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Now in its twelfth year of operation, Asia’s first international training facility for the propagation of sustainable and effective models of eye care continues to reach out to the developing world by sharing its expertise ever more broadly.
 
     
 
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  LAICO conducts collaborative and independent research projects such as clinical trials, prospective studies, community surveys, and operations research in eye care delivery. The infrastructure at Aravind Eye Hospital – clinical laboratories, modern diagnostic tools, high clinical load and extensive community outreach – provides an opportunity for research.

LAICO also provides services to others regarding design, administration, data management and analysis of the research data, LAICO undertakes a number of projects with the support or in collaborations with other organisations.

Current Projects
Developing Aravind Tele-Ophthalmology network in collaboration with Orbis International and Acumen Fund, USA.
Aravind Eye Hospitals, as a centre that handles a large number of patients and as a premier training and research institute, is well placed to further strengthen its mission of eliminating needless blindness globally by deploying tele-ophthalmology for patient care, training & education and capacity building of other eye care programmes. Currently, Aravind Eye Hospitals conduct around 1500 screening camps each year in Tamilnadu and Kerala to identify patients with cataract and transport them to the base hospitals for cataract surgery. With the telenetwork, Aravind is now able to screen patients for specialty diseases like diabetic retinopathy by deploying a mobile van fitted with a complete set up of ophthalmic equipment for diagnosis and VSAT for connectivity between the base hospital and the campsite. Ophthalmologists at the campsite will be able to consult with specialists at the base hospital to diagnose and treat the patients accordingly. This helps patients save time, money and their vision. Aravind collaborates with various leading eye institutes around the world for education, training and research. Institutions such as the Wilmer Eye Institute of Johns Hopkins University, Cornell University and University of Lowa will soon be collaborating with Aravind in teaching and patient consultation. Tele-ophthalmology will further strengthen cross-learning between these Institutes and Aravind for enriched training inputs thus benefiting the students and residents. This technology will be further explored to enhance the skills of ophthalmologists with the latest developments in ophthalmology through e-learning opportunities.

Five year pilot diabetic retinopathy project
Recognizing the rapid increase in the number of diabetics and WHO’s projection that will triple in India to 57 million by the year 2030, the Lions Clubs International Foundation in Collaboration with Aravind Eye Hospitals has conducted a pilot project to develop a comprehensive model to treat diabetic retinopathy in Madurai, Theni and Coimbatore districts of Tamilnadu. The broad objective was to prevent and reduce blindness resulting from Diabetes mellitus. Creating awareness in the community, organizing screening camps and developing a service delivery model for diabetic retinopathy were the specific objectives. Four press meetings have been conducted and 38 write-up and articles about diabetic retinopathy have been published in the local newspapers. A talk on Diabetic Retinopathy followed by a question and answers session was broadcasted on National Radio. Seminars and workshops were conducted for the medical practitioners and ophthalmologist. Health education training was conducted on Diabetic Retinopathy for medical officers, paramedical personnel, Lions, Rotary members, Medical shop owners and Diabetic patients in the hospital. Necessary Information, Education and Communication (I.E.C) materials like posters, booklets, leaflets, stickers were distributed to the public in the project area during training, seminars, visits and counselling.

Based on the experience gained in the Lions Diabetic Retinopathy Project, the World Diabetes Foundation (WDF), Denmark and Aravind Eye Hospital have joined hands to combat diabetic retinopathy. The aim of the project is to create awareness in collaboration with diabetologists, screen diabetic patients for diabetic retinopathy and provide appropriate treatment in Tirunelveli district. It also harnesses the advancements in information technology through the establishment of rural remote screening at Aravind Eye Hospital, Theni and moble unit at Madurai to screen patients through digital imaging, which then transmits to a reading and grading centre at Madurai for an expert opinion and advice.

Health education project
The project was initiated in 2000 under the guidance of Dr. Lakshmi Rahamatullah, then director of the Aravind Center for Women, Children and Community Health in collaboration with SEVA Foundation, USA, with logisties support from LAICO. The duration of the project is 2 years. The main objective of the study is to reduce severe malnutrition (grade III) among children 6-35 months from 7%-4% by motivating their mothers to avail existing nutrition services in Kariapatty block of Virudhunagar district. It also provides health and nutrition education to pregnant women encouraging them to use the nutrition and health care facilities to bring down the low birth weight numbers from 33% to 28%. By making them aware of the importance of good health and nutrition the project hopes to improve the overall status of the pregnant women. All eligible couples, pregnant women and children aged 6-35 months were enumerated and enrolled in the project. Trained community workers visited each mother and provided health education. Details of antenatal care were recorded during each visit. Postnatal detals of children and mothers were also recorded. The height, weight and mid arm circumference of children were recorded. Birth weight of all newborn children was collected. Details of immunization was noted. Regular community meetings were conducted to impart health education to large group. A nutrition supplement utilizing locally available food materials was prepared and provided to all children in the block. Voluntary women’s groups are now being trained in the preparation of this supplement. The project is currently in its evaluation phase.

Kariapatti Paediatric Eye Evaluation Project (KPEEP)
The Kariapatti paediatric eye evaluation project was initiated in April 2002 by LAICO, and the Department of Paediatric Ophthalmology at Aravind Eye Care System, Madurai and Aravind Center for Women, Children and Community Health, in collaboration with SEVA Foundation, USA, and SEVA, Canada. The project aims to determine appropriate strategy(ies) for paediatric eye care service delivery in the region based on scientific estimates of magnitude of disease, current practices, knowledge and awareness of disease among caretakers of children, existing utilization patterns, and an evaluation of different service delivery strategies. The project performs ocular examinations on approximately 25,000 children from 144 villages in Kariapatti. The prevalence of blindness was estimated to be 6.2 per 10,000 children. Initially trained community workers screened children, and secondary screening & examination was performed by a clinical team from the paediatric ophthalmology department. Three different service delivery strategies have been tested and the results are presently being analyzed. The project is now starting to train voluntary womens groups to screen for ocular abnormalities in children as an intervention strategy to improve the uptake of service. This phase of the project is expected to be complete by December 2003.

International Eye Foundation Project
International Eye Foundation (IEF) and Lions Aravind Institute of Community Ophthalmology (LAICO) have joined hands to develop resources for implementing Vision 2020 strategy.
LAICO with Aravind has developed considerable experience in running its own network of hospitals and working with 216 eye hospitals to improve their efficiency and effectiveness. However for wider application, this experience will need to be translated into case studies, protocols and tools for effective teaching, planning and implementation. These resources will include consulting tools, model for planning of services / hospitals, administration and clinical protocols, Human Resource Management tools and process protocols for quality assurance, demand generation, etc. Further Aravind and LAICO have a rich resource of materials on eye care. These organized materials can be used by all.
A considerable amount of work has been carried out on both the tools development and organizing the materials for what we hope will become Aravind Vision 2020 Resource Centre. Currently we are validating the existing tools and identify new tools that can be helpful for implementing the Vision 2020 strategy. A website ‘aravind eyesite’ exclusively for the management eye care resources in being developed as a part of this project. http://www.v2020eresource.org

ORBIS – Aravind Paediatric Ophthalmology and Paramedical Training Centre
The prevalence of childhood blindness in India is five times that in the developed world. In terms of infrastructure and manpower to tackle the existing problem India has inadequate paediatric eye care centres and trained personnel to deal with the problem of childhood blindness. Inadequately trained ophthalmologists practice only medical ophthalmology and do not undertake any paediatric eye care surgeries. Because of inadequate trained ophthalmic human resources, many conditions like ocular injuries are treated by non-ophthalmologists like general surgeons or physicians. Even anaesthesia facilities for paediatric surgeries like ocular injuries are inadequate.
The insufficient number of well-trained mid-level ophthalmic workers greatly limits the quality and availability of services. At the primary level, there is a shortage of adequate trained personnel to undertake preventive and promotive paediatric eye care.
Effective delivery of paediatric eye care services requires a team approach. This project will contribute towards the development of trained manpower as a team consisting of a Paediatric ophthalmologist, optometrist, ophthalmic assistants and Anaesthetist to combat childhood blindness in Inida as well as in the South Asian region. By the end of the project period a total of 77 paediatric ophthalmologists and paramedical personnel will have been trained to render paediatric eye care services in the region.

Biostatistics Department
Biostatistics is an essential part of medical research and hence is vital in Aravind Research Foundation. The department’s primary role is to augment the research carried out in Aravind Eye Hospitals and LAICO by providing valuable inputs in design at the initial stage and all phases of clinical / population based projects. Further guidance on data collection and analysis is provided to the researcher. Analysis, presentation and interpretation of data is done at the department along with the researcher.
Data entry and management is done in high scale for population based studies such as the Paediatric Eye Survey and the Corneal Abrasions study that are currently on. There have been successful inputs by the department in the past studies such as MIOLS, VASIN and Cataract Program Evaluations (at Sivagangai, Tirunelveli and Palakkad). All these results have also been published.
The department is involved in providing biostatistical inputs to the PG Ophthalmology students for thesis and presentations through consultations. Reviewers are provided with inputs on the statistical content in research articles. The department coordinates with Epidemiologists, Project managers and Programmers in an effort to improve the quality of research.
Sophisticated statistical packages such as Stata, SPSS, Epi Info and Geographic Information System like Health Mapper (WHO) and ESRS’s Preview GIS are now employed in this department.