|LETTER TO THE EDITOR
|Year : 2020 | Volume
| Issue : 8 | Page : 1715-1719
Role of an ophthalmologist after patient loses vision- are we doing enough?
Javed Hussain Farooqui1, Umang Mathur1, Ashish Saksena2
1 Department of Cornea, Cataract and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India
2 Department of Comprehensive Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
|Date of Web Publication||24-Jul-2020|
Dr. Javed Hussain Farooqui
Department of Cornea, Cataract and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Marg, Daryaganj, New Delhi - 110 002
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Farooqui JH, Mathur U, Saksena A. Role of an ophthalmologist after patient loses vision- are we doing enough?. Indian J Ophthalmol 2020;68:1715-9
|How to cite this URL:|
Farooqui JH, Mathur U, Saksena A. Role of an ophthalmologist after patient loses vision- are we doing enough?. Indian J Ophthalmol [serial online] 2020 [cited 2020 Aug 10];68:1715-9. Available from: http://www.ijo.in/text.asp?2020/68/8/1715/290443
Five years of medical school, 3 years of post-graduation, a couple more for fellowship—that is how most of the ophthalmologists are trained in our country. After a minimum of 10 grueling years, one would think, it is enough! But how much is enough and who decides that? After all these years, when we come across a patient in our clinic who is blind (without light perception), are we doing enough for them?
The thought for this correspondence to you has stemmed from this very important, yet sparingly discussed, the issue at hand. Does an ophthalmologist in his busy clinic have time, or more importantly, enough knowledge to guide a patient without light perception to the next step of treatment? Is he so focused on treating “seeing” patients that he is subconsciously ignoring “blind” patients?
India is home to around 12 million blind people, which accounts for one-third of the world's total blind population., Disproportionately, we hardly have a handful of places which offer residential and rehabilitation services to blind people, and even a lesser number working towards integrating these people in the society. Of course, a lot of work is being done for patients with low vision,, and most of the ophthalmic centers and institutes have a dedicated department for the same. But when it comes to blind people, we need a more robust system to deal with the problem. When we started collecting data and interviewing people for this article, we realized how less the doctors know (leave aside the common man) in terms of gadgets, technology, and rehabilitation centers available to help blind people.
The most commonly discussed and used tool for the blind are assistive technologies based on the sense of body organs. These are specifically useful for patients in the younger age group, who can use these as pre-academic learning tools. Tactile-based assistive technology in form of Braille is one of the most universally used tools, and these days multiple Braille platforms are available in the form of Braille reading materials (BRM), Braille translator software, Braille dot watch, Braille keyboards; all these in addition to the conventional Braille slate and stylus. Of course, availability of these is an issue along with limited books available on BRM, but it is still important for doctors to be aware of these gadgets and offer options to their blind patients, specifically blind children as it helps in their cognitive development.
Technology is the next big thing that can help in the management of these patients. Simplified mobile phone software is commonly available in both android phones (TalkBack application) and Apple products (VoiceOver application). These applications can make phone use convenient for all visually impaired people. Various portable eBook readers are also available in markets, which can record up to 400 books and offer around 15 h of recorded material. Another interesting software is JAWS (Job Access With Speech), which is a computer screen reader program for Microsoft Windows that helps blind users to read the screen with text-to-speech output. It is available in multiple languages such as English, French, Mandarin, and German, but not Hindi. It is licensed software and comes with a cost. Other software like NVDA (Non Visual Desktop Access) is open access, portable screen reader from Microsoft Windows, which is available in 18 different Indian languages.
Finally, ophthalmologists should be informed about residential facilities where the blind can be referred for residence and rehabilitation. Our efforts should be focused on creating a more inclusive environment for these people, and to look at them as burden carriers, instead of a burden on society. Websites like eyeway.org operate a national toll-free number: 1800 53 20469, where a team of counselors at help desks across three locations respond to a variety of queries that are made on a day-to-day basis regarding education and employment opportunities, mobility, assistive technology, and legal rights for the visually impaired. This number can be shared with the patients who are looking for counseling and rehabilitation services. Few organizations in Delhi such as Blind Relief Association (blindrelief.org), National Association for the Blind (nabdelhi.in), and Silver Linings (silver-linings.org) offer residential facilities along with vocational courses for the blind people. [Table 1] discusses a list of various organizations working in Delhi for patients with different types of disabilities, and [Table 2] discusses a list of organizations working for patients with visual disabilities in other parts of India. These lists are by no means exhaustive and we are sure that there may be several more working in this field, but the idea of sharing this is to make ophthalmologists aware of some of the referral points available in their respective areas.
|Table 1: List of various organizations working in Delhi for people with different types of disabilities|
Click here to view
|Table 2: List of various organizations working in a different part of India for people with visual disabilities|
Click here to view
Attitude must be changed in this regard and currently work is being done to add topics like “what happens when disability sets in” in the M.B.B.S. curriculum to sensitize medical students. Similar workshops should be arranged for ophthalmology residents and fellows to make them visit rehabilitation centers and orient them to these facilities. Also, sessions should be organized in various national conferences where speakers from various rehabilitation centers and NGOs should be invited to speak and share their experiences with the attending ophthalmologists.
We believe an ophthalmologists' role should not be confined to merely handing out “disability certificates” to patients without light perception but should be of a counselor giving hope and information to the patient about the next steps of treatment and social rehabilitation.
Once we are able to integrate blind people in mainstream work as human resources and use their skills for the betterment of society that is when we would have done enough!
We would like to thank Ms. Preeti Monga (Silver Linings), Mr. George Abraham (Score Foundation) for their time, ideas, discussions, and inputs. Special mention of Mr. David Absalom (Blind Relief Association) for sharing the list of NGOs with us and for the tour of the BRA.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]