75,000 ophthalmic technicians needed

While we have enough ophthalmologists (estimated at about 15,000 and a training capacity that graduates 1,000 new ophthalmologists a year), the situation pertaining to all other cadres of eye care personnel is extremely bleak.

I would like to focus especially on those who work in a hospital under the supervision of an ophthalmologist. In a way, they enhance the overall efficiency of the system and the quality of eye care provided. They are referred to as 'Ophthalmic Technicians'.

For an ideal performance, an ophthalmologist needs five ophthalmic technicians. Thus, India would need anywhere between 75,000 to 100,000 such personnel. Today, very few structured training programmes exist in the country. Even less have any sort of accreditation and there is no national accrediting body for this entire workforce.

In general medicine nurses carry out routine diagnostic and clinical tasks. So doctors can focus on more important aspects. Such nurses with general training are not useful in an eye care setting since most techniques employed, such as refraction, measuring intraocular pressure, assessing the field of vision or performing ultrasound biometry are not taught to them. Also, most nursing skills are not relevant in an eye care setting.

Moreover, when there is a shortage of nurses in India, it doesn't make sense to take well-trained nurses and train them in completely new skill sets, while discarding what they have already learnt. This necessitates the development of the cadre of ophthalmic technicians, as a separate career track.

Currently there are such people working in eye hospitals or eye clinics, under an ophthalmologist. They are all trained on the job. As a result they possess varying levels of skills and knowledge, and their utilisation is also varied.

This very situation existed in the US, some decades back. To address this enormous problem, various eye care associations in the US came together, to promote an independent body. The organisation known as the Joint Commission for Allied Health Personnel in Opthalmology (JACAPO), took on the role of defining a common curriculum and conducting examinations to certify qualifying candidates in the US.

While neighbouring countries such as Nepal, Bangladesh, Sri Lanka and even a tiny country like Bhutan, have accredited training programmes for this cadre, for some reasons this has not happened in India despite several attempts over the last two decades.

But recently, various organisations involved in eye care came together, and asserted the urgent need to have a common curriculum and certification process, so that this cadre of personnel - who in many ways are the backbone of eye care - can evolve into a formal, well-trained and effective workforce.

Several eye hospitals that are currently engaged in such training have formed a network. This network, which is in the process of taking form, will initially focus on establishing the standards and guidance for accreditation, agree upon a common curriculum and lay down the assessment and certification process for the students undergoing the training. The network will also produce and disseminate teaching materials so that standard of training is enhanced.

This initiative would contribute towards developing a new cadre of formally certified eye care personnel. This would also open up career opportunities for them in a big way. And it would be further strengthened when the government comes forward and recognises the training.

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