Eyeworld

EW MEETING REPORTER 144 March 2017 Reporting from the All India Ophthalmological Society, February 16–19, 2017, Jaipur, India gional institutes of ophthalmology; and coordination developed with existing health schemes. Dr. Gupta said that there is a need to adopt a mission mode approach to clear the backlog of cataract with emphasis on quality of surgery, a nationwide human resource and facility survey, and increasing focus on other causes of visual impairment such as diabet- ic retinopathy, ROP, and corneal blindness, along with training and sensitization of government oph- thalmologists for glaucoma. Other speakers at the sympo- sium discussed other approaches currently being explored and imple- mented in the fight against visual impairment. Tapping human resources to fight visual impairment "Of all forms of inequality, injustice in healthcare is the most shock- ing and inhuman," said Umang Mathur, MD, New Delhi, India, quoting Martin Luther King, Jr. In India, Dr. Mathur said there is an imbalance in rural allocation of eyecare. The higher the population in a state, the better should be the workforce; however, high-density states such as Rajasthan have work- force densities lower than average in the country. With an overall density of 0.78 eye doctors per 1,000 people, there is a severe shortage of human resources for health; the existing workforce is further concentrated in urban areas, leaving the rural areas bereft. Dr. Mathur proposed empow- ering allied health professionals to be leaders of change in underserved areas. With help from the Lavelle Foundation, Dr. Mathur and his colleagues undertook an allied oph- thalmic personnel training program with the objective of empowering rural school graduates to be com- munity ophthalmic professionals (dubbed COPs) with appropriate ophthalmic knowledge, skills, and attitude to increase work efficiency and strengthen both delivery and quality of eyecare. The program took a holistic approach. While focused on em- India's NPCB—whose nomenclature, Dr. Gupta said, should be changed to National Programme for Control of Blindness and Visual Impairment to cover all categories—must treat all patients with vision worse than 6/18. Dr. Gupta said that the ap- proach is to provide universal access to eyecare, with equity of distribu- tion; the approach must be evi- dence-based, offering treatment for life, and empowering people with visual impairment. To achieve these goals, Dr. Gup- ta said there is a need to generate evidence of the magnitude and causes of visual impairment. This ev- idence can then be used to advocate for greater political and financial commitments to eye health by the government. She further proposed that mem- ber states develop and implement an integrated national eye health program to enhance universal eye health. The state should address multisectoral engagement and effec- tive partnership to strengthen eye health. Indicators for success would include prevalence of causes of blindness. At the primary eyecare level, Dr. Gupta said that vision centers should be set up in all primary health centers (PHCs), with the provision of essential ophthalmic equipment at eyecare delivery points; paramedical ophthalmic assistants (PMOAs) should be posted in PHCs for primary check up and refractive services, and vision centers linked through tele-network for con- sultation and referral services. At the secondary eyecare level, the eye departments of district hos- pitals should be strengthened, with posting of eye surgeons and PMOAs in all districts, and the development of dedicated eye wards and oper- ating theaters in district hospitals, and empaneling of more NGOs and private practitioners for providing eyecare services. At the tertiary eyecare level, government medical colleges should be developed by providing modern ophthalmic equipment; identified medical colleges upgraded as re-

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