Anusuya D, Bachelor’s in Optometry

Aravind Fellowship in Clinical Optometry, Aravind Eye Care System, Chennai

Visual impairment (VI) has been a major health concern in rural areas. More than 70% of India’s population lives in rural areas, with inaccessibility to affordable basic eye care. Approximately 80% of VI in developing countries is avoidable using available and relatively low-cost interventions. Poverty is one of the predisposing factors for blindness. People from low-income backgrounds are more likely to become blind due to the lack of access and ability to pay for services. Though there are several eye hospitals and outreach activities in rural areas, there is a lack of access to eye care in rural areas. Thus, there is a need for a cost effective and permanent eye care facility.^(1,2)

Need of vision centre

There are various existing outreach activities, but they are not on a permanent basis. Avoidable blindness and VI can only be tackled by permanent and comprehensive eye care. Thus, Vision Centres act as a bridge between the public and the tertiary eye hospitals. It is available at their own community, which avoids the need for commutation. Of the patients who seek care at these centres, over 90% can be fully treated on-site and less than 10% are referred to the base hospital for further treatment, usually for surgery or advanced investigations.^(3.4)

What is a vision centre?

Vision centre is an accessible permanent facility set up to provide primary eye care services to semi-rural & rural communities. Optometrists and vision technicians operate the centre, with the help of telemedicine. Complicated cases and other speciality cases are referred to the base hospital. ^(3.4)

How do vision centres work?

Like any other eye hospital, Vision Centre starts with patient registration and aims at providing comprehensive eye care examinations at low cost. Functions of the vision centre include identification and treatment/ referral of eye problems, refraction services, referral and post-operative follow up and creating awareness among the local population on different eye conditions and the means of prevention. ^(3.4)

Patient records are maintained in the electronic medical records (EMR) and their data will be shared with the ophthalmologists. The patient is also made to interact with the ophthalmologist at the base hospital via video call conferencing. The ophthalmologist discusses their eye conditions and advises according to the prognosis. Patients who have normal findings and who need a glass prescription will be disposed of by the optometrists at the vision centre.^(3.4)

Success of vision centre:

Though the Vision centre reaches the unreached people, communication and creating rapport with the patients play a pivotal role. Optometrists and vision technicians must be friendly with patients and explain the prognosis of the disease, in such a way that the patient can understand. Explaining the need for follow up is also important. Regular monitoring should be ensured for proper functioning of the vision centre. ^(3.4)

Conclusion:

Thus, permanent primary eye care facilities like vision centres enable the people to get their eyes checked earlier. These initiatives will drive the eye care professionals to achieve the goal of eliminating avoidable blindness.

Keywords : primary eye care, public health, vision centre.

Reference:

1. World Health Organization, International Agency for the Prevention of Blindness, Vision 2020: The Right to Sight. Global Initiative for the Elimination of Avoidable Blindness – Action Plan 2006-2011: World Health Organization; 2007.
2. Khanna, R. C., Sabherwal, S., Sil, A., Gowth, M., Dole, K., Kuyyadiyil, S., & Chase, H. (2020). Primary eye care in India–The vision center model. Indian journal of ophthalmology, 68(2), 333.
3. The link between blindness and poverty. India Development Review. (2021, July 7). Retrieved January 27, 2022, from https://idronline.org/the-link-between-blindness-and-poverty/
4. Vision Centre Manual – vision2020india.org. (2011, December 1). Retrieved January 27, 2022, from https://www.vision2020india.org/wp-content/uploads/2016/09/Vision-Centre-Manual-2012.pdf