1. Optometry in India- Optom. Rajesh Wadhwa M.Optom B.Ophth.Tech.(Hons.) AIIMS B.Sc.(Hons.) DU Fellow of International Association of Contact Lens Educators (Australia) PGDHRM (IGNOU) where do we stand?

2. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 What do we see in a process.... We see what the mind wishes to appreciate We see what the mind wishes to appreciate An Intellectual sees Public health professional sees Corporate sees opportunity Optometry has rewards for all… -Society --Universities --- Country ----Corporate ----- Hospitals

3. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 When the knowledge of profession and willfull effort of all will flow in the country …. Country will also save US$ 23 billion per year through eye-care In addition to improving quality of life for many…..

4. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 World has…. 37 Million blind 37 Million blind India owns 15million India owns 15million Visually impaired in world=133million Visually impaired in world=133million India owns 52 million India owns 52 million This little child misses school Poverty & blindness encourage each other

5. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 What is the cost to country? We can save here We can save here India: the loss of productivity & economic burden of maintenance is over $23 billion per year India: the loss of productivity & economic burden of maintenance is over $23 billion per year

6. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Monetary loss is not the real pain........ about 85% of all vision impairment and 75% of blindness globally could be avoided, prevented or cured (need personnel, facilities).... about 85% of all vision impairment and 75% of blindness globally could be avoided, prevented or cured (need personnel, facilities) This is where optometry is eager to share the responsibility This is where optometry is eager to share the responsibility Do we know? NPCB partnering with other agencies is doing a commendable job to eliminate the “needless blindness” by year 2020

7. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 India Main cause of visual impairment is “unoperated cataract” (72L) & “uncorrected refractive error” (24L) Main cause of visual impairment is “unoperated cataract” (72L) & “uncorrected refractive error” (24L) We have only about 6000 surgically active ophthalmologists (general perception) We have only about 6000 surgically active ophthalmologists (general perception) We need another professional to do non-surgical work in eye-care We need another professional to do non-surgical work in eye-care Answer is “Optometrist” (we are 40,000+) Answer is “Optometrist” (we are 40,000+) Who is an optometrist ?

8. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 WHO through World Council of Optometry Classifies Classifies Optometry as an independent primary health-care profession And And defines optometrists as 'the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, the detection/diagnosis and management of diseases in the eye, and the rehabilitation of conditions of the visual system”

9. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Questions regarding optometry today What can optometry offer in eye care ? What can optometry offer in eye care ? What can an optometrist do to relieve the time of ophthalmologist ? What can an optometrist do to relieve the time of ophthalmologist ? Is optometrist different from optician ? Is optometrist different from optician ? Who represents optometry in India for any policy? Who represents optometry in India for any policy? How will society, universities, country,health care system & corporate world benefit from growth of optometry? How will society, universities, country,health care system & corporate world benefit from growth of optometry? Next slide is a busy-slide

10. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 What can an optometrist do as an independent practitioner Other fields include: Other fields include: Spectacle dispensing Spectacle dispensing Spread public awareness about common eye conditions, their treatment and the need for regular eye check-up Spread public awareness about common eye conditions, their treatment and the need for regular eye check-up Timely referral of patients where medical/surgical intervention is required Timely referral of patients where medical/surgical intervention is required Low Vision Aids, assistive vision devices & rehabilitation Refraction Contact Lenses Childhood blindness Orthoptics, & pre/post op co-management Tonometry, fields, A-scan etc.

11. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 An optometrist.. ….is able to deliver appropriate level of high quality eye care from the small clinic or practice in remote region as a stand- alone vision care and eye health expert ….is able to deliver appropriate level of high quality eye care from the small clinic or practice in remote region as a stand- alone vision care and eye health expert

12. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 e.g. in my small practice of 10 new cases a day : We detect-by looking at eyes 1/wk we detect a new hypertensive 1/wk we detect a new hypertensive 1/wk we detect a new diabetic 1/wk we detect a new diabetic 1/mth we detect glaucoma (3 suspect) 1/mth we detect glaucoma (3 suspect) 1 in 2yrs we detect lesions at higher centers 1 in 2yrs we detect lesions at higher centers

13. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Why is optometrist a health care professional Diagnose conditions due to systemic diseases and refer patients to other health practitioners as needed. Diagnose conditions due to systemic diseases and refer patients to other health practitioners as needed. This integrates optometrist with rest of health-care system This integrates optometrist with rest of health-care system Hong Kong, Malaysia, Mauritius, Philippines, US, UK,Australia, Canada are some countries where the use of diagnostic drugs is now permitted to qualified optometrists Hong Kong, Malaysia, Mauritius, Philippines, US, UK,Australia, Canada are some countries where the use of diagnostic drugs is now permitted to qualified optometrists Overcoming obstacles in Outreach Socially optometrist is first point of contact & therefore first line of defense against blindness

14. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Organization of eye-care Ophthalmologist represents the highest level of eye-care- provider in India Ophthalmologist represents the highest level of eye-care- provider in India We have optometrist & opticians also We have optometrist & opticians also

15. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 India-in a process at this time Every one does almost everything Optician dispenses spects….ALSO prescribes spects & fits contact lenses Optician dispenses spects….ALSO prescribes spects & fits contact lenses Optometrist does orthoptics, investigations, prescribing spects, contact lenses etc, also manages minor eye-ailments & runs optical outlets Optometrist does orthoptics, investigations, prescribing spects, contact lenses etc, also manages minor eye-ailments & runs optical outlets Ophthalmologist practices medicine & surgery ….AND does orthoptics, refractions & runs optical outlets Ophthalmologist practices medicine & surgery ….AND does orthoptics, refractions & runs optical outlets Ophthalmologi sts Opticians Optometrist

16. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 In countries with mature eye-care system Performs surgeries & medical work Ophthalmologist Prescribes spectacles, LVA, orthoptics etc fits contact lenses, investigates treats minor eye ailments etc. Optometrist Dispenses spectacles on prescription Optician In USA & Australia, approx 70% of all eye care is provided by optometrists

17. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 In countries with mature eye-care system Opthalmologist Ophthalmic assistant OT- technician Optometrist Optometry assistant Back office staff In India “ophthalmic assistant” is not this level of professional. “Optometrist” is sometimes called ophthalmic assistant in India In India when quality students qualify, some tend to move to countries where optometry is a recognized profession (in USA this is 4 th most preferred profession)

18. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 As optometry professionals Our primary public health responsibility is to eliminate uncorrected refractive error (URE). Our primary public health responsibility is to eliminate uncorrected refractive error (URE). In national interest: It costs so much less time, money & resource to train an optometrist than to train an ophthalmologist for non-medicinal work (e.g. Refraction, contact lens, orthoptics etc) In national interest: It costs so much less time, money & resource to train an optometrist than to train an ophthalmologist for non-medicinal work (e.g. Refraction, contact lens, orthoptics etc) 2

19. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 As optometrists- we are a major component of solution We stand united in strength of 40,000+ to fight the problem by getting involved in national policies We stand united in strength of 40,000+ to fight the problem by getting involved in national policies NO CONFUSION: the earlier confusion of who represents “optometry” & who represents “education in optometry” is resolved NO CONFUSION: the earlier confusion of who represents “optometry” & who represents “education in optometry” is resolved

20. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 With help of several agencies “Delhi declaration” was signed in Jul.2010…… DELHI DECLARATION ON OPTOMETRY AND BLINDNESS PREVENTION IN INDIA

21. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Example of commitments (out of 11) Assisting in the development and provision of accessible, affordable and excellent vision care services to all people of India – regardless of their geographical location or socio-economic status (public:priv=10:90) Assisting in the development and provision of accessible, affordable and excellent vision care services to all people of India – regardless of their geographical location or socio-economic status (public:priv=10:90) Developing competent human resources in Optometry to meet the current and future eye care needs and reduce the burden of vision impairment and blindness in India (mango tree) Developing competent human resources in Optometry to meet the current and future eye care needs and reduce the burden of vision impairment and blindness in India (mango tree)

22. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 We have created the base Any agency now needs to talk only to one organization regarding “optometry” in India Any agency now needs to talk only to one organization regarding “optometry” in India Indian Optometry Federation (IOF) Indian Optometry Federation (IOF) Education in optometry ASCO (Association Of Schools & Colleges Of Optometry) Education in optometry ASCO (Association Of Schools & Colleges Of Optometry)

23. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Is a registered body Is a registered body Has membership of VISION 2020 Has membership of VISION 2020 Is voice of all (40000+ optometrist) Is voice of all (40000+ optometrist) Is working towards partnership with Govt., NGOs and international agencies to standardize & regulate optometry Is working towards partnership with Govt., NGOs and international agencies to standardize & regulate optometry Is committed to Delhi Declaration Is committed to Delhi Declaration

24. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 NPCB In India A National Programme for control of Blindness was started in 1975 with the motto that ‘One of the basic Human rights is the right to see,……” At IOF we have adopted one single nomenclature “Optometrist” for all 2 years or higher ( 4,6,11 yr ) qualifications

25. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Public health contribution of optometry can not be overlooked As As individual practitioners individual practitioners institutional professionals institutional professionals schools of optometry schools of optometry Also done work in Also done work in school vision screening, cataract screening, special children screening, etc. school vision screening, cataract screening, special children screening, etc. Next 2 slides show an example of success with optometry involvement in national programs

26. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 OPTOMETRISTS to OPHTHALMOLOGISTS Countries Optometrists Ophthalmologists Countries Optometrists Ophthalmologists Australia 12.5 3.3 Australia 12.5 3.3 Canada 10.26 3.3 Canada 10.26 3.3 U.K 13.27 1.06 U.K 13.27 1.06 New Zealand 10 2 New Zealand 10 2 USA 10.99 5.7 USA 10.99 5.7 India 0.65 2 India 0.65 2 Ratio for 100000 people (per 0.1mill) Ratio for 100000 people (per 0.1mill) (source Dr.Hofstetter in WCO monthly bulletin) (source Dr.Hofstetter in WCO monthly bulletin)

27. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 OPTOMETRISTS to OPHTHALMOLOGISTS Blindness Blindness New Zealand= blind: popu= 0.003 per mill New Zealand= blind: popu= 0.003 per mill India= blind: popu =0.012 per mill India= blind: popu =0.012 per mill India has 4 times more blind per mill. India has 4 times more blind per mill. Countries Optometrists Ophthalmologists Countries Optometrists Ophthalmologists New Zealand (Pop 4.4mil) 10 2 New Zealand (Pop 4.4mil) 10 2 India (Pop 1210mil) 0.65 2 Ratio for 100000 people (per 0.1mill) India (Pop 1210mil) 0.65 2 Ratio for 100000 people (per 0.1mill)

28. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Universities: Time line (IOF) Our internal timeline target=No university will offer less than 4 year course in optometry by 2020 (grandfather clause till then) Our internal timeline target=No university will offer less than 4 year course in optometry by 2020 (grandfather clause till then) Draft Common-minimum optometry curriculum & bridge courses to upgrade 2 year diploma to 4 year degree is ready Draft Common-minimum optometry curriculum & bridge courses to upgrade 2 year diploma to 4 year degree is ready Several universities are now accepting lateral entry Several universities are now accepting lateral entry

29. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 The IVI project India Vision Institute (IVI) inaugurated on oct.18,2011 India Vision Institute (IVI) inaugurated on oct.18,2011 Task force set up to look into optimizing existing human resources and developing new professionals Task force set up to look into optimizing existing human resources and developing new professionals 2

30. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 What will IVI do ? An enthusiastic plan for the development of optometry & vision industry over 5 years An enthusiastic plan for the development of optometry & vision industry over 5 years Develop human resources Develop human resources Ensure fundamental infrastructure is in place Ensure fundamental infrastructure is in place Establishing professional and regulatory framework for optometry Establishing professional and regulatory framework for optometry

31. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 IVI PhD scholarship available within India PhD scholarship available within India On our agenda specialties like On our agenda specialties like Contact lenses Contact lenses Low & assistive vision devices Low & assistive vision devices Rehabilitation Rehabilitation Paediatric optometry Paediatric optometry 2

32. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Opportunity for the industry The global vision and eye care industry is worth approximately $89 billion in retail product sales The global vision and eye care industry is worth approximately $89 billion in retail product sales $180 billion including professional fees $180 billion including professional fees India’s vision industry sits at a modest 1% of the world’s consumption and is valued at $5 billion at the retail level India’s vision industry sits at a modest 1% of the world’s consumption and is valued at $5 billion at the retail level Yet India has 17% of the world’s population Yet India has 17% of the world’s population

33. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Opportunity for all Partnership between Educational institutions + optometry + corporate world will lead to a win- win situation for all three & also for the country,hospitals & society Partnership between Educational institutions + optometry + corporate world will lead to a win- win situation for all three & also for the country,hospitals & society

34. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Availability of optometry education in India 119 recognized universities/ institutions offer optometry courses 119 recognized universities/ institutions offer optometry courses 65 Offer 3 or 4 year graduate level program 65 Offer 3 or 4 year graduate level program 16 offer M.Optom 16 offer M.Optom 4 offer Ph.D. program 4 offer Ph.D. program 4 Optometrists in India are at “Professor” level 4 Optometrists in India are at “Professor” level

35. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Indian optometrists are no less on international standards 44 out of 253 FIACLE s in world are here 44 out of 253 FIACLE s in world are here Lot of international research (esp. CCLRU/BHVI, LVPE) is done by Indian optometrists Lot of international research (esp. CCLRU/BHVI, LVPE) is done by Indian optometrists Our optometrist has received a Padmasree Our optometrist has received a Padmasree We hold a national/international conference every year We hold a national/international conference every year As faculty in foreign universities…… As faculty in foreign universities…… Does anybody know of another profession that has grown to this level without being recognized by Govt.?

36. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Regulation through a council We require support from the Government to form a Council. We require support from the Government to form a Council. Meanwhile, in the interim period, we are in the process of creating a self-regulatory body that will act as a council. Meanwhile, in the interim period, we are in the process of creating a self-regulatory body that will act as a council. 2

37. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 Our wish-list.. We wish to serve the people “ Freely and fully ” We wish to serve the people “ Freely and fully ” We need a council We need a council Actually, now India needs a council of optometry Actually, now India needs a council of optometry We request the government to make use of existing professionals & avoid re-inventing the wheel We request the government to make use of existing professionals & avoid re-inventing the wheel

38. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 The day is not far.. When optometry in India will have similar place as in developed countries like Australia & USA When optometry in India will have similar place as in developed countries like Australia & USA

39. The country needs Optometry & Optometrists stand ready & motivated to meet the challenge of Right to Sight in India by 2020

40. Rajesh Wadhwa- New Delhi r_wadhwa@yahoo.comPh:09868010187 My contact details: Rajesh Wadhwa r_wadhwa@yahoo.com 9868010187 www.indianoptometryfederation.org Thank You!