The role of an optometrist in India is slowly and steadily evolving towards the definition matching that of the World Council of Optometry - ‘a primary healthcare practitioner of the eye and the vision system who can successfully manage the leading cause of vision impairment, refractive error, and can also help alleviate the burden of other causes of blindness by way of diagnosis, referral and co-management.’
As primary eye care practitioners, optometrists have to play a vital role in detecting potentially serious eye diseases, such as cataract, glaucoma, and age-related macular degeneration, as well as systemic diseases such as hypertension and diabetes.1
Historical perspective
Gone are the days when optometry was introduced in India (1958) by means of the two-year diploma course with the aims of:
- Lessening the burden of time-consuming refraction on the busy ophthalmologist
- Saving members of the society from exploitation in the matter of spectacle-dispensing in the hands of traditionally non-qualified opticians.
Optometry in India is now a four-year degree course comprising three years of theory, practical, and clinical labs training, and the fourth year consisting of an internship involving clinical practice under the guidance and supervision of practicing optometrists and ophthalmologists.
The Association of Schools and Colleges of Optometry lists about 50 teaching institutions across the country which provide training in the four-year degree in optometry course,2 notably:
- Amity University in Haryana
- Bausch & Lomb School of Optometry in Telangana
- Bharati Vidyapeeth Deemed University and Lotus College of Optometry both in Maharashtra
- Elite School of Optometry in Tamil Nadu
- Manipal College of Allied Health Sciences in Karnataka
- Ridley College of Optometry in Assam
- Dr RP Centre for Ophthalmic Sciences in Delhi
- ITM Vocational University in Gujarat.
Neilsen De Souza et al3 summarise the role of optometrists in India as an integral part of an eye health system. India has a proud tradition of blindness prevention, being the first country in the world to implement a blindness control programme which focused on a model to address blinding eye disease.
However, with 133 million people blind or vision impaired due to the lack of an eye examination and provision of an appropriate pair of spectacles, it is imperative to establish a cadre of eye care professionals to work in conjunction with ophthalmologists to deliver comprehensive eye care. The integration of four-year trained optometrists into primary health services is a practical means of correcting refractive error and detecting ocular disease, enabling co-managed care between ophthalmologists and optometrists.
Current challenge
At present, optometrists range from two-year trained ophthalmic assistants/optometrists or refractionists, to four-year degree trained optometrists. The optometry profession in India is not regulated, integrated into the health care system or recognised by the majority of people in India as a provider of comprehensive eye care services.
In the past couple of years, however, the optometry profession in India is beginning to take the necessary steps to gain recognition and regulation to become an independent primary health care profession. The formation of the Indian Optometry Federation as the single leading body of optometry in India and the establishment of the Optometry Council of India are important steps in the development and regulation of optometry.
The future
As to the future of optometry in India, Neilson De Souza et al3 sum it up thus: ‘The training and scope of the practice of optometry in India has been somewhat fragmented in the past but has, in the recent years, made tremendous progress toward the establishment of a unified, standardised, and regulated profession that will meet its responsibilities for vision care, eye health, and provision of optical services to all those needing vision correction.’
Progress has included the formation of the Indian Optometry Federation, the adoption of the Common Minimum Optometry Curriculum, the development and adoption of the Delhi Declaration, the commitment to a four-year degree programme for all optometry registrants from 2020, and the establishment of a peer review Optometry Council of India to oversee education and educational institutions and to register optometrists.
This augurs well for the elimination of the blindness and impaired vision that affects 133 million at a societal cost of several billion in lost productivity and for 456 million Indians requiring vision correction to go about their daily lives. Indian optometry awaits approval from the government to grant an independent healthcare professional status to optometrists.
Journal
The Indian optometric journal, Optometry Today4 (figure 1), continues in its quest, since its launch in 1970, to improve optometry by way of better informed eye care professionals.
All said and done, the author would like to sum up the situation with the words: ‘Besides refraction, eyewear dispensing, low-vision aids and contact lens fittings, and detecting ocular pathology and making referrals, optometry in India aims at the incorporation in its practice of ophthalmic pharmaceutical medications in emergency cases. And, it’s struggle for survival for optometry in India…of course with a bright future!’
Dr Narendra Kumar, BAMS, DROpt, PGCR, is editor of Optometry Today, New Delhi, OptometryToday@gmail.com
References
1. www.optometrycouncilofindia.org
3. Neilsen et al: The role of optometrists in India – an integral part of an eye health team. Indian Journal of Ophthalmology, Septeber-October 2012.
4. Optometry Today <OptometryToday@gmail.com>