Eye Care in India

by Sudeep Pramanik, MD, MBA

Central Pennsylvania Eye Institute
sudeeppramanik@yahoo.com

Like most of the developing world, India is burdened by a high rate of avoidable blindness. There are 15 million of the 1.08 billion population who are visually challenged. There are 52 million visually impaired, and childhood blindness affects more than 320,000 kids. The estimated financial burden to India is $11.1 billion. In the 1970s, physicians recognized that the government alone could not meet the eye care needs of the population. Across India, private doctors established an alternate health care model that supplements the efforts of the government and is also self-supporting. Great strides have been made in making eye care more efficient, higher quality and more affordable. For example, an intraocular lens manufactured in India costs $5 (versus $150 in the US), and the total cost for a cataract surgery and lens implantation is between $10-15 (versus $650-1200 in the US). Reduced costs allow even working class Indian citizens to have access to care for themselves and their families.

Photo 1: Birdseye view of the Aravind Eye Care system, Madurai, India

This past December, as part of my cornea fellowship at the University of Iowa, I was able to travel to India to teach and perform eye surgery at the Aravind Eye Hospital, Madurai (http://www.aravind.org/), the Vittala Institute of Ophthalmology, Bangalore, and the Disha Eye Hospital, Barrackpore (http://www.dishaeye.org/). These institutes have been at the leading edge in providing quality, affordable eye care to the masses. The revenues from paying patients as well as donations fund their public service outreach work. They are supported by organizations in the U.S. like the Combat Blindness Foundation (http://www.combatblindness.org/). They are also actively involved in the training of resident physicians from the U.S.

With such a large number of patients in need of care, there are ample opportunities for residents and fellows to see patients and perform surgery. I look forward to continuing my work with them in the future. Next spring I will return to teach courses on endothelial corneal transplant. I will also work with Dr. Michael Abramoff who is developing a low cost, automated method to screen for treatable eye diseases in children.

Photo 2: Waiting lines at the Free Hospital

There are many blessings we enjoy in America. Among them is an excellent health care system. In the developing world, most patients live in remote areas without ready access to care. As technology advances, it provides a unique opportunity in history to bridge this gap. By transferring skills in business management, technology, and surgery, the U.S. has a great opportunity to benefit citizens in the developing world. Also, by collaborating with researchers overseas, the U.S. stands to benefit from studying large cohorts of patients with less common diseases. It is a win-win situation that makes working in international medicine quite rewarding.