Optometry in India-

1. where do we stand? Optometry in India- 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)

2. We see what the mind wishes to appreciate What do we see in a process.... Optometry has rewardsfor all… -Society --Universities --- Country ----Corporate ----- Hospitals An Intellectual sees Public health professional sees Corporate sees opportunity

3. 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 world=133million • 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

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

7. India Who is an optometrist ? • Main cause of visual impairment is “unoperated cataract” (72L) & “uncorrectedrefractive 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+)

8. 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”

9. 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

10. 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-scanetc. Childhood blindness Orthoptics ,& pre/post op co-management

11. 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

12. 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

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

14. 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 Every one does almost everything Opticiandispenses spects….ALSO prescribes spects & fits contact lenses Optometristdoes 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 Ophthalmologists Opticians Optometrist

16. In countries with mature eye-care system In USA & Australia, approx 70% of all eye care is provided by optometrists

17. 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) In countries with mature eye-care system In India “ophthalmic assistant” is not this level of professional. “Optometrist” is sometimes called ophthalmic assistant in India

18. 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

20. With help of several agencies “Delhi declaration” was signed in Jul.2010…… DELHI DECLARATION ON OPTOMETRY AND BLINDNESS PREVENTION IN INDIA

21. 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 (public:priv=10:90) • 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)

22. 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)

23. 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

24. 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,……”

25. Public health contribution of optometry can not be overlooked • As • individual practitioners • institutional professionals • schools of optometry • Also done work in • school vision screening, cataract screening, special children screening, etc. Next 2 slides show an example of success with optometry involvement in national programs

26. OPTOMETRISTS to OPHTHALMOLOGISTS • CountriesOptometristsOphthalmologists • 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)

27. 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)

28. Universities: Time line (IOF) • Our internal timeline target=No 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

29. 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

30. 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

31. IVI PhD scholarship available within India On our agenda specialties like Contact lenses Low & assistive vision devices Rehabilitation Paediatric optometry 2

32. 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 • India’s vision industry sits at a modest 1% of the world’s consumption and is valued at $5 billion at the retail level • Yet India has 17% of the world’s population

33. 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

34. 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

35. 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.?

36. 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

37. 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

38. The day is not far.. • When optometry in India will have similar place as in developed countries like Australia & USA

39. The country needs Optometry &Optometrists stand ready & motivated to meet the challenge of Right to Sight in India by 2020

40. My contact details:Rajesh Wadhwa r_wadhwa@yahoo.com 9868010187 www.indianoptometryfederation.org Thank You!