Nearly half the world’s population requires attention to eye health, and this, before the novel coronavirus brought eye screening and interventions to a grinding halt.

But as eye care professionals adapt to challenges in a post-Covid world, the call to integrate eye health into universal healthcare rings out louder than ever before.

The pre-Covid days in India, for instance, saw an improvement in quantitative and qualitative cataract interventions, eye-banking (where India is second to the US in cornea donations) and there was even the beginnings of online education to raise qualified human resources, observed Dr G N Rao, Founder-Chair, LV Prasad Eye Institute, speaking at a conclave on eye health, hosted by the India Vision Institute.

With support from philanthropists, Government and private entities, many institutions were involved in improving eye care in the country, he said.

And then came the pandemic.

Everyone in eye care saw a significant drop in the volumes of people seeking care; this led to closures and disruption of education programmes across the board and in eye care; concerns emerged on employment and this led to the loss of investment made in people, and the losses increased the threat to the financial sustainability of the sector, he said.

There was also disruption in screening programmes, eye camps, and other mobile programmes, leading to a weakened eye health system and increased backlog in the country.

In recovering from this crisis, he said, “the future belongs to those individuals and organisations who can best combine talent with technology and to that add an element of tenderness, that would be a real winner.”

The model of delivering eye care may well need to change, he indicated, from having eye-camps and such to establishing more vision centres giving permanent ongoing care and commitment. There was no need for “more Taj Mahals”, he said, pointing to a shift to smaller tertiary care centres, more rural centres and a migration to smaller towns (as people choose proximity of care) and tele-opthalmology. And as opportunities in urban areas begin to dwindle, prepare for lower levels of compensation, he pointed out.

Policy changes needed

Highlighting the universality of vision impairment and sight loss, Peter Holland, Chief Executive of the International Association for the Prevention of Blindness, said, “everyone will be affected by an eye condition in their life time.”

The World Report on Vision last year from the World Health Organization was the first of its kind and it mapped the scale of the problem, complete with its inequities, lack of access and integration problems.

The fundamental challenge was that eye care and health was a “Cinderella” subject, outside of funding, insurance and mainstream healthcare. Policy changes are needed to address that, said Holland. Reiterating the recommendation from the WHO report, he said eye care should be part of universal health coverage.

Covid-19 had witnessed eye care initiatives being suspended, except for emergencies, as professionals went to work in the front lines. Restarting is not straightforward, he observed, but it is important not to lose the focus on eye care.

Eye data
  • Globally, at least 2.2 billion people have a vision impairment or blindness, of whom for at least 1 billion it could have been prevented or is yet to be addressed.
  • $14.3 billion is needed to address the backlog of 1 billion people living with vision impairment or blindness due to short and far-sightedness, and cataracts.
  • More than 1 billion people worldwide are living with vision impairment because they do not get the care they need for conditions like short and far-sightedness, glaucoma and cataract. Source: World report on vision