State plans to become model in eye care

By K. Venkateshwarlu

HYDERABAD, SEPT. 30. After the trend-setting Vision 2020 document, the State is set to become a model in eye care in the country by coming up with a "Vision 2020- The Right to Sight for AP", a perspective plan to eliminate all avoidable blindness by 2020.

The programme prepared by the L V Prasad Eye Institute (LVPEI), to be launched by the Chief Minister, Mr. N. Chandrababu Naidu, shortly, will be implemented in four five-year phases, focussing on problem areas. A recent population-based survey in the State put prevalence of blindness at 1.84 per cent or about 1.5 million people. In addition 8.09 per cent or 65 lakh people have significant visual impairment. Over 70 per cent of this problem is needless, as it can be prevented or treated easily with proven, cost-effective interventions. And unless state-wide efforts are intensified and accelerated, this number is expected to double by 2020.

It is keeping in view the dimension of the problem that a state- wide highly focussed and coordinated initiative has been finalised. The phase-wise programme includes an all-out attack on cataract. In terms of numbers it means a phenomenal increase in the number of cataract surgeries performed annually from 350,000 at present to 500,000 by 2005 and to 600,000 by 2010 employing high-quality modern surgical techniques. Implantation of intraocular lenses is to be made mandatory unless medically not advisable.

It looks ambitious but is it possible to achieve? "Yes, if we, the Government and the NGOs act together," says a confident Dr. Gullapalli N. Rao, Director of LVPEI, Secretary General of the International Agency for Prevention of Blindness and the man behind the programme. "We have a fairly decent infrastructure and adequate opthalmologists. A proactive political and bureaucratic set up and the willingness of the international agencies to support".

Along with cataract, prevalence of refractive errors form the major chunk. Hence, the objective is to eliminate all refractive blindness in all age groups by 2010. To begin with, all children below the age of 15 having refractive errors and adults above 40 years with near vision problems are to be provided spectacles by 2005. Another goal is, no child in AP should go needlessly blind after 2010 and the strategies include Vitamin `A' distribution, immunisation against Measles and Rubella and development of primary eye care centres. The other objectives are developing an effective eye banking system of optimal medical standards and adequate number of trained corneal surgeons.

Recognising the massive manpower requirements, it is planned to train all ophthalmologists in micro surgery and modern cataract surgery by 2005, besides building adequate number of paramedical personnel, eye care managers and low vision professionals. As for infrastructure, the entire eye care pyramid with LVPEI as the nodal point would start functioning by April 1, 2002. The second one would be the Sarojini Devi Eye Hospital.

How about funding? For the first five years, the budget estimated is Rs. 325 crores of which about Rs. 168 crores (51.6 per cent) needs shared funding. Dr. Rao explained that it should not be difficult, as already 50 per cent of the eye care needs are met by private hospitals. The remainder can be pooled at the rate Rs. 32 crores every year by the Government and the funding agencies.

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