MOBILE VISION CARE
Community outreach programs have been an integral part of Mehboob Charity Vision from its inception in 2015. Since then, the outreach eye camps have worked extremely well in identifying and surgically treating cataract patients in high volumes. In the 2018-19 financial year, Mehboob Charity Vision screened more than 10,000 patients and performed close to 900 cataract surgeries through over 36 outreach camps.
This approach has significantly contributed to clearing the backlog of cataract blindness, identifying and treating refractive errors, and other anterior segment eye problems. However, this model has not been optimal in addressing sight threatening ailments of the posterior segment such as diabetic retinopathy, glaucoma, optic neuropathy, and vascular occlusions.
In the conventional eye camps, ophthalmologists use torchlight and direct ophthalmoscope for screening while refractions use streak retinoscope and trial sets for refraction. Intro-ocular pressure is measured using a Schiotz tonometer. All the camps use manual paper-based medical records. The stations and activities in the camps are well standardized to maximize efficiency and to ensure quality. These camps are designed to provide sustainable eye care to the rural masses through subsidized prescription spectacles. Cataract surgery including to and fro transport, stay, food, and post-operative medications are provided on paid, subsidized free of cost depending on the financial standing of the patients.
Mehboob Charity Vision has introduced a novel approach to existing outreach with the use of an array of innovative low-cost technology and established Satellite Optometry Clinics. The goal is to enhance the comprehensiveness and yield of eye camps with a special focus on posterior segment diseases.
The establishment of Satellite Optometry Centers in the MCV catchment region has led to a considerable increase in the rate of early detection of sight-threatening problems and referral to the base hospital compared to the conventional approach. The medical record of screened patients helps in tracking and following up with the patients referred to the base hospital more effectively compared to the old referral system. Early detection of sight-threatening ailments will help to have improved treatment outcomes and reduced treatment costs.
Our experience shows that this novel approach of community outreach and converting to Satellite Optometry Clinics can address all the broad three aspects of sustainability – Social, Economic, and Environmental.
From a social responsibility perspective, eye care providers should focus on prevention, promotion, treatment, and rehabilitation. This will ensure comprehensive and holistic eye care delivery to unreached populations. It is important to identify and treat cataracts and refractive errors which are the major causes of avoidable blindness. But focusing only on these low-hanging fruits will leave that patient with other major sight-threatening eye problems unaddressed. Identifying these conditions at early stages is crucial in preventing vision loss and promoting eye health for communities at the grassroots level. This approach will help improve the quality of life and wellbeing of active citizens thereby ensuring social sustainability, especially in unreached communities.
Outreach camps are targeted to reach the unreached rural populations that are economically underprivileged. This modified approach enables more comprehensive screening for eye problems, especially of the posterior segment, leading to early detection and management. This ensures significant cost savings for the patient who will have to travel to a base hospital in a faraway town to diagnose the problem. Moreover, when the problems are at later stages, more advanced and expensive interventions such as surgery will be required for treatment. Early detection also ensures better treatment outcomes thereby making it more cost-effective both for the providers and the patients.
The community outreach model as such has been environmentally friendly because a large number of patients are screened in one location ensuring optimal utilization of resources. Patients who required eyeglasses can avail a pair on the spot in about 30 minutes’ time, thereby saving multiple travel sessions to a distant place. Patients who are identified for cataract surgery, usually 60-70 patients from one camp, are transported in MCV Van to base hospital. This significantly reduces transportation-related emissions compared to the patients traveling separately. As the screening in the novel approach is more comprehensive, the referral rate to the base hospital will be more appropriate and avoid unnecessary referrals. This again reduces the number of hospital visits.