From Darkness to Light

Most of us take the gift of vision for granted. But, consider this: Every five seconds darkness engulfs a person's world. Every minute a child goes blind worldwide. There are already 45 million blind and 135 million people with low vision globally, with 90 per cent living in developing countries. Eighty per cent of the problem is avoidable. By 2020, an estimated 75 million will go blind.

India is a nine million blind population, and contributes to 25 per cent of worldwide eye problems. Closer home, in Andhra Pradesh, the situation is as bleak. About 1.5 million are blind and 6.5 million visually impaired. One in every 10 people requires serious eye care, and 70 per cent of the problem can be prevented with cost effective intervention, according to a recent study by the LV Prasad Eye Institute, which has taken an initiative along with the state government and the WHO to bring light into the lives of the visually impaired.

The state is the first in the country to launch the Vision 2020: Right to Sight programme, a global initiative by the WHO, governments, eye care organisations, health professionals, philanthropic institutions, individuals and the International Agency for Prevention of Blindness (IAPB), to eliminate avoidable blindness worldwide by year 2020. It aims at preventing an additional 100 million from becoming blind by 2020.

The project in AP envisages an increase in number of cataract surgeries from present 350,000 per year to 500,000 by 2005 and to 600,000 by 2010.

All children with refractive errors and adults over 40 will be provided spectacles by 2005 and eliminate refractive errors in all age groups by 2010. No child will go blind after 2010.

An effective eye banking system of optimal medical standards be developed by 2020, while low vision services initiated and strengthened at tertiary and secondary centres by 2005 and 2010. A task force will be established by January 2002. A second nodal point centre of excellence will be developed at Sarojini Devi Eye Hospital by 2010.

Terming it a happy coincidence with his own Vision 2020 programme for the state, while launching the programme in Hyderabad, a highly enthusiastic Chief Minister Chandrababu Naidu expressed the belief that with the existing infrastructure and resources, the state could achieve the results by 2010 itself.

Something that might not be too ambitious to seek, considering that the state is equipped with the best of resources. There are about 1000 opthalmologists, while a centre of excellence already exists -- the LV Prasad Eye Institute. However, there is a need to build primary infrastructure in terms of tertiary hospitals, and paramedical personnel and evenly distribute it statewide. Currently while East and North seem to be equipped, the South and West part of the state are poor in eye care facilities.

The efforts to eradicate blindness need to focus on women, children, the poor strata of society, the diabetic, who are the major victims of blindness, says R D Thulasiraj, IAPB regional chair South East Asia.

The project will be launched in four 5-year phases, for which a budget of Rs 325 crores is needed over five years. Of this, Rs 168 crores needs shared funding with the balance to be covered by private fees for service. In AP, Rs 1840 crores will be spent till 2020 in eye care, of which Rs 720 to 800 crores required from grants and philanthropy.

"About 50-55 per cent of eye care is paid for by patients, the support is needed for the rest. State government will provide half of it and the rest is needed from donors. We need 16-17 crores a year for AP alone," says IAPB secretary general Dr GN Rao, director of the LVPEI. AP has the most detailed information and the best data that could be available. It also is endowed with resources and it needs to develop a model that can be replicated all over the world, says Dr Allen Foster, senior vice president IAPB.