As Indian eye care shifts towards cataracts, experts urge shift to retinal health

While the National Programme for Control of Blindness and Visual Impairment (NPCBVI) has made significant progress in addressing cataract and glaucoma-related blindness in India, experts stressed the urgent need to prioritise retinal health. They warned that damage to retinal nerve cells, which can lead to loss of central vision, is irreversible.

The pool of ophthalmologists in India is primarily focused on treating the anterior part of the eye, with around 80% of them specialising in cataract and glaucoma. Dr Raja Narayanan, network director, Anant Bajaj Retina Institute at LV Prasad Eye Institute, and Dr Mudit Tyagi, head, Kanuri Santhamma Centre for Vitreous Diseases at LVPEI Hyderabad, while interacting with the media in Hyderabad on Wednesday, said that only 8% of ophthalmologists specialise in retina care (back part of the eye) and most of them are concentrated in tier-one cities.

The need for retinal care is growing steadily due to the rising burden of diabetes in India. Of the country's 10 crore diabetics, one crore suffer from diabetic retinopathy, a condition in which high blood sugar damages the retina. Of these, 30 lakh patients require immediate treatment. However, India has only 24,000 ophthalmologists, which is just 13 per million people – this shortage is a challenge in addressing retinal diseases, doctors said.

Globally, retinal disorders are responsible for 6% of all cases of blindness. Conditions such as diabetic retinopathy, diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) are of particular concern. DME is caused by fluid leaking into the retina from damaged blood vessels, while nAMD is a degenerative disease that affects the central retina in people over the age of 50.

“Current treatments for retinal disorders, such as frequent injections, place a significant burden on patients due to the cost and the need for regular eye clinic visits. Many patients also fear eye injections, which adds to the challenge,” said Dr Raja Narayanan.

Both experts highlighted the importance of early diagnosis and treatment, which can prevent vision loss and its serious impact on patients and their families.

Dr Mudit Tyagi called upon NPCBVI to expand its focus to include retinal treatments and urged that retinal care, including intravitreal injections, should be covered under the Pradhan Mantri Jan Arogya Yojana (PM JAY). He also advocated for more flexible insurance policies to provide more coverage for these treatments.