LVPEI has developed a five-tier pyramidal model of sustainable and high quality comprehensive eye care, and this has involved collaboration between clinicians, researchers, charity trusts and individual donors, but most importantly community participation and partnership, which makes the model sustainable.
At the base of the pyramid are Vision Guardians – volunteers who deliver community eye care. Each Vision Guardian monitors the eye health of 5000 people (especially children and the elderly), refers those needing an eye check-up to the nearest Vision Centre, monitors post-surgery patients and provides near-vision glasses.
Vision Centres (VC) at the next level are primary care centres that provide full eye screening, prescription and supply of low cost spectacles, referrals to Secondary Centres (SC) for surgeries and other conditions and linkages to other community services. Each VC caters to 50,000 people in 20-25 villages and is managed by Vision Technicians, who screen the village population. Each VC is a one-person operation, located in a 200 sft space, equipped with the same high quality slit lamp biomicroscope and other tools used by the high-end city eye doctor. The space is either rented, or – as is increasingly in practice – donated by a public-spirited individual from the village.
At the next tier are secondary care Service Centres (SC), providing comprehensive world-class outpatient and surgical services, community based rehabilitation and low vision care. Each SC serves a population of 500,000 and is networked with 10 Vision Centres, within a radius of 50 km. One or two ophthalmologists, trained at LVPEI, run each SC, with a technical staff of 10-12 and support staff of 10-12 (all taken from the community, trained at LVPEI and placed back at the SC). In a year, a Service Centre sees 10,000-15,000 patients, performs 1500-3000 surgeries (referring 5-10% for tertiary care), performs 50 community screening programs and acts as a referral and administration source for its 10 Vision Centres.
At the next level are the Tertiary Care Centres (TCC). Each Tertiary Eye Centre services 5 million people, offering complete eye services including subspecialty care, low vision and rehabilitation, and conducting training and research.
LVPEI’s world-class Centre of Excellence (CoE) at the apex of the pyramid is an advanced Tertiary Care Centre at Hyderabad that engages in “Training of Trainers” and specialists, active research, and advocacy.