Operation Eyesight India is a non-governmental organization with its head office in Hyderabad. It is part of Operation Eyesight Universal, a Canada-based international development organization working to prevent blindness and restore sight in South Asia and sub-Saharan Africa. Founded in 1963 to address the backlog of cataract surgeries in India, Operation Eyesight now has comprehensive eye health programmes in eight countries. Common eye issues that we see in these countries include cataracts, trachoma, eye cancer, diabetic retinopathy, glaucoma, macular degeneration, and uncorrected refractive error, among others. When people suffer from poor eye health, their quality of life is diminished and the cycle of poverty is perpetuated. By creating access to affordable eye health care services and addressing the root causes of avoidable blindness, we create a lasting impact in our communities of work – For All The World To See.

In India, we are currently working with 35 partner hospitals (including government health departments and eminent universities) across 18 states, covering over 90 underserved districts. To date, we have established 145 Vision Centers, 18 Advanced Vision Points, and 37 Vision Points, and declared over 1,072 villages as avoidable blindness-free. In 2021 through our initiatives, nearly 700,000 people received a comprehensive eye examination, nearly 160,000 patients received sight-saving surgery and over 180,000 pairs of prescription eyeglasses were dispensed.

Our work in India falls into four thematic programming areas:

• Health System Strengthening: We collaborate with hospital and government partners to ensure that hospitals have the resources necessary to provide quality eye health care, and to integrate eye health care into the primary health care system. We build the capacity of hospitals, increase human resources and implement referral linkages within existing systems.Secondary- and tertiary-level eye care is often the crucial missing piece of a complete eye health care system. Establishing and upgrading hospitals through new equipment, technology, and renovations to facilities improves the availability and quality of services. There are currently not enough trained ophthalmic personnel and eye health workers at the primary and secondary levels – and this personnel are critical to eliminating avoidable blindness. We’re working with our partners to close the human resources gap so that together we can address common eye conditions such as cataracts, uncorrected refractive error, diabetic retinopathy, and glaucoma.
• Vision Centers: Vision Centers are permanent facilities that are established in strategic locations within a project area and staffed by trained eye health personnel. They act as a link between communities and our partner hospitals, providing eye exams, dispensing prescription eyeglasses, and referring patients to the hospital for treatment as needed. Most of our Vision Centers become self-funding within a few months of their establishment. This is done through meticulous planning and a cost-recovery model where revenue generated through the sale of eyeglasses and from patients who can afford to pay for services helps offset the cost for those who cannot afford to pay.
• Community Eye Health: Sustainability is often looked at from the “supply-side” (service provision) and rarely through the “demand-side” (generating need in the target area). We look at sustainability from both perspectives. Our community-centric approach leads to a community’s ownership of their eye health. Through our Hospital-Based Community Eye Health Programmes, we train and employ women as Community Health Workers (CHWs). CHWs conduct door-to-door surveys, identify those with eye health issues and refer patients to a Vision Center or appropriate facility for treatment. They also conduct health education sessions in the community to increase the knowledge and awareness of eye health, thus encouraging eye health-seeking behavior.
• Maternal and Child Health: Through our community outreach programs, we address the root causes of avoidable blindness. Community health workers educate families about nutrition, immunization, newborn care, prenatal and postnatal care, and other health issues. We work with various community partners to provide eye drops for newborns and vitamin A supplements for children under five. In 2020, we also opened a Retinopathy of Prematurity clinic to screen infants at risk and provide treatment to those suffering from the condition.
• Sustainable Development Goals: Through our mission to prevent blindness and restore sight, we are contributing to the achievement of the Sustainable Development Goals. While all of these goals are interconnected, we focus on five goals that are core to our mission: Good Health and Well-Being, No Poverty, Gender Equality, Clean Water and Sanitation, and Partnerships for the Goals.

According to the 2019 World Report on Vision, at present, at least 2.2 billion people around the world have a vision impairment, of whom at least 1 billion have a vision impairment that could have been prevented or is yet to be addressed. Overall potential productivity losses of moderate and severe vision impairment and blindness were estimated at $408.5 billion PPP, 0.5% lower than estimates using GDP. As per projected changes in vision loss from 2020 to 2050; the vision loss will increase by 55% or 600 million people. By 2050, the number of people over 65 will almost double; this is concerning as the prevalence of vision loss increases rapidly with age. The World Report on Vision recommends an integrated people-centered programming approach with eye care as an integral part of healthcare delivery systems, supported by high-quality research and community engagement for desirable outcomes.India contributes to 21% of the world’s blind population and 22% of the world’s visually impaired population. Up to 90% of these people are suffering from avoidable blindness, which means their condition can be treated or could have been prevented.

Eye health is one of the most neglected areas of India’s public health care delivery systems and suffers more acutely from the traditional challenges of a lack of adequate funding, appropriate infrastructures, human resources, service delivery tools, models, accountability, and integration into existing public health systems.The two major challenges that are adversely affecting eye care in India are inadequate facilities and a lack of access. In India, there are 16 ophthalmologists per million population and the ratio of ophthalmic assistants is 7 per million population. With a population of more than 1.32 billion people, this means a serious shortage of medical professionals leading to a severe limitation in both the screening and treatment of eye conditions in the country. While there are regions that have a ratio of 1:9,000 (mostly urban centers), some regions have a ratio as low as 1:608,000. The uneven distribution of surgeons, compounded with the underutilization of their skills and the unavailability of optometrists for basic procedures, has resulted in an unabated increase in avoidable blindness, despite all the efforts made so far by the government, private sector, and civil society organizations.Recognizing the critical need for eye health services, the Government of India included eye health in its service delivery package under its ambitious “Ayushman Bharat” program, but there are many gaps in the program that need to be addressed, including gaps in policy development, referral mechanisms, and supply chain management. The situation in India is further exacerbated by limited financial and human resources, inadequate eye health facilities, a lack of trained eye health care personnel in rural areas, and a lack of access to eye care services.

Operation Eyesight is partnering with Government bodies and partner eye hospitals to address these issues. With the participation of the corporate, the elimination of avoidable blindness from fellow Indias can be achieved at a greater scale at a faster pace. This will allow for better living conditions, enhanced livelihood, and overall increased productivity of the society; thus boosting the economy and progress of the country.