Figuratively speaking, the Indian government may talk of Vision 2020 but it would scarcely want to admit that India is literally the world’s blind capital. Fifty per cent of the world’s blind are in India and the official number is 15 million.
But the fact remains that one in 10 Indians has never had an eye exam. This means there is inadequate assessment of the country’s ophthalmological health. The World Health Organization (WHO) holds that 80 per cent of all causes of visual impairment are preventable or curable.
Indeed, timely attention can address a range of eye-related concerns such as uncorrected myopia, presbyopia, astigmatism or other refractive errors in the eye. Yet, in India, even though the eye is considered the most beautiful feature on a person’s face and possibly the most precious of the senses, it is also the most neglected and it is not till one has lost has lost one’s vision irretrievably that one goes for a check up.
‘Vision 2020: The Right to Sight’, yet another global initiative to eliminate the main causes of all preventable and treatable blindness as a public health issue by the year 2020 (launched in 1999) said that globally there were 253 million people who were visually impaired in 2015 of whom 36 million people were blind and 217 million people had severe or moderate visual impairment (distance). The more significant finding was that 55 per cent of visually impaired people are women.
There are two issues around this troubled vision space in India, the first of which is the shortage of ophthalmologists, of whom there are no more than 12,000 for a country of a billion plus people. The USA has one ophthalmologist for every 15,800 people and that is the accepted ratio.
The second is poor awareness about the need for eye care. It is not surprising, therefore, that India has not lived up to the target set by the WHO for all member states in 2014 to reduce avoidable visual impairment by 25 per cent by 2019, from the baseline established by WHO in 2010. Nor has the National Programme for Control of Blindness and Visual Impairment, launched in 1976 as a 100 per cent centrally-sponsored scheme delivered to its potential.
Given that productivity is so critical in the Indian scheme of things, especially amongst the lower rungs of the economy, it is important to realise that good vision helps people work better, longer and enhance one’s earning years. The WHO estimates, globally, poor vision results in an economic productivity loss of $275 billion.
Yet another study among Indian workers showed that good eye care and vision correction led to an over 30 per cent increase in their incomes and a 25 per cent increase in productivity.
The point is that given the state of technology and the possibility of tele-consultation for patients with eye problems in rural India it is possible to deliver comprehensive tele-ophthalmology, something that has been achieved at a pilot project level in India. It only needs an understanding of the beneficial impact and a commitment to creating an enabling environment of policy and finances to give to all Indians the gift of eyesight.