Integrating Primary Eye Care with Primary Health Care Services in India: Perspectives and Learnings to Strengthen Primary Healthcare Systems in India.

Abstract

Background: Vision impairment and blindness are major public health challenges, especially in low- and middle-income countries. Although the prevalence of blindness in India has reduced considerably, untreated cataract still remains a public health challenge. The World Report on Vision (2019) emphasizes the need to make eye care an integral aspect of universal health coverage and incorporate integrated people-centred eye care in health systems.

Objective: (1) To describe the setup of an Integrated Primary Eye Care model. (2) To describe the pattern of ocular morbidity among patients attending the primary healthcare clinics across four states in India.

Methods: Retrospective observational study describing the primary eye care services delivered across four states in India between August 2019 and March 2020. The de-identified secondary data were analyzed for the pattern of ocular morbidity.

Results: Seven thousand and twenty-four patients availed the eye care services across the four primary care clinics. Majority of the patients were female (54.7%), most patients belonged to the age groups of 45-60 years (33.2%) and 30-45 years (32.3%). Elderly patients of both genders had equal access to the eye care services. The common presenting complaints were diminished vision (83.1%), redness (9.5%), and pain (6.4%).

Conclusion: Uncorrected presbyopia (35%), refractive error (32.8%), and cataract (12.8%) were the commonly observed ocular morbidities. Integration of primary eye care into primary health care can improve access to eye care services, especially for vulnerable population such as elderly and women, who otherwise face several challenges to access eye care services.