A concerted effort to develop infrastructure and research at all levels of eye care will go a long way in combating the incidence of unavoidable blindness in the country, according to Dr G N Rao, Director, L V Prasad Eye Institute, Hyderabad.

Delivering the first Dr Narendra Swarup Memorial Lecture on "The future of ophthalmology in India," Dr Rao said training a committed faculty, evolving a standard curriculum by the Medical Council of India and training paramedical staff were essential if preventable and avoidable blindness was to be eliminated in the country.

He said a four-tier pyramidal structure should be developed starting from vision centres at the rural areas to the centres of excellence at the top. Dr Rao said poor budgetary allocation, poor quality residency training, unequal distribution and under-utilisation of ophthalmological infrastructure, lack of standardization and undue emphasis on surgery were some of the challenges faced on this front and they needed to be tackled immediately.

Medical colleges and hospitals, as training centers, should ensure excellent residency training, and centres of excellence at the top should focus more on research and system development. Proper attention should also be paid to tackle the problem of low vision, he said.

Dr Rao said Indians suffered from several eye diseases. The experts here need to develop a passion for excellence for making the country free of all avoidable blindness. Referring to the problem, Dr Rao said the diagnosis of eye-related diseases was poor in the country. "Research lacked vigour and hence we need a focus to develop research and the experts should come forward to produce more journals related to eye care," he said.

Almost 50 per cent of the population in the country earns Rs 260 a month and they cannot afford eye care. On the other hand, the government, which is already overburdened with responsibilities, can offer very little in this direction. In spite of that promotion of quality eye care can be a reality. The state government had announced "the right to sight" in its Vision 2020. This needs a number of training programmes. Research needs major funding and manpower to promote eye care. He said ophthalmologists should review the need of the people and develop the infrastructure independently without the support of the government agencies. Para-medical personnel should also be trained for better results in eye care.

He said by 2020, the global blindness would touch the 75-million mark and the goal should be to bring it down to at least 20 million. Mooting an action plan, he said each vision centre at the lowest level should be made to provide primary eye care to a minimum of 50,000 people and the district hospitals and private eye clinics should take up secondary care, rehabilitation of the blind and public education programmes.

Dr G Shyamsunder, Vice-Chancellor, NTR University of Health Sciences, Dr L N Sharma, member of the Sushila Swarup Charitable Trust and others also spoke.

Earlier, a workshop on Manual Small Incision Cataract Surgery was conducted in which Dr Ravi Kumar Reddy of Sarojini Devi Eye Hospital, Dr Ravi Thomas of LVPEI and Dr M S Ravindra of Kartik Netralaya, Bangalore, gave their views. About 200 doctors attended the programme organised by Swarup Eye Clinic and Sushila Narendra Swarup Charitable Trust.