How can the eyecare ecosystem function given the national programme strategies as we move forward during and beyond the COVID-19 lockdown? Dr Praveen Vashist, Professor and Head – Community Ophthalmology, RP Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, has the answers
The COVID-19 virus is expected to remain for a long time in India and has a strong potential to re-emerge, even if contained, at present. As the nation-wide lockdown due to the rising COVID-19 cases in India progressed, many eye hospitals had to suspend their daily Out Patient Department (OPD), In Patient Department (IPD) and community outreach services. This has impacted the collective goals of not only the eye hospitals and government, but also eye health foundations NGOs, eye hospitals and eyecare NGOs since only emergency wings were permissible at hospitals.
Given this background, the government, through National Programme for Control of Blindness and Visual Impairment (NPCB&VI), decided on formulating guidelines and strategies as we move forward during and beyond COVID-19. The good news is that eye hospitals can resume daily operations but with maximum precautionary measures and minimum patients at facilities to adhering to the physical distance guidelines as laid out by the government. The guidelines spell out the need to follow routine clinical activities including OPD, IPD and surgical procedures, in all areas except for in containment areas and in red zones.
Notably, there are specific guidelines for community eye health and vision centers that have been outlined through collaborative efforts among NGOs, community ophthalmology experts from RP Centre, AIIMS, and Vision 2020: The Right to Sight-INDIA in association with All India Ophthalmological Society (AIOS).
The AIOS guidelines have been developed based on COVID-19 affected zones whereby it is clear that outreach camps and mobile vans are not allowed at this stage.
What emerged from the zonal division is that teleophthalmology is the only eyecare activity that can operate in every zone. It is only clear that technology should be leveraged at this time to reach out to as many people as possible, including Accredited Social Health Activists (ASHAs). Similarly, barring containment zones, eye hospitals have the go ahead to resume primary eye care services which are integral to not only hospital functions, but also crucial for communities. It becomes essential to point out that this is the right time to strengthen our primary eyecare services, especially vision centers. One of the key aspects for doing that is also training of ASHAs through teleophthalmology medium during this time.
As for comprehensive eye camps, which are a major part of many eye hospitals’ community outreach activities, it is estimated that resuming the activities is not advisable anytime soon. Although, an initial discussion pointed towards resuming the functions by July, the same cannot be guaranteed. It really depends on the COVID-19 case trends and unless the curve declines, there are chances that such activities would have to be suspended for six months even.
However, the silver lining remains in the fact that the eye care community can still serve through the activities permissible including surgical interventions and primary eyecare service delivery.
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