According to the World Health Organization, glaucoma is the second leading cause of blindness throughout the world.1 World Glaucoma Week falls between March 6th to 12th this year, and aims to increasing awareness about this debilitating disease for which there is no cure. Glaucoma causes optic nerve damage, permanent eye damage, and blindness.2 Treatments exist to help slow the onsets of the disease, with screening being the most effective method of prevention. Eighteen programs in the CHMI database have specific interventions that deal with glaucoma prevention and treatment. Half of these programs are located in India, and six of the total have a CHMI Plus Gold program rating. One such Gold program, Advanced Eye Treatment Unit-Nayana, located in the Indian state of Karnataka, centers its operations out of Bangaluru as a sliding-scale, mobile clinic that routinely visits rural areas to screen for glaucoma and diabetic retinopathy.
Financing Affordable Eye Care: Treatment for the Poor
One of the biggest obstacles for preventing glaucoma throughout the world is ensuring affordability of screening and treatment procedures. Many CHMI programs are thinking of new ways to eliminate financial barriers for the poor in order for eye care to be delivered, one of the primary methods being cross-subsidization models.
A CHMI Plus Gold Program, the Aravind Eye Care System (AECS) is private network of hospitals located in India. AECS provides 70% of its patients with free eye care. For the 30% of patients charged, full-fee services are charged, which then fund the hospital and ensures the free services to the rest of the population. This model has allowed self-efficiency for AECS, and has grown from one hospital in 1976 to becoming the largest eye provider chain in the world.
SalaUno, located in Mexico and another CHMI Plus Gold Program, uses a cross-subsidization model for their services, as well as keeps costs below the national average through a high-volume approach. SalaUno’s overarching goal is to help reduce the 60% incidence of eye-related disabilities in Mexico.
Innovative Operational Processes: Scaling-Up with Mobile Clinics
In addition to Advanced Treatment-Narayana, eight other programs identified has having or serving as mobile eye clinics for patients. Mobile eye clinics are important to reach rural and poor populations with limited access to screening and treatment services.
Phelophepha Healthcare Train, a CHMI Plus Gold Program in South Africa, travels throughout the country and serves approximately 360,000 people each year that may not have had healthcare otherwise. The number of people served has increased substantially since the program’s inception in 1994, and in addition to a regular clinic and dental center, there is a specialized eye clinic that screens for diseases, such as glaucoma, and provides eyesight tests to patients.
Sadguru Netra Chikisalaya (SNC), a rural hospital located in Anandpur, has established 23 “Vision Centers” that operate as outreach camps for eye disease screenings, namely glaucoma, pediatric ophthalmic diseases, and cataract surgery. SNC serves around 230,000 patients every year, and performs 75,000 surgeries.
Regulating Performance: Training Health Professionals
A huge component of detecting and treating glaucoma is to have a health workforce that can accurately screen and provide medical care for the population. Quite a few CHMI programs focused on eye care, and specifically glaucoma, provide training to community health workers, nurses, and other health professionals.
The Chittagong Eye Infirmary and Training Complex is a major tertiary care center in Bangladesh that provides eye care services and screenings. At the complex, doctors can take high-level courses in Community Ophthalmology, which train them in operating mobile eye clinics and providing outreach to communities. Additional courses are available for nurses, paramedics, and technicians.
Initially training around 300 surgeons in eye care, screening, and surgery in 1993, the Fred Hollows Foundation: Vietnam Blindness Prevention Program has expanded tremendously and has served as the further training grounds of hundreds to thousands more doctors in eye care. In Kenya, a similar program, Upperhill Eye and Laser Center (UHEAL), aims to train 120 health professionals in eye care through providing educational materials on glaucoma, diabetic retinopathy, and cataracts surgery. UHEAL is a CHMI Plus Gold Program.
Recognizing World Glaucoma Week
Glaucoma is a debilitating disease because it can cause optic nerve damage, permanent eye altercations, and blindness. CHMI recognizes eighteen programs in the database that work hard to decrease the burden of disease due to glaucoma and other eye diseases and ailments. These programs seek to finance eye care for the poor, reach rural populations through mobile clinics, and train the next generation in comprehensive eye care. Glaucoma Awareness Week is recognized as March 6th to 12th of 2016.
Image: Vula Eye Health