In India, diabetic retinopathy was the 17th cause of blindness 20 years ago. Today, diabetes-related blindness has ascended to the 6th position.Diabetes prevalence in India is expected to rise 195% from 18 million in 1995 to 54 million in 2025. With better treatment modalities being available for the treatment of diabetes, the life expectancy of this population sub-group is also increasing.With this, the prevalence of diabetic retinopathy is also likely to increase.The project seeks to prevent blindness resulting from diabetes through screening, treatment and care.
In India, there is an inequitable distribution of wealth and resources. At the same time, 70% of the population lives in villages, and about 80% of ophthalmologists practice in the cities. India has one ophthalmologist per 100,000 population, and this ratio is even more dismal for rural settings.Screening for diabetic retinopathy can be either ophthalmologist-based or ophthalmologist-led. Given the ophthalmologist/population ratio, the ophthalmologist-based approach is not cost-effective.Tele-ophthalmology, an ophthalmologist-led screening model, offers a cost-effective and feasible model for screening large groups of people in remote and often poor areas.The Vision Research Foundation, Medical Research Foundation and the Indian Space Research Organisation collaborate to develop, test and implement this model.Geographically, the project targets the districts of Bangalore, Kolar, Mandya, Mysore, Chamrajnagar and Tumkur in Karnataka.Mobile units will be equipped with the latest technology for screening and satellite communication and manned by optometrists. These units will be used to access rural, remote areas to conduct screening camps for diabetic retinopathy.Before each of these camps, two screening camps for diabetes will be conducted to detect undiagnosed people with diabetes in the population.The data and images for people consulted in the mobile unit will be transferred to the hub at Sankara Nethralaya in Bangalore, where a vitreoretinal surgeon will review the pictures and data and advise management.All people detected to have diabetic retinopathy at the screening camps would undergo detailed clinical evaluation and ancillary investigations like ultrasound if required in the van itself by the optometrists.The ophthalmologist will advise appropriate treatment, either in the form of laser photocoagulation or surgical intervention.Once treatment is over, appropriate follow-up schedules with fixed follow-up dates will be given to the patients.Patients with advanced diabetic retinopathy who are not amenable to further treatment will be provided with low visual aids in the van by the optometrist.Treatment will be free to all patients with income less than USD 40 per month.
• Awareness of diabetic retinopathy enhanced in general population in 6 districts of Karnataka• 51,261 Diabetics who underwent Eye exam • 8,445 diabetic retinopathy patients underwent treatment and advice• 429 people received laser treatment and 20 people underwent vitrectomy