Eyecare is mostly being delivered by not-for-profit sector: G N Rao

Interview with founder and chairman, LV Prasad Eye Institute

Hyderabad-based LV Prasad Eye Institute is in the process of fully establishing six new centres of excellence in eyecare meant for furthering research and its delivery in the country. Speaking to N Madhav, its founder and chairman G N Rao says quality eyecare is in infancy stages in India, and there is a need for standardisation of processes in the system. Edited excerpts

How is the quality of eyecare services being offered in the country?

In rural and remote areas, it is very poor because a lot of eyecare is being delivered through the camps. Secondly, wherever the government has primary health centres, the infrastructure is poor and where there is a proper infra, there is a dearth of trained personnel. So, there is hardly any good combination of both. According to government statistics, eyecare is mostly being delivered by not-for-profit sector in the country, and there is no uniformity in quality.

Do you think eye camps fail to address the need of the hour?

We should have the right kind of system and appropriate trained people delivering services in these eye camps. We should track the way it is being done and what percentage of local population have got the right benefit. If you don't track the outcomes in the long-run, the exercise is of no big purpose.

Social enterprise is being considered a good model to improve healthcare access and affordability.

Social enterprise has a role. But those things have to be carefully monitored to see if they are standardised. As of now, rural areas are not ready for social enterprise. If one looks for returns in terms of actual benefit being delivered, there is a lot of scope. However, what dividend are they looking for, is quite important.

What are the key concerns in the delivery of eye care?

Lack of standardisation is a big concern. In India, there is no proper regulatory system. However, eyecare is somewhat better because it is self-regulated and the private sector is now catching up.

Any new observations in cases involving eye cancer in the country?

A third of eye cancer (retinoblastoma) patients are present in India. It is mostly seen in children and its causes are both genetic and environmental. While we don't know the actual reasons for it, by the time they visit hospital, it is too late. At our centre here, we are seeing 300 new cases coming each year. The treatment we offer is chemotherapy along with the radiotherapy. The advanced intra-arterial chemotherapy, in which we inject drug through arteries to have a greater affect on cancer, costs Rs 6-10 lakh. We are focusing on creating an institute for eye cancer in partnership with some of the best institutes in the West.

Is there a dearth of ophthalmology professionals in the country?

Currently, there is a dearth of quality professionals in eyecare. At our academic institute, we are equipping optometrists with the right kind of training to support our community reach programme. Including the ongoing postgraduate programmes in ophthalmology, we are producing 1,300-1,400 quality professionals for the industry. We are also helping other institutes in the country and the neighbouring nations to create sustainable child eyecare programmes.