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Anyone can open an optical shop in India without training or registration, so getting the profession of optometry fully recognised in the country continues to be a struggle.
Optometry was introduced in 1958 with the establishment of a school of optometry at Gandhi Eye Hospital, Aligarh, to provide a two-year diploma course run by UP State Medical Faculty, Lucknow. The government's aim was to lessen the burden of refraction on busy ophthalmologists, and to save the public from exploitation at the hands of unqualified opticians.
The Diploma in Optometry and Diploma in Orthoptics courses followed in the 1960s at about a dozen institutions. But a move was soon made to transform optometry into clinical technology, with the introduction of the Diploma in Clinical Technology (Optometry) and Diploma in Clinical Technology (Orthoptics) courses at All India Institute of Medical Sciences (AIIMS), New Delhi.
These courses were replaced in the 1970s with a three-year BSc (Hons) in Ophthalmic Techniques at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS. A two-year Diploma in Ophthalmic Assistance was introduced at about three dozen medical colleges, and a three-year Diploma in Ophthalmic Techniques was started at about two dozen centres under the auspices of the National Society for the Prevention of Blindness.
The Elite School of Optometry, Chennai (the brain-child of ophthalmologist Dr SS Badrinath), introduced a four-year BSc degree course in Optometry in 1985, and now provides an MPhil in optometry.
Optometrists can register for a PhD programme at Birla Institute of Technology & Science, Pilani, and four-year BOptom courses are offered at Bharati Vidyapeeth University, Pune Bausch & Lomb College of Optometry, Hyderabad Aditya Jyot Institute of Optometry, Mumbai Lotus College of Optometry, Mumbai Nagar College of Optometry, Ahmedabad and College of Optometry & Ophthalmic Sciences, Nashik. Currently, there are over 100 institutions offering diploma and degree courses in optometry ranging in duration from two to four years.
Optometry's relations with 'opticianry' are less than cordial in India. In the 1960s diploma optometrists were offered miserably low wages by optical showroom owners, and asked to fulfil a number of duties besides refraction, such as counter attendance, spectacle fitting, stock taking and so on. The optometrist's worth was, however, gradually recognised, with openings in hospitals and clinics.
In the 1970s, the Delhi Opticians Association sought the help of optometrists in furthering the knowledge of dispensing opticians with lectures and practicals as part of its fellowship training course. Over the years, however, this activity posed a threat to optometry, as those acquiring an FDOA suffix started presenting themselves as optometrists. Another setback to quality was the growth of sub-standard distance learning courses.
Optometric leaders are hopeful of optometry becoming the first line of defence against blindness in India. Good optometrists are in constant demand by ophthalmologists, contact lens labs, optometric teaching institutions, retail optical outlets and hospitals. However, they are engaged in an ongoing struggle in getting the profession recognised.
Optometry and ophthalmology have not so far been envisaged as two different disciplines. Optometry was created as an off-shoot of ophthalmology in 1958 essentially to prepare 'assistants'. Differing nomenclature (such as 'clinical technology', 'ophthalmic assistance', 'ophthalmic technology', and 'paramedical ophthalmic assistant') was used to keep it tamed. Courses are now available at diploma, degree, and masters level at over 100 institutions, but the aim practically remains the same, namely to prepare 'supporting personnel'.
Fortunately, several schools are now being run by optometrists (as per overall policy laid down by ophthalmologists), and there is scope for better prospects for optometry in the long run. With broad-based education, things are changing, and optometry may one day emerge as an independent profession.
However, since optometrists largely continue to be employed by ophthalmologists and since ophthalmologists' agreement seems essential for the introduction of legislation to regulate the practice of optometry, it is logical that the two disciplines work hand-in-hand in the overall interest of the visual welfare of the Indian people.
● Optometrist Narendra Kumar is editor of Optometry Today (India) (OptometryToday@gmail.com)