Unit 5- Public Health and Community Optometry | 6th Semester Bachelor of Optometry

Optometrist’s Role in School Eye Health Programmes

Introduction

Children’s vision is critical to their academic performance, development, and social participation. School Eye Health Programmes aim to identify visual problems early in life, especially refractive errors, amblyopia, squint, and nutritional deficiencies. Optometrists are essential for these programs because of their expertise in eye screening, refraction, vision therapy, and awareness building among students, teachers, and parents.

Need for School Eye Health Programs

• Over 20% of school children may suffer from undiagnosed visual issues
• Uncorrected refractive errors significantly impact reading, writing, and learning
• Visual problems are often mistaken as learning disabilities or behavioral issues
• Early intervention can prevent amblyopia and improve quality of life
• Schools serve as an effective platform to reach large child populations

Objectives of School Eye Health Programs

• Early detection of refractive errors and eye diseases in children
• Provision of free or affordable spectacles to needy students
• Educate students, teachers, and parents about eye hygiene and nutrition
• Promote regular eye check-ups and build healthy visual habits
• Establish referral pathways for advanced care

Optometrist’s Responsibilities in School Programs

1. Screening and Refraction

• Perform visual acuity tests using Snellen or LogMAR charts
• Check for signs of squint, nystagmus, or amblyopia
• Use retinoscopy and subjective refraction for accurate spectacle prescriptions
• Perform color vision and stereoacuity testing if necessary
• Detect ocular surface issues like allergic conjunctivitis or dry eye

2. Planning and Coordination

• Work with schools and local health authorities to schedule screening days
• Ensure availability of screening materials, prescription pads, and spectacles
• Coordinate with ophthalmologists for complex referrals
• Train school teachers as primary screeners in resource-limited settings

3. Spectacle Dispensing and Follow-Up

• Select child-friendly spectacle frames with appropriate lens material
• Ensure proper fitting and visual correction
• Educate children on spectacle care and importance of compliance
• Follow up in 1–3 months to monitor use and changes in prescription

4. Health Education and Advocacy

• Deliver talks on eye hygiene, digital eye strain, and safe screen usage
• Promote good lighting and posture while reading
• Highlight the role of nutrition (e.g., Vitamin A) in eye health
• Distribute IEC (Information, Education, and Communication) material in local languages

5. Data Collection and Reporting

• Maintain records of students screened, diagnosed, and treated
• Analyze prevalence of refractive errors and other conditions by school or district
• Submit reports to school authorities and program managers
• Use feedback to improve future screening quality

Common Conditions Detected in School Eye Screening

• Myopia (common after age 10)
• Hypermetropia and astigmatism
• Amblyopia (lazy eye)
• Squint or strabismus
• Allergic conjunctivitis
• Color blindness (usually in boys)
• Computer Vision Syndrome (CVS) due to increased screen time

Tools and Equipment Used

• Visual acuity charts (Snellen, Tumbling E)
• Retinoscope and trial lens set
• Autorefractor (optional)
• Occluders and pinhole
• Color vision charts (Ishihara)
• Torchlight and loupe
• Smartphone/tablet-based screening apps (modern additions)

Success Stories: India’s National Programs

• NPCBVI (National Programme for Control of Blindness and Visual Impairment) supports school screening with funds and technical support
• RBSK (Rashtriya Bal Swasthya Karyakram) includes vision screening as one of the 30 child health conditions
• Sightsavers, Orbis, Mission for Vision are NGOs that conduct mass school vision screening across states

Challenges in Implementation

• Low awareness among teachers or parents
• Reluctance to wear spectacles due to stigma or fashion
• Logistical issues in remote areas (transport, availability of optometrists)
• Poor follow-up after referrals
• Budget constraints in government or NGO-funded programs

Solutions and Recommendations

• Train school teachers and health workers in basic vision checks
• Use tele-optometry to connect schools with urban optometrists
• Promote awareness through social media and educational videos
• Offer attractive, durable, and fashionable spectacle designs
• Develop monitoring systems to track compliance and vision improvement

Conclusion

School Eye Health Programmes are a cost-effective and impactful strategy to ensure healthy vision during a child’s formative years. Optometrists are the backbone of such programs due to their expertise in screening, diagnosis, refraction, education, and referral. Their presence ensures quality and continuity of care. By actively participating in these initiatives, optometrists contribute to the larger goal of reducing childhood blindness and improving academic and social outcomes for millions of children.

References

1. Ministry of Health & Family Welfare. NPCBVI School Eye Screening Guidelines. [https://npcbvi.gov.in]
2. World Health Organization. Vision Screening in School Children, WHO/PBL/03. [https://www.who.int]
3. Sightsavers India. School Eye Health Program Toolkit. [https://www.sightsaversindia.in]
4. Park K. Preventive and Social Medicine. 25th Edition, Banarsidas Bhanot, 2019.
5. Rashtriya Bal Swasthya Karyakram (RBSK), Ministry of Health and Family Welfare. [https://rbsk.gov.in]

Basics of Tele Optometry and its Application in Public Health

Introduction

Tele-optometry is the remote delivery of optometric services using telecommunications technology. It bridges the gap between trained eye care professionals and populations with limited access to vision care — especially in rural, tribal, and underserved areas. In public health, tele-optometry has emerged as a powerful tool to deliver screening, consultation, monitoring, education, and referrals through digital platforms.

Definition of Tele Optometry

Tele-optometry refers to the provision of optometric care, including vision testing, refractive services, eye health consultations, and follow-ups through digital communication tools such as video conferencing, smartphones, cloud-based platforms, and artificial intelligence (AI).

Core Components of Tele Optometry

• Store-and-Forward (Asynchronous): Patient data (images, refraction, visual acuity) is collected and sent to optometrists for later review
• Real-Time (Synchronous): Live video consultation between patient and optometrist/ophthalmologist
• Remote Monitoring: Using mobile apps and devices to track patient eye health over time
• Health Education: Delivering IEC materials, awareness videos, or vision training remotely

Technology Used in Tele Optometry

• Smartphones and tablets with camera and internet access
• Portable autorefractors and slit-lamps with digital integration
• Cloud-based EHR (Electronic Health Records)
• Teleconsultation software (Zoom, Skype, Practo, etc.)
• AI tools for fundus image grading and screening (e.g., diabetic retinopathy detection)
• IoT-based vision screening tools and wearable devices

Applications in Public Health

1. Rural and Remote Eye Care

• Optometrists at rural vision centers conduct refraction and image capture
• Images are sent to tertiary eye hospitals via the internet for consultation
• Expert diagnosis and referral provided without requiring patient travel

2. School Eye Screening Programs

• Teachers or trained volunteers use mobile apps to collect screening data
• Optometrists review and recommend glasses or referral remotely

3. Diabetic Retinopathy and Glaucoma Screening

• Fundus photography done at primary centers
• Images interpreted remotely by optometrists or AI-based software
• Ensures early detection and referral

4. Tele-education and Training

• Remote training of optometry students and vision technicians
• Webinars and CME (Continuing Medical Education) for professionals

5. Low Vision and Rehabilitation

• Virtual counseling for use of low vision devices
• Home-based exercises and video-based therapy guidance

Advantages of Tele Optometry in Public Health

• Expands reach to underserved populations
• Reduces travel cost and time for patients
• Supports early detection and timely treatment
• Efficient use of manpower (optometrist-ophthalmologist link)
• Facilitates data collection and research

Challenges of Tele Optometry

• Need for reliable internet and electricity in rural areas
• Initial cost of digital equipment
• Legal and privacy concerns in storing patient data
• Lack of awareness among patients and providers
• Language and digital literacy barriers

Optometrist’s Role in Tele Optometry

• Conduct visual assessments and capture images at the community level
• Interpret results or coordinate with ophthalmologists for diagnosis
• Educate patients about eye health and compliance
• Train vision technicians in digital equipment handling
• Manage electronic medical records and teleconsultation workflow

Future Prospects

• Integration with Ayushman Bharat digital health mission (ABDM)
• Use of AI for autonomous vision screening
• Virtual reality-based rehabilitation tools for low vision
• Community-level kiosks for tele-optometry in every block

Conclusion

Tele-optometry is revolutionizing the way optometric care is delivered in public health. It is particularly valuable in India where access to trained optometrists is limited in remote areas. With advancements in technology and supportive health policies, tele-optometry can be scaled to deliver equitable, efficient, and quality vision care services. Optometrists are central to this transformation — serving as facilitators, educators, and providers in this digital shift.

References

1. World Health Organization. Telemedicine: Opportunities and Developments in Member States, 2010. [https://www.who.int]
2. LV Prasad Eye Institute. Tele-ophthalmology Vision Center Model. [https://www.lvpei.org]
3. Vision 2020 India. Telemedicine in Eye Care: Guideline Document. [https://www.vision2020india.org]
4. Ministry of Health & Family Welfare. National Digital Health Mission (NDHM). [https://ndhm.gov.in]
5. Park K. Preventive and Social Medicine, 25th Edition. Banarsidas Bhanot, 2019.

Information, Education and Communication (IEC) for Eye Care Programs

Introduction

Information, Education, and Communication (IEC) is a strategic tool in public health used to promote healthy behaviors, increase awareness, and encourage community participation. In eye care, IEC plays a crucial role in spreading knowledge about preventable blindness, eye hygiene, refractive errors, cataract surgeries, nutritional blindness, and the importance of regular eye check-ups. IEC empowers individuals and communities to make informed decisions about their eye health.

Definition of IEC

IEC is the process of providing accurate, relevant, and culturally appropriate health information to individuals and communities through various media and communication strategies, with the aim of influencing behavior change and improving health outcomes.

Objectives of IEC in Eye Care

• Increase awareness about common eye diseases and their prevention
• Encourage early diagnosis and timely treatment of visual problems
• Promote use of spectacles, low vision aids, and surgical services
• Motivate communities to participate in eye screening camps
• Reduce myths and misconceptions about eye care
• Enhance treatment compliance and follow-up

Key IEC Messages for Eye Care

• “Vision problems can be treated if detected early.”
• “Children need regular eye check-ups to succeed in school.”
• “Cataract surgery is safe and restores sight.”
• “Vitamin A prevents childhood blindness.”
• “Wear your spectacles regularly to see clearly and avoid complications.”

Target Audiences for IEC

• General public (rural and urban)
• Parents and caregivers
• School children and teachers
• Diabetic and hypertensive patients
• Pregnant women (for nutritional education)
• Community health workers (ASHA, Anganwadi)

IEC Strategies and Channels

1. Interpersonal Communication

• One-on-one counseling at vision centers and outreach camps
• Group education sessions at schools or community meetings
• Peer educator programs involving local influencers

2. Print Media

• Posters, leaflets, and banners in local language
• Pamphlets distributed in schools, markets, and clinics
• Wall paintings and flip charts in public places

3. Mass Media

• Radio jingles promoting cataract surgery or screening camps
• Television programs or news coverage of vision programs
• Newspaper advertisements and articles on eye care

4. Digital Media

• Social media campaigns on Facebook, WhatsApp, Instagram
• YouTube videos and reels on spectacle use or eye hygiene
• SMS and app notifications for appointment reminders and eye tips

5. Community-Based Activities

• Rallies and awareness marches on World Sight Day
• Eye health exhibitions and quiz competitions in schools
• Street plays and puppet shows to convey messages in local dialects

Designing an Effective IEC Campaign

1. Identify target group: e.g., school children, women, or elderly
2. Define clear message: Short, simple, relevant, and actionable
3. Choose appropriate channels: Based on audience literacy and media access
4. Use culturally sensitive content: Language, images, customs
5. Pre-test materials: Try materials on a small group before rollout
6. Monitor impact: Evaluate reach, behavior change, and service uptake

Optometrist’s Role in IEC

• Develop IEC material tailored for specific communities
• Educate patients during visits about their condition and preventive steps
• Participate in outreach activities and school programs
• Train vision technicians and community workers in key health messages
• Use social media to spread awareness and bust myths
• Track patient compliance and adjust messages accordingly

Successful IEC Examples in India

• Vision 2020 India: “Netra Suraksha Abhiyan” eye health awareness campaigns in rural areas
• NPCBVI: School screening programs supported with posters and radio ads
• Sightsavers: Use of audio-visual vans for awareness in tribal regions
• ORBIT (Orbis): YouTube videos and comics on refractive error and amblyopia

Challenges in IEC Implementation

• Low literacy and poor comprehension in some communities
• Limited budget for mass media campaigns
• Resistance to behavior change (e.g., reluctance to wear spectacles)
• Difficulty in measuring long-term impact of IEC efforts
• Lack of trained personnel to deliver consistent messages

Recommendations

• Use a mix of media for maximum reach
• Customize messages to age, culture, and socioeconomic group
• Involve local leaders and school teachers as IEC ambassadors
• Evaluate IEC efforts regularly to refine strategy
• Integrate IEC into every eye care program from the planning phase

Conclusion

Information, Education, and Communication are powerful pillars of community-based eye care programs. IEC creates awareness, fosters preventive behavior, and increases uptake of essential services like refraction and cataract surgery. As frontline providers and educators, optometrists play a key role in designing, implementing, and evaluating IEC activities that drive public eye health forward.

References

1. Ministry of Health and Family Welfare. National IEC Strategy for Health. [https://mohfw.gov.in]
2. NPCBVI. School Eye Screening Operational Guidelines. [https://npcbvi.gov.in]
3. Vision 2020 India. IEC Materials for Community Eye Health. [https://www.vision2020india.org]
4. World Health Organization. Health Promotion Glossary, 2021. [https://www.who.int]
5. Park K. Preventive and Social Medicine. 25th Edition. Banarsidas Bhanot, 2019.

For more units of Public Health and Community Optometry click 👇

👉 Unit 1

👉 Unit 2

👉 Unit 3

👉 Unit 4