News from our member L V Prasad Eye Institute

This month, we hosted Derek Hodkey, Orbis’ CEO, at the Institute. As our teams took Derek around, it was a good opportunity to revisit the decades of work Orbis and LVPEI have collaborated on together: training programs, treatments especially for children, and our partnerships in innovation, research, and community outreach. We have also supported Orbis’ program to improve capacity for pediatric eye care across India. Derek’s visit also made me nostalgic: I was one of four LVPEI alumni who were staff ophthalmologists on the Orbis flying eye hospital – a fully equipped, MD-10 airplane that is also a teaching hospital—over the years. This is Orbis’ flagship education initiative and many more current faculty members are contributing as volunteer faculty for both on plane and ‘off plane’ activities. During his visit, Derek got to see our push towards product engineering as part of our innovation arm for ensuring last mile eye health coverage for vulnerable populations, and for those living in remote rural areas. He also got to meet and speak with our excellent pediatric eye care team as well.

It got me thinking about LVPEI’s long and deep relationship with eye care NGOs, both national and international, over the years. A diverse group of civil society organizations have been committed supporters of the expanding LVPEI pyramid. Along with infrastructure, they have supported training and human resource development, and community outreach. In addition, they helped support our research to understand the prevalence and causes of a variety of eye conditions in the population. These organisations have taken on the mandate to eradicate avoidable vision loss around the world—a mission that is central to LVPEI. Together with our partners, we are building an eye care service delivery ecosystem that improves outcomes and increases access to eye care.

LVPEI’s Public health journey

Take Harpreet Kapoor, advisor on disability for the international NGO, CBM, who visited us too this month. In 2022, I wrote to you about a new project in Nirmal district of Telangana, the ‘Sight for all: community-based inclusive eye health’ project. With CBM’s support, we are screening over 700,000 people in more than 400 villages of that district. Along with identifying those with sight loss, the project will also identify those with disabilities or are otherwise vulnerable and bring them into the ambit of eye care. CBM has been at the forefront of disabilities-related policy and practice, and this project will add vital, population-level data to support such policies. It will, of course, ensure that no one with disabilities in Nirmal district will be left behind while serving the district’s eye care needs.

LVPEI’s relationship with CBM goes back decades; they are one of our founding organisations. In the early 90s, the late PG Michael of CBM (and Nagarajan of Sightsavers) urged Dr Gullapalli N Rao, (our founder chair, fondly called ‘Nag’) to tackle the vast problem of vision loss prevalent in rural India. They ended up funding our first two secondary centres, the first in Mudhole (also in Nirmal district now) and Thoodukurthy. Allen Foster, another key presence at CBM, and Nag Rao worked out the basic blueprint of the LVPEI pyramid (and from it, some of the building blocks of VISION 2020: The Right to Sight global initiative. In fact, both played a key role in the International Agency for the Prevention of Blindness and its efforts to build an eye care coalition to advocate for global eye health.) on a train journey visiting CBM-supported eye hospitals in Andhra Pradesh. It was a memorable journey for both for many more reasons–but that is for another time. This fateful train journey also seeded the development of the International Centre for the Advancement of Rural Eyecare (ICARE), LVPEI’s public health arm.

We now take for granted the idea that the primary node for eye care service delivery is a ‘vision’ centre (a primary care centre). However, for more than a century, the nidus of care delivery was an ‘eye camp’. A team of doctors and support staff would roll into a village, commandeer a community hall or school, and set about operating on hundreds of patients. Over decades, evidence began to mount that the outcomes were abysmal. But what was the way forward? The vision centre presented a revolution: permanent sites for eye care that foster health-seeking behavior and build a sense of trust because it is a centre that is supported, run, and patronized by the community around it. 

CBM and Sightsavers had taken a great leap of faith in supporting LVPEI and our vision. They ran independent evaluations and supported our first vision centres as well. CBM partly supported the Andhra Pradesh Eye Disease Study (APEDS), the landmark population-level survey that grounded in evidence our public and community health work.

Diverse friendships

Over the years, many other NGOs came in to support our efforts to tackle needless vision impairment and blindness. Operation Eyesight Universal, a Canadian NGO, funded two of our tertiary centres along with other infrastructure. Wen Giving Foundation and Mission for Vision have been supporting the spread of our vision centres in the three states of Telangana, Andhra Pradesh, Odisha, and the training of allied health work personnel. We also work closely with the Seva Foundation (and TOMS) and the Lions Clubs International Foundation. Together with Rotary Clubs International, we helped upgrade hospitals they work with. Our vision centres have been supported by numerous NGOs and civil society organisations like the Lavelle Fund for the Blind, the Latter-day Saint Charities, OneSight International, USA among many others. The Cognizant Foundation has supported our project to screen babies with Retinopathy of Prematurity (ROP). 

Working closely and together with all these civil society organizations we have built an eco-system where the efforts of each organization multiply and bring us closer to a world without needless vision impairment and blindness. It takes a village to raise a child, they say. It takes a large and diverse set of partners to tackle global vision loss, and I’m grateful for all the partnerships: past, present, and future. 

– Prashant Garg