Uncorrected or impaired vision is one of the most debilitating, yet preventable, disabilities in the developing world. Refractive error, a very common eye disorder, occurs when the eye cannot clearly focus the images of the outside world. Refractive error, when left uncorrected, leads to blurred vision and visual impairment.
Ninety per cent of the world’s blind live in developing countries. It is estimated that around 60% of them reside in sub-Saharan Africa, China and India. A study to examine the extent, pattern, and trends of non-fatal health loss across countries found that in Indian women, musculoskeletal disorders, including shoulder injuries and fractures from osteoporosis, chronic obstructive pulmonary diseases, diabetes and uncorrected refractive error are the main causes of years lived with disability.
Uncorrected refractive error (URE) is said to be the cause of 19.7% of all prevailing blindness in India. Studies conducted by the Vision Impact Institute on the impact of poor vision among Indians have found that 41% children in India have eyesight problems that can negatively impact their health, their progress in school and their integration into society. Forty-two per cent of workers have vision problems that can reduce their productivity and 42% of drivers have vision problems, which could be the cause of 59% of road traffic accidents.
In India, the National Programme for Prevention of Blindness under the Ministry of Health and Family Welfare is actively trying to address this issue by identifying and treating vision impairment at primary, secondary and tertiary levels; strengthening comprehensive eye care services and quality service delivery, upgrading regional institutes of ophthalmology to become centres of excellence; strengthening the existing human resources and infrastructure facilities, enhancing community awareness, expanding research in vision care and securing the participation of voluntary organisations and private practitioners in eye care through public-private partnerships. Regional institutes of ophthalmology and tertiary-level eye hospitals provide venues for training, research and complicated medical and surgical treatment. For district-level activities, there are district blindness control societies. However, these efforts need to be upscaled with the involvement of wider stakeholders and increased partnerships across sectors.
The ophthalmologist to population ratio in urban India is 1:25000 but in rural India it is about 1:250000. According to internal assessments conducted by 2.5 New Vision Generation (NVG), an initiative from Essilor, a global name in vision care, there also exists a skewed ratio of availability of qualified optometrists, which is approximately one for every 250,00 people whereas, in other developed countries, this ratio is 1:6000.
To address the paucity of skilled optometrists, the government needs to partner with public and private stakeholders. 2.5 NVG is an endeavour to fill this gap. The Eye-Mitra Optician Model aims at providing sustainable livelihood to the youth through an empowering skill building initiative in rural India. Rural youth are trained in the basics of vision screening and spectacle dispensing. After that they start their own businesses in the form of an optical store. They also conduct vision-screening events with the support of 2.5 NVG.
Saugata Banerjee is Vice-President, 2.5 NVG, South and South-East AsiaThe views expressed are personal