Our country is the second most populous in the world, having 23.5% of the world’s blind population. The prevalence of blindness and visual impairment remains a major problem. Cataract, corneal opacities, glaucoma and posterior segment conditions are key reasons for blindness. These conditions can be treated only by skilled eye doctors in a hospital setting. We need to establish evidence for occurrence of eye problems by conducting baseline surveys to understand precise prevalence of specific conditions.
A national program for control of blindness was started in 1976 in India. Unfortunately it has not been possible to generate enough information for all of the country. However detailed information has been gathered in certain areas through research studies by concerned eyecare agencies. All such studies have shown that prevalence of cataract as the most common cause of blindness. Up until quite recently prevention of blindness was therefore largely cataract-focused.
Of late now ophthalmologists are being trained to increase emphasis on focusing on other critical causes of blindness like refractive errors, childhood blindness, corneal blindness and glaucoma. An ophthalmic workforce and infrastructure survey was undertaken to provide a valid evidence base for human resource and infrastructure requirements for elimination of avoidable blindness. This was the first time that such an extensive survey has been undertaken.
The study was conducted by Ophthalmology Cell, Ministry of Health and Family Welfare, Government of India from April 2002 to March 2003. Pre-tested questionnaires were administered to all district-level blindness officials and ophthalmology training institutions and supplementary data sources were used too. Data analysis and projections of existing ophthalmologists and dedicated eye beds were made for the entire country using the mean, median and range for each individual state.
The study ascertained that more than half the eye care facilities were located in the private sector. Sixty-nine per cent of the ophthalmologists were employed in the private and non-governmental sectors. 71.5% of all dedicated eye beds were managed by these two sectors. Five states -Maharashtra, Uttar Pradesh, Karnataka, Andhra Pradesh and Tamil Nadu had half the practicing ophthalmologists in India. There was a wide disparity in access to ophthalmologists and dedicated eye beds across the country.
In order to meet these requirements India will have to work hard to achieve the goals of Vision 2020. Some states and certain regions will be needing special attention. Instead of an across-the-board increase in ophthalmologists and eye beds, regions which are deficient will need to be prioritized and concerted action initiated to achieve an equitable distribution of available resources.
Shockingly, as per this study an estimated 9031 ophthalmologists worked in eye care facilities in our country. Of these 69% (6235) worked in the private sector and 31% (2796) worked in government sector. This clearly shows the disparity in availability of ophthalmologists. We need to increase the efficiency of eye care system in India by increasing the availability of ophthalmologists. Also we need to generate more eye doctors and eye specialists. It is only appropriately skilled ophthalmologists and trained technical staff that can respond to eyecare health in India.