Abstract
Purpose: :
To take treatment of diabetic retinopathy to the semi urban and rural population of India.
Methods: :
Treatment of diabetic retinopathy requires repeated examinations and multiple treatment sessions. Screening the patients on a camp basis and treating them in base hospital does not meet with much success as it costs the patient to travel to the city and obtain treatment.There are many practicing ophthalmologists serving in different areas of our country who are formally trained in ophthalmology but not treating diabetic retinopathy due to lack of equipment and a lack of training in treating these conditionsThe Nayana project aims at overcoming this difficulty by co-operative sharing of expensive equipment between different practicing ophthalmologists.The project takes a fundus camera with angiography and fundus photography facilities, a diode laser retinal photocoagulator, B-scan ultrasound, ultrasound biomicroscope, visual field machine, applanation tonometer and YAG laser on a specially designed mobile van.A vitreoretinal surgeon imparts training in the use of the equipment, diagnosis and treatment of diabetic retinopathy to the participating ophthalmologists in a graded and phased manner over a period of 6 months. After 6 months a V-R fellow trained in medical retina accompanies the van. The van is specially designed to carry delicate equipment on rural Indian roads. All the equipment are packed in special custom made boxes which is strapped in a cabin when the van is in motion.Patients treated on the van pay a nominal amount for their treatment. Patients below the poverty line are treated free of cost. The van with the equipment is available to the ophthalmologist or group of ophthalmologists in a town on one specific day of the month.
Results: :
The van has been on the road for the last 30 months. It touches 21 destinations in 13 districts of Karnataka involving 83 ophthalmologists and 219 general practioners/physicians. 24,420 pts have been seen on the van, 9312 lasers have been performed. 381 retinal surgeries have been performed in base hospital through this project, of which 317 are diabetic related.
Conclusions: :
In a developing country like India where 72% of population lives in rural areas, access to treatment of diabetic retinopathy is a major hurdle. This project by its ingenuity offers a large population of people access to treatment of diabetic retinopathy within 50 kms from where they stay. Since the project also earns a revenue it is sustainable and easily replicable in other developing countries with limited resources.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • diabetic retinopathy • diabetes