“Our Aim is to reach the unreached communities with comprehensive eye care services and to reduce the burden of eye diseases from service catchment area.”

Introduction

The idea of establishing dedicated community ophthalmology wing is the brainchild of Dr.B.K Jain, Director  & Trustee of Shri Sadguru Seva Sangh Trust. The exposure gained by Dr.B.K Jain during his visits to Nepal and Southern India resulted to establishment of community outreach department 2001. The department started in a small place with four people today grown into an internationally recognized Centre for Community Ophthalmology. The objective behind initiating community outreach program was:

• Combating seasonal imbalance in service delivery at Sadguru Netra Chikitslaya (SNC)
• Creating healthy environment for eye care service delivery that is accessible, acceptable and affordable to all
• Creating awareness among community for developing eye health seeking behaviour
• Developing sustainable model of service delivery i.e. high volume, high quality and low cost (to patient) services.

Currently CCO caters to eye care needs of 23 million population spread in the 250 kms. radius.It reaches to remote and densely located villages where existence of any care service provider is almost impossible.

Reach-out camps

Outreach eye camps take eye care services to the doorstep of the community. Started in 2001-02 with mere 32 outreach camps and 340 odd surgeries, today outreach program run by CCO is one among the largest rural outreach program across the globe.

Districts covered:

Uttar Pradesh

Banda, Chitrakoot, Mahoba, Hamirpur, Fatehpur, Kanpur, Kanpur Dehat, Auraiya, Jhansi, Lalitpur, Kaushambi, Prayagraj (Allahabad), Jaunpur, Amethi, Raibareilly, Sonbhadra, Bhadhoi, Varanasi, Unnao, Jalaun, Mirzapur and Pratapgarh.

Madhya Pradesh

Satna, Katni, Rewa, Sidhi, Panna, Chhatarpur, Tikamgarh, Singrauli, Shahdol, Umaria, Jabalpur, Damoh, Sagar, Mandla, Dindori, Anuppur & Niwari.

District	# of camps	OPD	RE	AS	OD	MD	Adv/Sur	Act Sur	Free	Sub	Pay	Prem.
2007-8	273	55572	14247	9712	3702	0	11961	8633	7137	1490	6	0
2008-9	368	62267	14295	10043	4479	0	14583	10965	9153	1801	11	0
2009-10	4	0	0	0	0	0	0	156	137	19	0	0
2010-11	549	70120	18535	13219	6558	0	21277	16523	14745	1714	62	2
2011-12	537	85337	21203	15060	7422	17940	24260	16584	14455	2005	118	6
2012-13	547	90469	23149	16881	9321	26364	27707	20560	18706	1738	113	3
2013-14	908	117168	38264	26672	11514	44649	43608	26317	23418	2734	152	13
2014-15	1895	241312	67904	44971	13780	82074	64892	46365	4316	2920	256	20
2015-16	2458	337073	93605	59501	20405	121339	70671	55869	51915	3640	281	33
2016-17	1770	297443	85293	56956	23257	11176	64039	50932	46176	3999	719	38
2017-18	1971	298233	81083	54314	31680	114673	66944	52258	44882	5997	1302	77
2018-19	2124	287365	80364	56404	34920	102571	76996	57916	48999	7032	1776	109
2019-20	2007	282485	77687	59251	41913	87802	82314	56962	46440	8087	2291	144
2020-21	772	133810	28712	22356	16049	23890	51062	34102	25682	6487	1754	179
2021-22	1601	259998	71695	54585	42173	65313	86360	53014	40138	10217	2174	485
2022-23	2116	297050	76946	60670	47652	81858	96258	52066	37358	11638	2519	551

Primary Eye Care Centers

The model of vision centre is envisaged by the Vision 2020 – The Right to Sight, a global initiative of International Agency for Prevention of Blindness (IAPB – a global machinery working across the world for the prevention of avoidable blindness). Vision Centres are aimed towards providing primary eye care services to the rural underserved population. Aligning with this initiative, Government of India is planning to set up at least 20,000 vision centres across the country. At present, the department has established 117 IT enabled vision centres in remote rural locations of Uttar Pradesh & Madhya Pradesh.

Particulars	No. of Vision Center	Vision Center OPD	Total spectacle prescribed	Total spectacle dispensed	No. Of Camp Vision Center	Vision Center CAMP OPD	Vision Center Camp Surgery	Camp Follow-up attend at Vision Center
2010-11	23	11193	5320	0	527	0	10213	27%
2011-12	23	42991	25335	13533	589	21710	11215	72%
2012-13	23	63885	41051	37426	762	66480	22260	83%
2013-14	26	76870	47465	42223	1014	77686	24128	86%
2014-15	33	90542	52400	48416	1244	84387	22119	94%
2015-16	35	114162	58756	52429	1296	87442	22825	85%
2016-17	39	127611	64385	57939	1454	98078	24843	84%
2017-18	40	142258	69114	63763	1505	109251	25629	84%
2018-19	41	152184	70227	66375	1551	94126	26297	70%
2019-20	43	179262	85925	77841	1671	92916	25570	90%
2020-21	56	157342	75940	70684	1005	14438	22131	77%
2021-22	76	223930	109070	96439	1889	69203	30076	78%
2022-23	107	306922	132540	117620	3088	97455	41406	73%

School Eye Health Program

School eye health program & Anaganwadi Screening is the regular activity of CCO to provide eye care services to neglected and sensitive population .i.e 0-15 age group.

Particulars	2010-11	2011-12	2012-13	2013-14	2014-15	2015-16	2016-17	2017-18	2018-19	2019-20	2020-21	2021-22	2022-23
VC CAMP OPD	0	21710	66480	77686	84387	87442	98078	109251	94126	92916	14438	69203	97455
PAID(OPD)	7119	29942	40019	51256	61365	84090	95972	109351	120770	140665	127491	174976	204559
FREE(OPD)	493	1352	1846	2132	2461	3444	4393	4193	2865	3642	2274	12798	57022
VC FOLLOW-UP	160	842	1107	916	993	3223	4532	6084	9019	10807	8525	10730	13368
VC CAMP FOLLOW-UP	2716	8046	18444	20692	20763	19337	20915	21606	1849	2294	17057	23471	30292
CAMP FOLLOW-UP	465	2459	1948	1213	4185	3151	1441	683	715	890	1199	1468	1357
HOSPITAL FOLLOW-UP	240	350	521	661	775	917	358	341	322	312	796	487	324
TOTAL SCREENED PEOPLE	1193	64701	130365	154556	174929	201604	225689	251509	246310	272178	171780	293133	404377
REFRACTIVE ERROR	7044	27670	4504	52201	59260	67627	71808	76620	80093	91633	78486	114113	155528
TREATMENT PROVIDED	437	19728	33714	49306	73567	95084	117676	137335	137151	143845	117853	154475	199184
SPECTACLE PRESCRIPTION (DIRECT)	2852	14876	20368	25261	27036	36024	42030	46545	49848	58495	54522	80416	98115
SPECTACLE PRESCRIPTION (VF)	42	385	625	534	504	1181	1273	1586	3082	3875	3605	4669	5507
SPECTACLE PRESCRIPTION (VCF)	2057	7545	17728	19881	20100	18133	19373	2003	16405	22384	15992	22290	27535
SPECTACLE PRESCRIPTION (CF)	242	2206	1839	1176	4032	2615	1395	658	616	870	1080	1249	1100
SPECTACLE PRESCRIPTION (HF)	127	323	491	613	728	803	314	302	276	301	741	446	283
TOTAL SPCT. PRESCRIPTION	5320	25335	41051	47465	52400	58756	64385	69114	70227	85925	75940	109070	132540
SPCT. DISP. (DIRECT PAID)	0	6702	16454	19859	22719	29380	34700	40168	44274	50970	49184	67867	82918
SPCT. DISP.(VF)	0	286	733	642	589	1217	1510	2039	3237	3961	3714	4765	5514
SPCT. DISP.(VCF)	0	5568	17844	19908	20269	18268	19981	20584	17868	21781	15867	22181	27713
SPCT. DISP.(CF)	0	795	1894	1184	4100	2722	1422	671	701	861	1169	1363	1195
SPCT. DISP.(HF)	0	182	501	630	739	842	326	301	295	268	750	443	280
TOTAL SPCT. DISPENCED (PAID+FREE)	0	13533	37426	42223	48416	52429	57939	63763	66375	77841	70684	96439	117620
TOTAL SPCT. DISPENCED (PAID)	0	7302	17258	20651	23319	33463	38331	44201	49831	59815	59442	79207	97497
Total SD(<=250/-)	0	5791	12416	12817	12056	17096	18574	19065	19319	20729	17880	20515	22262
Total SD(>250/-)	0	1511	4842	7834	11263	16367	19757	25136	30512	39086	41562	58692	75235
REFER TO SNC	1629	4958	5976	7166	6991	7025	7877	7249	7369	8191	14207	21260	34626

Management information system is a big challenge in managing mega outreach programs as well as primary eye care centers.  It is almost impossible to keep track each performance indicator of outreach camps, vision centers, school eye health and other community programs.  It is very complex to maintain database according to varied demands of funding agencies and donors.  To overcome this barriers Center for Community Ophthalmology (CCO) developed its own information systems to manage, monitor and evaluate community programs.

Camp Automation System (CAS):  Our IT team has developed in-house software program to manage information systems for outreach camps. Developed in 2006, CAS is very useful and effective tool to manage huge database for tracking performance of each outreach camp.  With-in single flick CAS software provides required data in tabular form and analyzes crucial information for decision making. It provides systematic information on all performance indicators to make tailor made reports as per various reporting requirements. It has inbuilt tab for generating report on Visual Acuity Analysis, and financial reports.

Vision Center Management Systems (VCMIS): Another feat achieved by our IT team by developing software to manage Vision Centers.  Developed in 2009, VCMIS is capable to track each and every activity of Vision Centers. It provides day-to-day information on Outpatient visits, Refraction and Optical dispensing, treatment and follow-up records.  It also has separate tab for managing vision centers inventory and finances. It also has inbuilt mail delivery services to communicate with base hospital. VCMIS makes vision center monitoring easier and it is very user friendly.

School Eye Health Systems (SEHS): Developed in 2007 by our IT team SHES is user friendly software to manage and analyze data of school eye health program.  Once all basic information is entered it provides School Eye Health Program results in single click.  It is very helpful in managing, monitoring and evaluating School Eye Health Program.

Advocacy

SNC actively participates in raising the voice for marginalized and poor people from the region.SNC is the prominent member of Vision 2020-Right to Sight India. Trust is also member of Community Ophthalmology Symposium of India (COSI). In addition to this CCO never miss any opportunity to advocate the rights of marginalized people suffering with avoidable blindness at any forum. It actively celebrates all the advocacy events such World Sight Day, Eye Donation Fortnight, Diabetes day, Glaucoma day for creating awareness among masses etc.

Consultancy

SSSST always believe in team work and capacity building. Realizing the immediate eye care needs of marginalized population we are engaged in capacity building of other struggling/new eye hospitals to build their capacity in reaching more underserved population. Capacity building focuses on sustainable development of eye hospitals with putting systems in place and ensuring quality of care with high volume surgeries.

• Sitapur Eye Hospital, Sitapur
• Sadguru Sankalp Netra Chikitsalaya, Anandpur
• Seva Sadan Eye Hospital, Bhopal
• Ratanjyoti Eye Hospital, Gwalior

• Seva-Lavelle Vision Centre Project: Since 1978, Seva has been a leading innovator in the delivery of vital eye care services to the world’s most vulnerable including women, children, and indigenous people.  Seva-SSSST partnership started in 2002-03. Initially the project started with supporting adult outreach camps, hospital based training programs (HBPs) and training of manpower. Currently, Seva Foundation is supporting Seva-Lavelle project aimed towards development of Seva supported vision centres.  Seva Foundation is also playing  a catalyst role in Seva-IAPB-SNC mentoring project as well as TOMS service delivery project.
• TOMS: TOMS is a well-established American shoe company. When Toms sells a pair of shoes a pair of shoes is given to an impoverished child, and when Toms sells a pair of eyewear, part of the profit is used to save or restore the eyesight for people in developing countries. TOMS is working with SSSST through Seva Foundation since July 2011.
• SEVA-IAPB-CCO Mentoring Project: Through the efforts of the Seva Foundation and IAPB, selected institutions in every region of the world are becoming hubs for training, mentoring, and improvement among surrounding eye hospitals.  This network is known as the Global Sight Initiative (GSI), and its goal is to build the capacity of at least 100 eye hospitals through this process and to produce an additional one million sight-restoring cataract surgeries annually.  GSI partners are working to continually improve their own hospital’s services, while reaching out to help other hospitals in their region. The aim is to multiply the number of sustainable, community-oriented eye programs throughout every part of the world.
  SSSST as a CCO partner currently engaged in capacity building of two hospitals: (i) Sitapur Eye Hospital, Sitapur (ii) Sadguru Sankalp Netra Chikitsalaya, Anandpur, Vidisha and a plan for adding two more hospitals i.e. Seva Sadan Eye Hospital, Bhopal and Ratan Jyoti Eye Hospital, Gwalior is almost final.
• Help Me See – helping the blind see: Creating a massive treatment program that will provide millions, the miracle of sight surgeries in 80 of the world’s poorest countries. Help Me See aimed towards eliminating avoidable blindness due to Cataract by empowering local surgeons and hospitals towards sustainable eye care services.
  Help Me See is associated with SSSST since 2011. Help Me See-SSSST partnership making inroads in the Bundelkhand region for making Vidisha Division a ‘Cataract Backlog Free Zone’.
• Cataract Backlog Free Zone:
  • Chitrakoot: CCO was engaged in making Chitrakoot District a ‘Cataract Backlog Free Zone’. The population of Chitrakoot is around one million and there were estimated >10000 cataracts. Declaration of Chitrakoot district as Cataract Backlog Free Zone was made on 2nd October 2014.
  • Banda & Panna: Inspiring from the success of Chitrakoot Cataract Backlog Free Zone project our team is currently engaged in making Banda & Panna districts Cataract Backlog Free Zone. The project has been initiated in June 2014 and 50% of targets have been already achieved. It is estimated around 20,000 cataract surgeries to make both the districts Cataract Backlog free zone.