Optometry in India-

1
Optometry in India-
where do we stand?

• Optom. Rajesh Wadhwa
• M.Optom
• B.Ophth.Tech.(Hons.) AIIMS
• B.Sc.(Hons.) DU
• Fellow of International Association of Contact
  Lens Educators (Australia)
• PGDHRM (IGNOU)

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What do we see in a process....
Optometry has rewardsfor all -Society --Univers
ities --- Country ----Corporate ----- Hospitals

• We see what the mind wishes to appreciate

An Intellectual sees
Public health professional sees
Corporate sees opportunity
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When the knowledge of profession and willfull
effort of all will flow in the country
In addition to improving quality of life for
many..
. Country will also save US 23 billion per year
through eye-care
4
World has.
Poverty blindness encourage each other

• 37 Million blind
• India owns 15million
• Visually impaired in world133million
• India owns 52 million

This little child misses school
5
What is the cost to country?

• We can save here
• India the loss of productivity economic burden
  of maintenance is over 23 billion per year

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Monetary loss is not the real pain ....
Do we know? NPCB partnering with other agencies
is doing a commendable job to eliminate the
needless blindness by year 2020

• .... about 85 of all vision impairment and 75
  of blindness globally could be avoided, prevented
  or cured (need personnel, facilities)
• This is where optometry is eager to share the
  responsibility

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India
Who is an optometrist ?

• Main cause of visual impairment is unoperated
  cataract (72L) uncorrected refractive error
  (24L)
• We have only about 6000 surgically active
  ophthalmologists (general perception)
• We need another professional to do non-surgical
  work in eye-care
• Answer is Optometrist (we are 40,000)

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WHO throughWorld Council of Optometry

• Classifies Optometry as an independent primary
  health-care profession
• And defines optometrists as 'the primary
  healthcare practitioners of the eye and visual
  system who provide comprehensive eye and vision
  care, which includes refraction and dispensing,
  the detection/diagnosis and management of
  diseases in the eye, and the rehabilitation of
  conditions of the visual system

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Questions regarding optometry today

• What can optometry offer in eye care ?
• What can an optometrist do to relieve the time
  of ophthalmologist ?
• Is optometrist different from optician ?
• Who represents optometry in India for any policy?
• How will society, universities, country,health
  care system corporate world benefit from growth
  of optometry?

Next slide is a busy-slide
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What can an optometrist do as an independent
practitioner

• Other fields include
• Spectacle dispensing
• Spread public awareness about common eye
  conditions, their treatment and the need for
  regular eye check-up
• Timely referral of patients where
  medical/surgical intervention is required

Contact Lenses
Refraction
Low Vision Aids, assistive vision devices
rehabilitation
Tonometry,fields,A-scan etc.
Childhood blindness Orthoptics , pre/post op
co-management
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An optometrist..

• .is able to deliver appropriate level of high
  quality eye care from the small clinic or
  practice in remote region as a stand-alone vision
  care and eye health expert

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e.g. in my small practice of 10 new cases a day
We detect-by looking at eyes

• 1/wk we detect a new hypertensive
• 1/wk we detect a new diabetic
• 1/mth we detect glaucoma (3 suspect)
• 1 in 2yrs we detect lesions at higher centers

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Why is optometrist a health care professional
Overcoming obstacles in Outreach Socially
optometrist is first point of contact therefore
first line of defense against blindness

• Diagnose conditions due to systemic diseases and
  refer patients to other health practitioners as
  needed.
• This integrates optometrist with rest of
  health-care system
• Hong Kong, Malaysia, Mauritius, Philippines, US,
  UK,Australia, Canada are some countries where the
  use of diagnostic drugs is now permitted to
  qualified optometrists

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Organization of eye-care

• Ophthalmologist represents the highest level of
  eye-care-provider in India
• We have optometrist opticians also

15
India-in a process at this time

• Optician dispenses spects.ALSO prescribes spects
  fits contact lenses
• Optometrist does orthoptics, investigations,
  prescribing spects, contact lenses etc, also
  manages minor eye-ailments runs optical outlets
• Ophthalmologist practices medicine surgery
  .AND does orthoptics, refractions runs optical
  outlets

• Every one does almost everything

Ophthalmologists
Opticians
Optometrist
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In countries with mature eye-care system
In USA Australia, approx 70 of all eye care is
provided by optometrists
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In countries with mature eye-care system
In India when quality students qualify, some tend
to move to countries where optometry is a
recognized profession (in USA this is 4th most
preferred profession)
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As optometry professionals

• Our primary public health responsibility is to
  eliminate uncorrected refractive error (URE).
• In national interest It costs so much less time,
  money resource to train an optometrist than to
  train an ophthalmologist for non-medicinal work
  (e.g. Refraction, contact lens, orthoptics etc)

2
19
As optometrists- we are a major component of
solution

• We stand united in strength of 40,000 to fight
  the problem by getting involved in national
  policies
• NO CONFUSION the earlier confusion of who
  represents optometry who represents
  education in optometry is resolved

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With help of several agencies Delhi declaration
was signed in Jul.2010
DELHI DECLARATION ON OPTOMETRY AND BLINDNESS
PREVENTION IN INDIA
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Example of commitments (out of 11)

• Assisting in the development and provision of
  accessible, affordable and excellent vision care
  services to all people of India regardless of
  their geographical location or socio-economic
  status (publicpriv1090)
• Developing competent human resources in
  Optometry to meet the current and future eye care
  needs and reduce the burden of vision impairment
  and blindness in India (mango tree)

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We have created the base

• Any agency now needs to talk only to one
  organization regarding optometry in India
• Indian Optometry Federation (IOF)
• Education in optometryASCO (Association Of
  Schools Colleges Of Optometry)

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• Is a registered body
• Has membership of VISION 2020
• Is voice of all (40000 optometrist)
• Is working towards partnership with Govt., NGOs
  and international agencies to standardize
  regulate optometry
• Is committed to Delhi Declaration

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NPCB
At IOF we have adopted one single nomenclature
Optometrist for all 2 years or higher (4,6,11
yr) qualifications

• In India A National Programme for control of
  Blindness was started in 1975 with the motto that
  
• One of the basic Human rights is the right to
  see,

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Public health contribution of optometry can not
be overlooked
Next 2 slides show an example of success with
optometry involvement in national programs

• As
• individual practitioners
• institutional professionals
• schools of optometry
• Also done work in
• school vision screening, cataract screening,
  special children screening, etc.

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OPTOMETRISTS to OPHTHALMOLOGISTS

• Countries Optometrists Ophthalmologists
• Australia 12.5 3.3
• Canada 10.26 3.3
• U.K 13.27 1.06
• New Zealand 10 2
• USA 10.99 5.7
• India 0.65 2
• Ratio for 100000 people (per 0.1mill)
• (source Dr.Hofstetter in WCO monthly bulletin)

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OPTOMETRISTS to OPHTHALMOLOGISTS

• Blindness
• New Zealand blind popu 0.003 per mill
• India blind popu 0.012 per mill
• India has 4 times more blind per mill.
• Countries Optometrists
  Ophthalmologists
• New Zealand (Pop 4.4mil) 10
  2
• India (Pop 1210mil) 0.65
  2 Ratio for 100000 people (per 0.1mill)

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Universities Time line (IOF)

• Our internal timeline targetNo university will
  offer less than 4 year course in optometry by
  2020 (grandfather clause till then)
• Draft Common-minimum optometry curriculum
  bridge courses to upgrade 2 year diploma to 4
  year degree is ready
• Several universities are now accepting lateral
  entry

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• The IVI project

• India Vision Institute (IVI) inaugurated on
  oct.18,2011
• Task force set up to look into optimizing
  existing human resources and developing new
  professionals

2
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What will IVI do ?

• An enthusiastic plan for the development of
  optometry vision industry over 5 years
• Develop human resources
• Ensure fundamental infrastructure is in place
• Establishing professional and regulatory
  framework for optometry

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• IVI

• PhD scholarship available within India
• On our agenda specialties like
• Contact lenses
• Low assistive vision devices
• Rehabilitation
• Paediatric optometry

2
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Opportunity for the industry

• The global vision and eye care industry is worth
  approximately 89 billion in retail product sales
• 180 billion including professional fees
• Indias vision industry sits at a modest 1 of
  the worlds consumption and is valued at 5
  billion at the retail level
• Yet India has 17 of the worlds population

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Opportunity for all

• Partnership between Educational institutions
  optometry corporate world will lead to a
  win-win situation for all three also for the
  country,hospitals society

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Availability of optometry education in India

• 119 recognized universities/ institutions offer
  optometry courses
• 65 Offer 3 or 4 year graduate level program
• 16 offer M.Optom
• 4 offer Ph.D. program
• 4 Optometrists in India are at Professor level

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Indian optometrists are no less on international
standards

• 44 out of 253 FIACLE s in world are here
• Lot of international research (esp. CCLRU/BHVI,
  LVPE) is done by Indian optometrists
• Our optometrist has received a Padmasree
• We hold a national/international conference every
  year
• As faculty in foreign universities

Does anybody know of another profession that has
grown to this level without being recognized by
Govt.?
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Regulation through a council

• We require support from the Government to form a
  Council.
• Meanwhile, in the interim period, we are in the
  process of creating a self-regulatory body that
  will act as a council.

2
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Our wish-list..

• We wish to serve the people Freely and fully
• We need a council
• Actually, now India needs a council of optometry
• We request the government to make use of existing
  professionals avoid re-inventing the wheel

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The day is not far..

• When optometry in India will have similar place
  as in developed countries like Australia USA

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The country needs Optometry Optometrists stand
ready motivated to meet the challenge of
Right to Sight in India by 2020
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My contact detailsRajesh Wadhwa
r_wadhwa_at_yahoo.com
9868010187
www.indianoptometryfederation.org
Thank You!