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Rural Vision Centres - Aravind Eye Care System
Background:
Blindness and vision impairment is a major public health problem in India. Nearly 90% of the blindness in India is treatable and is attributed to either age related cataract or refractive errors. Other major causes for blindness are also on the increase as population demographics shift towards aging and people live longer. Conditions like diabetic retinopathy, age related macular degeneration and glaucoma assume importance from an adult blindness perspective. Childhood blindness and ocular morbidity is also being recognized as a major priority area for eye care programmes. There are an estimated over 200,000 children blind in India, about 42% of this blindness is avoidable. 11 million blind person years are estimated to be lost in India due to blindness in children compared to 22 million blind person years lost due to age related cataract.

Although several models for adult eye care exist including tertiary care models and outreach or eye camp models, utilization of services remains low. Several studies in south India have elucidated the barriers that exist to uptake of services from current models of care. Cataract surgical output in India has improved considerably from 1.5 million cataract surgeries per year to 4 million cataract surgeries per year, however, the backlog.

The overall goal of this project is to reduce needless blindness and vision impairment in Theni District through improved utilization of eye care services.

Objectives
  • To develop primary eye care service centers within communities and to develop links from these centers to available secondary and tertiary eye care centers using information technology.
  • To determine acceptance rates for services including compliance to follow-up and advised treatment.
  • To determine the quality of the outcome of the surgery and services (physical and social)
  • To determine cost effectiveness of the model.
Methodology:
Service Delivery:
    • Provide ophthalmic eye care services in Theni including identification and treatment for ocular disorders for adults and children. • Develop links from communities to existing eye care service providers such that persons with ocular disorders and receive timely and appropriate treatment.
Process:
    a) Identify adults and children with curable blindness using trained community workers. b) Develop eye care service centers within villages based on geographical clustering of villages or population size. c) Train eye care link workers as vision assistants

Vision Centre
  1. Active screening services
    1. Refractive error
    2. Cataract, squint & other external eye diseases
  2. First Aid services
    1. Conjunctivitis
    2. Corneal abrasion & corneal ulcer
    3. Trauma
    4. Foreign bodies
  3. Ophthalmogist services
  4. Referral services
  5. Health Education
  6. Follow up & compliance
  7. Population based surveillance system
  8. Training programmes
  9. School screening programme
  10. Report generation
At the Community Level
  1. Training Programme
  2. Household survey
  3. Compliance monitoring
  4. General Health and Eye Care Services awareness and promotion
  5. Networking with other NGO’s
  6. Strengthening the manpower
  7. Refreshment Training
  8. Reward given to the best performed group
  9. Getting feedback from the volunteers and
  10. Documentation
  11. Regular contact with the Vision Centre
At the Base Hospital Level
  • Generating the referral list from the vision centre and the community
  • Data base on treatment offered and follow up to be made.
  • Regular correspondence with vision centre.
  • Reporting will be done from project office at the base hospital, Theni to Madurai
Outcomes
Provision of primary eye care services to 5 centres in Theni District