Eye care is a Noble mission

“Let there be light”

I am delighted to address and interact with the doctors, nurses, paramedics, optometrist and staff of Eye Hospital. My greetings to all of you.I am happy that National Eye Hospital has a vision of becoming the best tertiary eye centre in Sri Lanka providing quality care to people across all sections of the society. Also, I appreciate the mission of this hospital to make a lasting impact on the eradication of blindness in Sri Lanka by providing quality care without any economic or social discrimination. When I am in the midst of healthcare giving community, I would like to share few thoughts on “Eye care is a Noble mission”.

Excellence in eye care

Friends, eye care in one area where India has reached good progress in diagnosis, treatment, particularly in reducing avoidable blindness nationally. Such an excellence is not by accident. It is due to vision of pioneering thinkers, imaginatively executed with systematic capability building, effective networking of specialists in India and abroad, good social entrepreneurship models to ensure inclusiveness and a desire to maintain excellence. I personally feel the eye care examples have elements which can be translated to many other areas. At the same time eye care professionals have to strive to maintain and excel in excellence by intensifying research. This excellence has arisen from the collective efforts of doctors, nurses, paramedics, and the staff of the eye-care institutions.

Status of Eye-diseases in India

I was going through the studies carried out by two important groups- the L V Prasad Eye Institute (the Andhra Pradesh Eye Disease Study, APEDS) and the Aravind Eye Hospital (the Aravind Comprehensive Eye Survey, AECS) on the overall prevalence of the Eye diseases including retinal diseases in general population in India. The results show the following trends.

Table 1
Andhra Pradesh Eye Disease Study (APEDS) Blindness Data
Disease Percentage
Cataract 44.0
Refractive Error 16.3
Retinal Disease 10.9
Glaucoma 8.2
Corneal disease 7.1
Optic atrophy 6.0
Amblyopia 4.3
Congenital eye disease 1.1
Others 2.2
(Source: Andhra Pradesh Eye Disease Study. Investigative Ophthalmology & Visual Sciences, 2001)

We can see that the Retinal disease constitutes around 11 percent of all the Eye diseases. The common retinal diseases are Diabetic Retinopathy (DR), Age related macular degeneration (AMD), Hereditary Retinal Dystrophies (HRD) and Retinopathy of Prematurity(ROP). I am sure, Retina India contribution will lead to development of bionic eye. I am confident that Doctors of National Eye Hospital are focusing on removing the problems related to all the Eye disease including Glaucoma, Refractive Error, and Congenital eye diseases. You may like to analyse whether the proportion of Eye diseases encountered in Sri Lanka is same as India. If they are different, you may like to carry out research for establishing the reason, so that corrective action can be taken by modifying the life style of Sri Lankan citizens.

Burden and Treatment

I am fortunate to have topmost ophthalmologists as my friends who are involved in various phases of treatment and particularly research, development on eradicating avoidable blindness in our country and abroad.

Let me share few experience, what I have learnt.

Cataract blindness (close to 50%) and Refractive error (close to 20%) continues to be the main causes of blindness, and is followed by Retina, Glaucoma and Corneal causes of blindness. But what differentiates is the amenability of treatment. Cataract needs a one-time surgery and refractive error needs a pair of spectacles. In contrast retina, glaucoma and cornea related blindness need a complex care in diagnostic and treatment, resulting in the need of highly skilled personnel, cost effective diagnostic tools and treatment outcome from research efforts.

Dimensions of Healthcare giving

Diagnosing diseases accurately without inducing diagnostic pain indeed reflects the professional excellence of the healthcare giver.

Curing the patients, with precise treatment, with minimum time and cost, and zero side effects, is a tribute to the human ingenuity.

Of course, based on the diagnosing the disease and curing experience, the healthcare givers, becomes a teacher to the families and other patients. The preventive cure is indeed, a great contribution for the national health and the healthcare giver becomes a partner to national development.

There are two aspects of medicine – curing and preventive. For example, the diabetic and cardio disorders are lifestyle disorders and preventive medicine can be applied. Another area is training. We have three famous ophthalmologists in India. One is Dr. S Badrinath, founder of Shankar Netralaya, Chennai, Dr. Namperumalswamy of Aravind Eye Care System, and Dr G. Nageswar Rao, founder Chairman of LV Prasad Eye Institute Hyderabad. These three ophthalmologist brought world class treatment for the Diabetic Retinopathy to Indian people. They have further trained about 300 doctors specializing in diabetic retinopathy.
Friends, now let us discuss the six virtues of medicare.

Six virtues medicare giver must possess

Friends, now I would like to share an experience with Choakyi Nyima Rinpoche, the Chief Monk in Kathmandu and a medical researcher. After nearly a kilometer of walk, I reached the white Kumbha where the chief Monk and his disciples were waiting to receive me. After reception the Chief Monk said, let us go to our study room and I followed him. He climbed the first floor, the second floor, the third floor, the fourth floor and the fifth floor, just like a young boy. Probably the life style has a positive impact on the mind and body. All along I was following and following.

When I reached his chamber, I saw a laboratory and a spiritual environment over looking the Himalayas. What surprised me was his research students come from different parts of the world. Particularly he introduced me to his co-author David R Shlim, MD who is working on a research area, Medicine and Compassion. The Chief Monk Choakyi Nyima Rinpoche and myself exchanged few books. The Monk has written with Dr. David R. Shlim a book titled “Medicine and Compassion”. I liked this book and read it during my journey from Katmandu to Delhi. This book gives six important virtues which a medical practitioner has to possess towards their patients.

First virtue is generosity; the second virtue is pure ethics; third is tolerance, fourth is perseverance, fifth is cultivating pure concentration and the sixth virtue is to be intelligent. These virtues will empower the care givers with a humane heart. I find these virtues are the core competence of the doctors, nurses, paramedics, and support staff of National Eye Institute.

Conclusion

We have the best of doctors and technologists in India and Sri Lanka. We have core competence in design and software engineering. Emerging technologies in virtual reality and micro machines will transform the healthcare scenario. This transformation should lead to helping the people who cannot afford the modern medical care, particularly in rural areas. To improve the availability of eye care facility to the rural masses, I would suggest the provision of vision centers, mobile eye clinics and tele-ophthalmologic clinics by National Eye Hospital.
My best wishes to all of you for success in your mission of removing the pain of needy patients.
May God bless you.

Oath for Ophthalmology community

1. I as an eye care professional I realize by removing the darkness and giving the light to the patient is indeed the God’s mission.
2. I will always give part of my time for treating patients who cannot afford.
3. Based on the experience and my core competence as a Doctor, I am capable of diagnosing the exact disease at right time.
4. I will treat at least 30 rural patients in a year by going to rural areas.
5. I will encourage the development of quality indigenous equipments and consumables by making use of them and assisting in enhancing the quality and reliability of the products.
6. As a doctor, I will teach the patients, their families in preventive eye care based on my diagnostic observations.
7. I will specialize the field of bionic eye and also glaucoma diagnosis and cure in similar standard what you all have achieved in cataract disease.
8. I will follow the motto “Let my brain remove the pain of the suffering humanity and bring smiles”.