Public Health and Optometry

Dr Uday Kumar Addepalli

Health is influenced by innumerable societal factors with direct effects on the quality of life and socio-economic standing of an individual. Here, rural communities are affected at large due to their poor economic status impacting health care services. To this end, medical community strives to grow to address the global needs by developing health strategies to reduce the burden on the society. The main objective of these policies was to establish public health activities to develop community health care providing comprehensive assessments in rural and urban communities. During the process of developing quality in overall health care, public health in eye care has eventually advanced in specializing and expanding into a broad spectrum of delivering eye care services with the assistance of optometrists and mid-level ophthalmic personnel.

According to the World Council of Optometry (WCO) “Optometry is a healthcare profession that is autonomous, educated, and regulated (licensed/ registered), and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/ diagnosis and management of diseases in the eye, and the rehabilitation of conditions of the visual system.” Thus far, there are about 300,000 Optometrists and the need of additional Optometrists rises due to eye health needs. In developing countries, the ratio of Optometrist to population is 1:600,000 or even worse. This concern has gradually and effectively driven Optometry into public health to become an integral part by ensuring quality eye care services reaching the high-risk populations. Therefore, it is utmost important to know that Optometry in public health has become a necessity especially in reducing avoidable blindness and visual impairment or identifying sight threatening conditions starting from the grassroots level.

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In India, 133 million people are living with blindness and visual impairment, of which the majority of them are due to the lack of basic eye care needs. This situation is aggravated by the fact that there is inadequate number of optometrists to address these needs in the rural communities who could serve as primary eye care providers. Furthermore, lack of an organized, stable governing body and appropriate recognition to the profession hinders the basic standards for independent Optometry care. Considering the global burden of blindness and visual impairment the scope of public health optometry goes beyond a school or a community screening program.

Optometry plays a major role with its intrinsic core values in the American Public Health Association affairs. In major affluent countries like USA, England, Scotland and Australia Optometry services in public health are vastly expanding where Optometrists act as the primary eye care providers. Vision programs such as Visiting Optometry Schemes (VOS) established more than a decade ago or recently established Vision CRC research programs focuses particularly on building a comprehensive and quality eye care and in improving the accessibility of eye care services in aboriginal islanders. Such programs aim at increasing the number of Optometrists delivering sustainable eye care to the remote communities. With these systems in place, they witness an increase in access to eye care services and Optometry examinations from 50% to 97% in the above mentioned countries. In spite of a good governing body for the profession, Optometry in New Zealand lacks initiatives in public health sector and in most of the rural areas, where a general practitioner or a nurse provides the basic eye care instead of an Optometrist or other eye care professionals, despite having more than adequate number of Optometrists in the country. This reflects the unavailing health care system and the current status of public health optometry in this region.

Hands-on screening training to community eye health personnel (left) & A snapshot from an awareness program on how to protect the tender eyes from the harmful radiations of higher altitudes; as part of Himalayan Vision Project – A collaborative project with L V Prasad Eye Institute to provide comprehensive quality eye care services to the communities living in higher altitudes (right).

Apart from the opportunity to experience and learn from various people, communities and cultures around the world, major competencies as an academic, a researcher, innovator of technology or quality eye care delivery system, appropriate utilization of technology or innovations for the benefit of the community, most importantly as a clinical acumen and an entrepreneur with skills in developing an isolated vision clinic to major social public-private partnership programs comes amidst. As Dr Rao wishes the future generation Ophthalmologists as the “3 H – Ophthalmologists”, with a rich combination “Hands”, “Head” and “Heart”, I would say that the same thing holds true for an Optometrist as well, the “3 H-Optometrists” who will be the driving force to bridge the gap at the last mile by creating opportunities in every scope.

Overall, there is a great need for improving the role of public health Optometry in delivering quality eye care to the communities in the remotest rural areas with shared eye care system, keeping aside the corporate hierarchy for the benefit of most neglected communities of the world is the need of the hour.

Finally, I would like to thank ALO for giving me this opportunity and I wish all the ALOians good luck in all of their future endeavors and for any queries on role of Optometry in Public Health or just a friendly advice on Optometry as a career option, you are always welcome to drop me an email at udeyes@gmail.com, or a text on +64225662344 (Whatsapp and Mobile).

Dr Uday Kumar Addepalli graduated from Bausch and Lomb School of Optometry (BLSO) in the year 2004. Acquiring great clinical skills, he worked as a consultant Optometrist in different regions of India and Dubai. Later, he returned to LVPEI in 2008 to continue his clinical and research career. In the year 2010, he started to pursue his PhD from the University of New South Wales (UNSW) whilst working as a consultant Optometrist. Uday, being an ambitious Optometrist, held different academic positions and became the head of quality and technical standards in 2015. He played a major role in establishing new vision centers in various parts of South Indian rural communities and actively involved himself in training vision technicians (VT’s) to deliver high quality and sustainable eye care to the community. Uday has recently attained his doctoral degree, PhD in Optometry and Vision Science from UNSW, Australia. Being a clinician, researcher and public health Optometrist, his focus is to empower remotest rural communities with high-quality comprehensive eye care services. With that passion, Uday recently moved to Auckland, New Zealand and continues his work for many national and international communities and groups supporting the elimination of avoidable blindness. He is now into retailing of Luxottica group and a consultant for One Sight Foundation for establishing and implementing vision centers in Bangladesh. He was also nominated as a Global Goodwill Ambassador (GGA) for India, New Zealand and Bangladesh.

Reference 

1. Prieto, Laura. "Who is an optometrist?"