|Year : 1988 | Volume
| Issue : 1 | Page : 50-51
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mohan M. Presidential address. Indian J Ophthalmol 1988;36:50-1
Honoured guests, distinguished colleagues of the fraternity, ladies and gentlemen. Thank you all very much for giving me the honour and the opportunity to address you on this occasion.
We can glance back at the past with satisfaction and pride on the achievements of the All India Ophthalmological Society. And on looking forward we see a bright future in the big force of our young and more accomplished colleagues From Darkness to Lighf is what is our commitment
Earlier plans on preventions of blindness were based on the available data of 9 million blinds with a vision of 6/60 as the cut-off line and 3.14 million blinds with 3/60 as the cut-off line. The latter figure tallies with the N. S. S.O. Assessment of the visually disabled (3.47 million), conducted in 1981.
To meet this challenge, the Government of India launched the National Programme for the Control of Blindness in 1976 with the objective of reducing the prevalence of blindness from 1.4% to 0.3 % by the year 2000 A D. The major strategies outlined therein are (1) to prevent the "Preventable" blindness through eye health education and primary eye care (2) to provide immediate relief by the eye camp approach and (3) to develop a permanent infrastructure, in a phased manner, to meet the long term needs. The programme is being implemented as a 100% Centrally sponsored national programme through the Governments of States and Union Territories.
Voluntary organisations have played a very significant and vital role particularly in the eye camp programme.
The members of our society have made major contributions in fulfilling the mandate and have conducted eye camps in remote areas at great personal inconvenience, hardship and financial sacrifice. We can in all humility claim to be the only group of medical specialists which has served the community right at their doorsteps and is willing to do so in the future. The Government on their part should consider instituting awards and incentives for eye surgeons and other members of the eye camp teams, as recommended by the Swaminathan Committee (1982).
We have been rightly concerned about the injudicious use of corticosteroids prescribed by RMP's and private practitioners. It is heartening to note that our recommendation for issuing a warning on all steroid preparations, and colour coded labels on ophthalmic drugs, has been accepted by the Drug Controller of India. We are making concerted efforts to seek custom duty exemption on all essential ophthalmic equipments to ensure that the benefits of modem science reach the people at reasonable costs. I have also, on your behalf appealed for liberalisation of the import of special qualities of steel for the manufacture of surgical instruments.
The problem of corneal blindness, though on the decline, will need many decades for its control. We still see corneal disasters due to Vitamin A deficiency, Serious corneal infections due to bacteria, TRIC agent fungi and viruses and other corneal inflammations due to systemic diseases.
latrogenic lesions due to the injudicious use of steroids, and the mushrooming of a new generation of L O. L surgeons, inadequately exposed to the art of surgery and least of all to its inherent dangers, have already started taking its toll on corneal blindness. The Society should evolve a code and develop guidelines for eye surgeons and the manufacturers of intra-ocular lenses.
Our efforts to create an awareness and mobilise eye donations did not yield the desired results for over 20 years. We now need to gear ourselves up to create eye collection facilities in every town and train more corneal surgeons for their utilisation.
Cataract is the major cause of avoidable blindness all over the world We in India, are deeply concerned about the accumulating backlog.
It is a matter of great concern that the trained ophthalmologists are unable to develop necessary facilities and mobilise resources to perform eye operations. At an average, I eye doctor is performing 200 operations a year. If we can achieve a target of 365 operations per ophthalmologist per year i e. one operation a day, we shall be quite close to our goal. Let us try to develop the required infrastructure and mobilise resources for the purpose.
The ultimate solution to the problem of cataract does not lie in its surgical corrections but in its prevention. Even if the occurrence of cataract can be delayed by 10 years, it will reduce the surgical burden to half Cataract Research Groups (C.C.RG.) have been formed in different countries and the epidemiology of cataract is being discussed at various international meets.
We have undertaken 3 major projects in this field with the support of the N. P. C. B., W.H.O. and L C. M R
Posterior Segment Blindness
Other posterior segment blinding disorders, particularly diabetes mellitus and senile macular degeneration, will need increasing attention of the eye surgeons once the anterior segment blinding disorders are reasonably controlled.
Primary Eye Care
The key to the control of blindness is to develop an efficient primary health care system It may not be possible for medical officers who are already overburdened with other programmes to take up this responsibility. He could be assisted by ophthalmic assistants and para-medical workers trained under the National Programme in eye health education, school health programme for detection of refractive errors and other ocular disorders. There is also a need to train ophthalmic technicians and nurses for ophthalmic nursing and investigative procedures.
Medical & Health Education
The society has still not succeeded in restoring separate examination in the final MBBS. The curriculum and training of under- graduates should lay emphasis in the development of competence to diagnose and treat simple and common blinding disorders and in handling of ocular emergencies. References should be minimised to what cannot be handled by general practitioners.
Our post graduate training at the diploma level should concentrate in aquisition of skill and competence to manage common blinding disorders leaving retinal detachment keratoplasty, ophthalmoplasty, and orbital surgery for the degree level.
Continuing medical education for control of blindness is a must for ophthalmic specialists, health planners, practitioners and para medical workers. The diagnostic facilities and ophthalmic equipment should be upgraded.
In our annual conference we see a galaxy of researchers sharing their experiences and many other equally young and fertile brains who are not able to bloom owing to lack of guidance and support We should pick out these brilliant people and give them research potential and at the same time recognize their work before it is recognized abroad.
We should raise the standard of research and quality of our papers be proud of our own Journal and send our best papers to the Indian Journal.
Newer, sophisticated and expensive equipment is produced abroad and we have to import these at present Indigenous industry with a co-ordinated effort between the industry, engineering, biotechnological industries and professionals may help in developing good inexpensive equipment Liberalisation of import of components and concession on customs duty will also help rapid development of this industry.
Each one tech one
We need to enroll all ophthalmologists as our members. Dr. B. T. Maskati in his presidential address last year had exhorted us with the axiom "EACH ONE REACH ONE". I would like to prescribe the second step, "EACH ONE TEACH ONE". Ours is a speciality of technical skills. Many of our colleagues need to update their skills. This can not be done in the workshops and conferences only. So let" EACH ONE TEACH ONE". Let each senior teach a junior.
Accountability of profession to the people
While it is out bounden duty to look after the development of the science of Ophthalmology and the interest of our members, we cannot escape our obligations and responsibility to the people. With the boom in industrial and scientific growth, expectations of the people have also grown. We must come up to their expectations. Our profession has tremendous potential and we should harness its strength - to meet our obligations.
Our people exhibit full faith in the doctor being largely guided by their advise and are grateful for the benefaction obtained.
As a poet has said,
"Those who thus can see again
A world clear, crystal bright
Will never cease to thank the man Who gave them back this light".
"Let there be no endless night Let the world glow with light Let us friends join In the fight for sight".
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