|Year : 2017 | Volume
| Issue : 2 | Page : 80-82
Dr. Rajendra Prasad Centre celebrates golden jubilee
Chairman and Consultant, MM Eyetech Institute, New Delhi, India
|Date of Web Publication||24-Mar-2017|
Chairman and Consultant, MM Eyetech Institute, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mohan M. Dr. Rajendra Prasad Centre celebrates golden jubilee. Indian J Ophthalmol 2017;65:80-2
The establishment of the All India Institute of Medical Sciences (AIIMS) was a turning point for high-standard postgraduate training in various medical disciplines in the country. The institute attracted many leading teachers and clinicians for its faculty from medical colleges in India and abroad. There was a congenial atmosphere to excel in all aspects of medical education, clinical services, and research.
The Department of Ophthalmology was fortunate to have a man of such far sight in Dr. L. P. Agarwal, who joined the AIIMS as professor of ophthalmology in 1958, followed by Dr. S. R. K. Malik and Dr. Madan Mohan, who joined as assistant professors in 1960. Within 8 years of planning and hard work, the faculty members were sponsored for advanced training abroad in major subspecialties of ophthalmology. Many workshops were organized for training in corneal surgery and eye banking. The National Eye Bank was established in the department in 1964. On its initiation, the “Eyes Act” was passed in 1982 by the Parliament.
Prof. Agarwal had a dream vision to moot the idea of developing a “National Institute of Ophthalmology” that would be at the forefront of eye health planning, academics, and clinical care. By the dent of discipline and leadership qualities, he proved to the government the need to establish an institute of ophthalmology. As a result, the Department of Ophthalmology was upgraded and christened as the Dr. Rajendra Prasad Centre for Ophthalmic Sciences in 1967. Its foundation stone was laid within the campus of AIIMS, by the Hon'ble Vice President of India Dr. Zakir Hussain. “Tamso Ma Jyotirgamaya” (from darkness to light) was adopted as the motto of the Centre.
The speed of developments and achievements of the Dr. Rajendra Prasad Centre in quality postgraduate education, clinical training of residents, and research became the focus areas. The subspecialties of ophthalmology developed through the establishment of specialty clinics. It was a self-learning-cum-teaching experience of the faculty. Advanced diagnostic equipment and ocular laboratories for pathology, biochemistry, and microbiology helped produce original research.
Under the auspices of the Indian Council of Medical Research, the Rajendra Prasad Centre leadership conducted a survey (1971–1973) on the prevalence of cataract in seven centers of the country. Based on the results of this groundbreaking study and projecting the financial loss to the Nation, due to avoidable blindness, the Government of India launched the 100% centrally sponsored “National Programme for the Prevention of Visual Impairment and Control of Blindness.”
Conscious of the magnitude of the problem of blindness, Prof. Agarwal contributed immensely as the secretary of National Society for the Prevention of Blindness (NPCB) with Dr. Sushila Nayar as the president (1965–1983). They were succeeded by Dr. Madan Mohan as the president and Dr. P. K. Khosla as the secretary (1983–1986). This gave a fresh impetus to the society by amending its constitution.
Prof. Agarwal had an ambition to globalize Indian Ophthalmology. He organized Afro-Asian Conference of Ophthalmology and tried to publish the International Journal “Oriental Journal of Ophthalmology” as the editor-in-chief. Most of the research papers got published from India and Dr. Rajendra Prasad Centre but did not get the expected response from neighboring countries. Later, he changed the name to “Eastern Archives of Ophthalmology” with new editorial board, but this too could not last long for publication. Publishing a scientific journal on good-quality paper was not commercially viable in the absence of sponsors and was therefore abandoned. The achievements of Prof. Agarwal brought him international recognition and invited him as a member of the Programme Advisory Group of the WHO, Geneva, Switzerland, which lays global strategy for the control of blindness.
| Change of Guard|| |
Prof. Agarwal's dynamism in medical education opened another canvas for him. He was selected and took over the charge as the Director, AIIMS, New Delhi. I (Prof. Madan Mohan) was appointed as the professor and chief of Dr. Rajendra Prasad Centre, Director of the WHO, Collaboration Centre, Advisor Ophthalmology in the Ministry of Health and Family Welfare, Government of India, and as the Member of the Programme Advisory Group of the WHO, Geneva, Switzerland.
Having had the experience of partaking in the development of the Centre under Prof. Agarwal, the development of the Centre's constructions, teaching, training and specialty clinic policy, and traditions were continued. The clinical subspecialties with their specialized equipment put together for diagnosis and treatment were designated as “Clinical Laboratories.” The existing paraclinical laboratories, radiology, were strengthened with the new addition of the Department of Ocular Pharmacology and Laser Laboratory. The Centre achieved about 10% annual increase in outdoor patient attendance, specialty clinics, and a number of eye surgeries.
The latest technology and advancements in ocular microsurgery were introduced for intraocular lens (IOL) implantation. Prof. Ake Holmberg from the Karolinska Institute, Sweden, was invited, through the WHO in 1985, as a visiting consultant for 3 months.
India is a vast country able to provide training in latest technology; faculty members from regional institutes of ophthalmology and medical colleges were invited to participate in workshops in addition to the training of postgraduates. During this period, ten regional institutes of ophthalmology were strengthened, and many medical colleges were upgraded and fully equipped with mobile units to reach the unreached in the remotest corners of India under the NPCB.
A round-the-clock separate eye casualty service was introduced. A junior and a senior resident and a faculty member were made available round the clock to attend to the emergency cases. It had attached dedicated casualty operation theater and 15 beds were earmarked for admission.
International Collaborative Study-1: A prospective study to find (evaluate) the various risk factors responsible for the causation of cataract was undertaken by the Chief of the Dr. Rajendra Prasad Centre in collaboration with the Director, National Eye Institute, Bethesda, Maryland, USA, under the science and technology initiative. An in-depth study regarding the effect of environmental, dietary, and socioeconomic factors and their relationship with the morphological type of cataract as also the biochemical disturbances during cataractogenesis was carried out and published.
International Collaborative Study-2: To keep abreast with latest international developments in fields such as IOL implantation, keratoplasty, keratoprosthesis, redial keratotomy, vitreoretinal surgery, and contact lens, an exchange program with the USSR had been undertaken.
Project Orbis, USA, the teaching flying hospital in DC-8 plane, visited New Delhi in 1988. Their consultant surgeons performed surgery off-plane and held teaching sessions at the Dr. Rajendra Prasad Centre. Impressed with Residency Training Program of its quality and standards of ophthalmic care, they decided to select doctors from India, for the first time, as onboard fellows and as visiting faculty surgeons to other countries.
| Research|| |
Dedicated paraclinical laboratories, with committed full-time faculties and residents, published high-standard original articles in almost all International Indexed Journals of Ophthalmology.
I (Dr. Madan Mohan) as the founder secretary established the All India Eye Donation Society in 1968 with the revered leader Shri Jai Prakash Narain as its founder president, succeeded by Shri Chandar Shekhar Ji. The society aimed to promote voluntary eye donation by creating awareness through mass media and publishing literature related to eye donation and its usefulness for restoring vision of corneal blind people.
We realized the fact that blindness cannot be controlled, until and unless the private sector is fully empowered and equipped. The high levy of 100% custom duty on importing ophthalmic equipment was a major deterrent for the private sector and service providers to deliver quality eye care to the people. Budgets those days used to be very secretive affairs. As Chief of the Rajendra Prasad Centre, I proposed to the government, the need for customs duty exemption on sight-saving equipment. However, I was asked to submit the list of essential equipment by the Ministry of Finance, since the required list had not reached from the Health Ministry. The Government of India after due deliberations announced 100% tax exemption on sight-saving equipment in 1988. Pursuing the demand, three notifications were issued to include IOL and all the essential eye equipment. This path-breaking development resulted in an upliftment of eye care services across the nation in the private sectors. Ever since, the ophthalmic trade scenario and modernization of private hospitals, nursing homes, and individual practice have seen no bounds. Greater trade participation by foreign manufacturers helped Indian engineers and manufacturers improve their products. It also stepped up advertising in trade exhibition at AIOC and in the Indian Journal of Ophthalmology for better quality publication and progress.
The fund availability under 5-year plan for National Programme for Control of Blindness was too meager to bring down the prevalence of blindness from 1.4% to 0.3% under health for all by the year 2000. The Rajendra Prasad Centre leadership launched the WHO-financed nationwide survey in 1986 on the “prevalence of blindness with particular reference to nutritional blindness, trachoma and associated infections, and the backlog of cataract” under Prof. Madan Mohan as the principal investigator. A new practical classification of blindness for survey was evolved as economic blindness (<6/60), social blindness (<3/60), manifest blindness (<1/60), and absolute blindness (No perception of light/faulty Projection of light [no PL/faulty PR]). Field of vision testing was excluded from the survey. Refractive errors for the first time were included as a cause of avoidable blindness. The survey selected one district from a geographical group of 5 districts, such 125 districts from all states and union territories were covered. The survey yielded invaluable data for planning National Programme for the Control of Blindness. Based on the report, the World Bank sanctioned Rs. 550 crores for the project for clearing backlog of cataract in seven states which were identified to have the highest prevalence of cataract.
A proposal to build a Railway Eye Mobile Unit in a modified railway carriage (abandoned railway saloons), on the lines of the flying hospital Project Orbis of the USA, was mooted in the Ministry of Railways. This led to the creation of the lifeline express to conduct eye camps on the rails at distant railway stations.
The Centre conducted District Pilot Project for the control of blindness with Danish International Development Agency (DANIDA) assistance. Based on this study, guidelines were formulated. This led to the creation of post of District Blindness Control Officers to control and monitor comprehensive eye care and better conduct of safe eye camps, under the supervision of the district administration all over India.
Contribution to AIOS and specialty societies, Prof. Agarwal, myself, Prof. Khosla, and many other faculty members of Dr. Rajendra Prasad Centre have held high offices. Dr. Madan Mohan was elected as the Editor Proceedings (1976–1979) of the AIOS and later as the Editor, Indian Journal of Ophthalmology, for two terms (1980–1986).
The landmarks of the development of specialty of ophthalmology and eye care in India and the role played by the Dr. Rajendra Prasad Centre are presented in the following picture [Figure 1].
Courtesy: Dr. Rishi Mohan
1947–1960: Eye camps and surma era of trachoma and its sequelae, keratomalacia, xerophthalmia, Graefe's knife, keratome, Smith Indian tumbling technique, capsule forceps, erysiphake, phacomorphic, phacolytic, and other common nomenclatures.
1958–1966: Growth of the Department of Ophthalmology at AIIMS.
1967: Establishment of the Dr. Rajendra Prasad Centre for Ophthalmic Sciences.
1971–1973: Survey of cataract blindness under Prof. L. P. Agarwal.
1967–1979: Launch of the National Programme for the Prevention of Visual Impairment and Control of Blindness by the Government of India.
1979–1989: Change of Guard - Rapid progress of Rajendra Prasad Centre as Apex Organisation, clearing of the backlog of cataract blindness and IOL implantation under the National Programme for Control of Blindness under Prof. Madan Mohan.
1988: Customs duty exemption 100% on sight-saving equipment. Modernization of delivery of eye care in the private sector clinics, hospitals, and institutions.
The successive Centre's leadership has continued to maintain the growth curve to achieve greater heights of excellence in clinical ophthalmology, especially in microsurgery, during the past over 30 years. Among the major technological introductions and clinical developments at the Dr. Rajendra Prasad Centre are (i) telescreening in retinopathy of prematurity; (ii) alternate visualization techniques; (iii) vitreous subtitles; (iv) confocal scan – heidelberg retina tomograph (HRT) III; (v) robotic eye surgery; (vi) Optical coherence tomography (OCT)-integrated microscopic, etc.
Prof. Agarwal's far sight developed a strong foundation and work culture at the Dr. Rajendra Prasad Centre. The Centre's faculty and alumni have proved to be global leaders in the ophthalmic world and have gained prominence in International, Indian, and State Ophthalmological Societies. Indian Ophthalmology led by the Dr. Rajendra Prasad Centre, AIIMS, today is on a firm footing to match global standards of eye care.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.