Community <strong>Eye</strong> Health & OutreachInternational Centre for Advancement of Rural <strong>Eye</strong> careICARE or the International Centre for Advancement of Rural <strong>Eye</strong> care is the public health division of L V <strong>Prasad</strong> <strong>Eye</strong><strong>Institute</strong>. <strong><strong>LV</strong>PEI</strong>’s strategy for eliminating avoidable blindness is summed up with its motto “Excellence, Equity andEfficiency” and has the following key components: permanent eye care infrastructure in underserved rural remoteareas, capacity building (from the community to eye specialists), and training and research (public health, basic and clinicalresearch). ICARE was established in 1998 with the support of CBM, Germany (formerly Christoffel Blindenmission)and Sightsavers, UK, with subsequent support from Operation <strong>Eye</strong>sight Universal, Canada. <strong>The</strong> development of the<strong><strong>LV</strong>PEI</strong> <strong>Eye</strong> Health Pyramidal model was based on scientific evidence found from the Andhra Pradesh <strong>Eye</strong> Disease Study(APEDS), a landmark epidemiological study conducted by <strong><strong>LV</strong>PEI</strong> in both rural and urban locations from 1996-2000.<strong>The</strong> <strong>Institute</strong>’s rural health coverage begins at the grassroots level with village volunteers (known as Vision HealthGuardians, serving approximately 5000 people each), who are linked to a primary eye care Vision Centre (approximately10 Vision Health Guardians linked to a Vision Centre), staffed by a local Vision Technician (trained for a year) andcovering a population unit of 50,000. Preliminary eye screening is done at the Vision Centre (VC). Ten VCs are linkedto a secondary care Service Centre (each serving about half a million population). <strong>The</strong>se three tiers of service togetherconstitute a Village Vision Complex.Currently, we have 72 Vision Centres (to be ramped up to 125 by the year 2012), 9 secondary satellite centres (10 by2012), 9 partner centres linked to 3 tertiary centres (Bhubaneswar, Visakhapatnam and Vijayawada) and a Centre ofExcellence at Hyderabad. In the 12 years since its inception, through its network of secondary and primary eye carecentres, ICARE has reached 2,204,647 people and performed 198,461 surgeries to eliminate avoidable blindness. Nearly46-49% of them were women, bridging the gender inequality gap in accessing eye care services.<strong>The</strong> highlights of 2010-2011 are the launch of two major epidemiological projects – <strong>LV</strong>P GLEAMS (L V <strong>Prasad</strong> GlaucomaEpidemiology Molecular Genomics) study and a ten-year follow-up study of the cohort of APEDS with technicalcollaboration with the International Centre for <strong>Eye</strong> Health (ICEH), UK. In operational research, Rapid Assessment ofVisual Impairment (RAVI) studies have been conducted in several locations in Andhra Pradesh. Another operationaldelivery project is empowerment of rural women as Vision Health Guardians (VHG) as vision, diabetes and hypertensioneducators in the Sight to Resight VHG project. As community eye health care models are undergoing a paradigm shiftwith a horizontal approach, we initiated the Community Linked Initiative Project (CLIP) to eliminate avoidable blindnessin Jainath mandal of Adilabad district with support from Operation <strong>Eye</strong>sight Universal, Canada.In the domain of childhood blindness, theNimmagadda <strong>Prasad</strong> – <strong><strong>LV</strong>PEI</strong> Children’s<strong>Eye</strong> Health Initiative has reached outto a total of 324,664 children, offeringa better quality of life through eye careservices. Of these 102,277 childrenreceived outpatient and surgical servicesacross the <strong><strong>LV</strong>PEI</strong> network. In addition,9162 children received surgical treatmentduring the period free of cost.Other focus areas of ICARE are thedevelopment of human resourceswith training programs for eye careprofessionals at all levels, capacity buildingof institutions through accompanimentprograms, research and advocacy. Amongthe education programs conductedby ICARE are Master’s in Community<strong>Eye</strong> Health, Diploma in Community<strong>Eye</strong> Health, Postgraduate Diploma inHospital Management, Certificate coursein Program Management & Evaluation,Certificate course in ComprehensiveCommunity <strong>Eye</strong> Care & Rehabilitationof Visually Impaired, Vision TechniciansCourse and training of Vision Guardians.Excellence | Equity | Efficiency50A day-old baby at Ada village
News12 th Anniversary of ICARE<strong>The</strong> 12 th anniversary of the International Centre for Advancement of Rural <strong>Eye</strong> care (ICARE) was celebrated onDecember 17, 2010. A Partners and Satellite Centre Workshop was held to mark the occasion; the theme was “DiabeticRetinopathy — <strong>The</strong> Emerging Challenge”. Ophthalmologists and administrators from 17 partner and satellites centresattended the workshop.World Sight Day CommemoratedICARE commemorated World Sight Day from October 14-21,2010 with events across its entire network; Dr Padmaja K Raniled the Hyderabad area program. A large rally was organized inHyderabad city by the Sight for Kids (SFK) Greater Hyderabadteam, supported by Johnson & Johnson, Lions Club InternationalFoundation (LCIF) and Lions <strong>Eye</strong> Hospitals of Greater Hyderabad.<strong>The</strong> SFK program addresses visual impairment and promotes eyehealth awareness among schoolchildren between 5 and 9 years ofage. <strong>The</strong> participants included schoolchildren (SFK beneficiaries),Vision Technicians and optometry students of Ranga Reddy Lions<strong>Eye</strong> Hospital.A budding Nayana Vanam at Adilabad<strong>The</strong> SFK partner eye hospitals conducted communityscreening programs in slums and other locations,screening several hundred people. Awarenessmeetings were organized at several places, includingschools and colleges, and talks given on theprevention and treatment of avoidable blindness.Free spectacles were distributed to those identifiedwith refractive errors.A new concept ‘Nayana Vanam’ (Vision Garden)was inaugurated at the secondary care SeshannaChennawar <strong>Eye</strong> Centre in Adilabad district. Allthe vegetables and fruits planted in the garden arebeneficial for the eyes. A diabetic screening programwas conducted for the high risk population at Adavillage.Kuchukalla Ramachandra Reddy <strong>Eye</strong> Centre,Thoodukurthy, <strong><strong>LV</strong>PEI</strong>’s second satellite centreat Mahabubnagar district, held a public meeting at An awareness meeting being conducted in a schoolManthati village.<strong>The</strong> GMR Varalakshmi Campus, Visakhapatnam organized a community screening program where 110 people werescreened, 10 were prescribed spectacles and 20 identified with cataract were referred to <strong><strong>LV</strong>PEI</strong>.51Activity Report 2010–2011