOP, anterior segment evaluation, and management of specific eye conditions, as well as appropriate referral to ophthalmologists or general practitioners as needed.
• Prescribe spectacle lenses such as single vision, bifocal, progressive, aspheric, customised glasses, and safety/protective spectacles based on the patient’s visual needs.
• Prescribe soft and rigid contact lenses, including orthokeratology, scleral lenses, prosthetic contact lenses, and therapeutic contact lenses based on wearing modalities and frequent replacement, such as extended wear, continuous wear contact lenses, and complex contact lens fittings for paediatric eye conditions, High myopia, keratoconus, postsurgical complications, eye trauma, and corneal ectasia and more.
• Vision therapy begins with an orthoptic evaluation, which include Near-Point Accommodation, Near-Point Convergence, Negative Relative Accommodation, Positive Relative Accommodation, Negative Fusional Vergence, Positive Fusional Vergence, Monocular Estimate Method, accommodation and vergency flippers, and so on. Therapy for children with learning problems and common binocular vision dysfunction, such as vergence and accommodation dysfunction, strabismus, and amblyopia.
• Low vision and rehabilitative services involve prescribing optical and non-optical aids such as telescopes, spectacle magnifiers, hand-held magnifiers, prisms, typo scopes, filters, and more to visually impaired individuals, referring them to appropriate health care professionals, and providing preventive vision care counselling.
• Counselling: Optometrists should provide early detection and preventative care by educating the community about their vision and eye health, including dry eye, diabetic retinopathy, glaucoma, vitamin A deficiency, refractive error, and cataracts. Advice to seek early intervention, promote lifestyle choices to ensure good vision and health, provide information regarding visual ergonomics, especially for computer users, advise them to follow the 20-20-20 rule, create the awareness in community about environmental hazards, particularly for people who work in the smoke, dust, and chemical industries, and educate the community to prevent problems and maintain ocular health.

Conclusion

Optometrists play an important role in eye care; they are not only responsible for evaluating conditions, but also superheroes because they help in treating a patient at an early stage.

Optometrist: National Pillar of India for the Upcoming Years

References:

1. De Souza, N., Cui, Y., Looi, S., Paudel, P., Shinde, L., Kumar, K., … & Holden, B. (2012). The role of optometrists in India: An integral part of an eye health team. Indian journal of ophthalmology, 60(5), 401.
2. Neena, J., Rachel, J., Praveen, V., Murthy, G. V., & RAAB India Study Group. (2008). Rapid assessment of avoidable blindness in India. PloS one, 3(8), e2867.
3. Smith, D. P. (2002). The 75th anniversary of the World Council of Optometry: Seventy‐five years of advancing eye care by optometrists worldwide. Clinical and Experimental Optometry, 85(4), 210-213.