REPORT ON LOWVISION SERVICE AT ARAVIND EYE HOSPITALS

Comparison Name of the Hospital 2013 2014 2015 Madurai 4967 5120 5558 CBE 3182 3743 3389 TVL 2378 2575 2396 Pondy 1560 1613 1527

No of patient improved with LVD No of Patient Recommended LVA    Name of the Hospital Total No of Patient No of patient improved with LVD No of Patient Recommended LVA Acceptance 2013 2014 Madurai 4967 5120 1214 2379 1055 1478 621 (59%) 706 (48%) Cbe 3182 3743 867 861 493 (57%) 539 (63%) Tvl 2378 2619 1463 2017 885 810 336 (38%) 555 (69%) Pondy 1560 1613 574 588 446 469 169 (38%) 176 (38%)

LVD – Acceptance (Jan – June, 2015) Total No of Patient No of patient improved with LVD No of Patient Recommended LVA Acceptance % Madurai 3024 1245 635 398 63% Cbe 1866 617 502 81% Tvl 1214 1000 302 185 61% Pondy 686 574 269 69 26% Salem Sold 3 Hand Magnifier & 1 Spectacle Magnifier

Man Power Man Power Madurai CBE TVL Pondy Salem Medical Officer 1 1 1  Rehabilitationist -  - Refractionist 2

Referral Pattern (Madurai) Name of the clinic No of Patient Percentage Cornea 9 1% Free 231 15% Glaucoma 121 8% IOL 30 2% Neuro 88 6% Orbit 12 Paed 618 41% Retina 451 30% Unit I 64 4% Unit II 71 5% Unit III 130 9% Uvea 57 Total 1882  

Assessment Equipment Madurai Vision Assessment Charts Log MAR - Distance ‘E’, ‘C’, Letter & Number Log MAR - Near Alphabet & Regular NV chart Reading Book Contrast Auro Chart Hiding Heidi & Lea Symbol for Paed. Colour vision PV 16 Ishihara Peadiatric Vision Assessment Distance Lea Symbol - 3mt Teller card Lea Gratings Lea Single & crowding chart Near Lea Symbol Mail Box Lea Rectangular game Lea Puzzle Lang Stereo test chart Advanced LVD Electronic Video Pocket magnifier Bioptic Telescope Smart Cane (Channel Partner)

CBE Vision Assessment Charts Log MAR - Distance E & C – Chart Log MAR - Near Alphabet & Regular NV chart Contrast Mars Letter Contrast sensitivity chart Hiding Heidi. Colour vision PV 16 Peadiatric Vision Assessment Distance Lea Single & crowding chart Advanced LVD Electronic Video Pocket magnifier

TVL Vision Assessment Charts E chart Contrast Pellirobson chart Colour vision Ishihara Advanced LVD Electronic Video Pocket magnifier

Pondy Vision Assessment Charts Auro Chart Contrast Mars letter contrast chart (Not using) Colour vision Ishihara Advanced LVD Electronic Video Pocket magnifier (Not working)

Salem: Has basic needed lvd for assessment Using only snellen chart No tint, Running light and Electronic device

Other Activities & Projects Madurai: USAID PROJECTS "Ensuring healthy eyes and quality life in premature infants (Proposal for developing a comprehensive ROP program)” Developmental assessment Paediatric Vision assessment Identification of person with low vision in VC (Completed) Dr. Rupa study for cone dystrophy patient Dr. Sathya study – Spectrum of Disorder for children 0 – 3 yrs. Online Education – Low vision Customised Training in Low vision – 15 Ophthalmic Technicians from Srilanka

USAID PROJECT Coimbatore “An approach to the detection and rehabilitation of children with low vision” Organizing camps in special schools, integrated schools and Government day care centers. Vision Stimulation Therapy

Tirunelveli Pondy & Salem Low vision Camp in NGO and School No activities

Mahema Endowment Fund Utilization (Jan – Nov, 2015)   No of Devices Cost Madurai 87 123,090 Tirunelveli 59 25,445 Pondicherry 52 33,500 Coimbatore 61 86,390 Total 259 2,68,425

Low vision service at Different service delivery level Eye Care Service Inventory Diagnostic Equipment Primary Level Vision Centre Hand & Stand Magnifier * 3x Pocket Magnifier * 4x Dome Magnifier * 4x Led Hand Magnifier * 6x Cutaway stand Magnifier * 7x Led Hand Magnifier Spectacle Magnifier * 5D Prismosphere * 8D Prismosphere * 10D Half Eye Spherical * 16D Half Eye Spherical * 20D Half Eye Spherical * Auro chart * Tinted glass for trial * Jaeger chart for near vision

Low vision service at Different service delivery level Eye Care Service Inventory Diagnostic Equipment Secondary Level Secondary Hospital, Community centre & City centre Hand & Stand Magnifier * 3x Pocket Magnifier * 4x Dome Magnifier * 4x Led Hand Magnifier * 6x Cutaway stand Magnifier * 7x Led Hand Magnifire * 8x Pocket magnifier Spectacle Magnifier * 5D Prismosphere * 8D Prismosphere * 10D Half Eye Spherical * 16D Half Eye Spherical * 20D Half Eye Spherical Telescope * 4x Telescope * 3.25x Spec Mounted Telescope Non optical devices * Auro chart * Tinted glass for trial * Jaeger chart for near vision * Black board / White board for telescope trial

Low vision service at Different service delivery level Eye Care Service Inventory Diagnostic Equipment Tertiary Level All Satellite hospital (Madurai, CBE, TVL, Pondy and Salem) Hand & Stand Magnifier * 3x Pocket Magnifier * 4x Dome Magnifier * 4x Led Hand Magnifier * 6x Cutaway stand Magnifier * 7x Led Hand Magnifire * 8x Pocket magnifier Spectacle Magnifier * 5D Prismosphere * 8D Prismosphere * 10D Prismosphere * 10D Half Eye Spherical * 16D Half Eye Spherical * 20D Half Eye Spherical * 24D Half Eye Spherical Telescope * 4x Telescope * 3.25x Spec Mounted Telescope * 3x Clipon Telescope * 3x Spectacle Binocular * Bioptic Telescope Electronic Devices * CCTV & Portable video magnifier Running Light Non optical devices (With smart cane) Special Software Tinted Glass for trial Vision Assessment chart: * Log MAR - Distance # ‘E’, Letter & Number * Log MAR - Near # Alphabet # Jaeger chart for Near vision * Reading Book Contrast: * Auro Chart * Hiding Heidi * Lea Symbol for Paed. Peadiatric Vision Assessment * Distance # Lea Symbol - 3mt # Teller card # Lea Gratings * Near # Lea Symbol * Mail Box * Lea Rectangular game * Lea Puzzle * Lang Stereo test chart

Comprehensive Vision Rehabilitation Primary Level Secondary Level Tertiary Level Reporting should happen from primary to secondary and secondary to Tertiary level. Tertiary level should posses a complete inventory and manpower to provide comprehensive rehabilitation and it will complete the rehabilitation circle. Tertiary level have the responsibility to monitor the primary and secondary level service.

Referral to Tertiary Level (Jan – June 2015) Madurai CBE TVL Pondy Primary Level 14 6 2 Secondary Level 17 9 3 1

Human Resource & Service delivery in Primary level Optometrist Screening, Referral & Reporting

Human Resource & Service delivery in Secondary level Optometrist & Ophthalmologist Treatment, Referral & Reporting

Human Resource & Service delivery in Tertiary level Ophthalmologist, Rehabilitationist & Optometrist Screening, Referral & Reporting

Human Resource & Service delivery in different level Primary Level Human Resource Optometrist Services Screening, Referral & Reporting Secondary Level Ophthalmologist & Optometrist Screening, Treatment, Referral & Reporting Tertiary Level Ophthalmologist, Rehabilitationist & Optometrist Treatment, Training, Research, Advocacy, Awareness creation & Monitoring

RECOMMENDATIONS Madurai,Coimbatore has Rehab staff,to consider recruiting such cadre in tirunelveli and Pondicherry who will be coreperson of the Team To standardise inventory at tertiary centres Capture referral pattern in parameter ,now only in Madurai only it is documented Introduce LOWVISION aids in primary and secondary centres in future