1. TILGANGA -
A CENTER OF EXCELLENCE
Dr. Sanduk Ruit

2. Eye care service delivery in Nepal - Last four phases
National Blindness Survey
Infrastructure
Human Resource
Quality Service
Technology
Sub specialty Trainings
Research & Documentation
Monitoring & Evaluation
Sustainability
Quality Assurance
Service Coverage

3. EYE CARE
High Quality
Affordable
Accessible
Sustainable

4. MODERN CATARACT SURGERY TO THE COMMUNITY
OUR MISSION– 20 Yrs
INITIATIVE TO PROVIDE
SUFFICIENT
SUCCESSFUL
SUSTAINABLE
MODERN CATARACT SURGERY TO THE COMMUNITY

5. BARRIERS COST OF HIGH QUALITY IOLS
ADAPTATION OF GOOD QUALITY SURGICAL TECHNIQUE
COST & COMPLEXITY OF EQUIPMENTS

7. 1992 – LEADERS IN THE COMMUNITY CONCEPTUALISED TILGANGA EYE CENTER SEED FUND OF Rs. 28000.00

8. Innovative
Strong Team
Good Base
Positive
Advocacy

9. Opened on June 7th, 1994
Model Set Up To Deliver High Quality Eye Care Efficiently
Manufacture of World Class Intraocular Lenses
Eye Bank
Community Outreach Activity
Training

10. ADAPTATION OF GOOD QUALITY SURGICAL TECHNIQUE
5 YRS
SIMPLIFIED,
ADAPTED & TESTED
TRAINING GLOBALLY
– POPULAR
SOP MANUALS
FRED HOLLOWS FOUNDATION & THE HIMALAYAN CATARACT PROJECT

11. DELIVERY SYSTEM HIGH VOLUME AMBULATORY – 1994
COST RECOVERY – SUBSIDIZED THROUGH CROSS SUBSIDY
SURGICAL
MODIFICATION AND PRODUCTION LINE APPROACH

12. INTRAOCULAR LENS INTRAOCULAR LENS – TILGANGA & FRED HOLLOWS FOUNDATION
MADE IT POSSIBLE
TO MANUFACTURE
STATE OF THE ART
IOL LOCALLY

13. INTRAOCULAR LENS COST CAME DOWN TO US $4 FROM US $100 - HISTORY
CONTINUOUS AND DYNAMIC INTO NEWER PRODUCTS
TYPE OF SURGERY NOW CAME WITHIN THE REACH OF POORER COMMUNITY

14. 4 MILLION LENSES TO 80 COUNTRIES!
QUALITY ASSURANCE
4 MILLION LENSES TO 80 COUNTRIES!

15. IMPACT OF HIGH QUALITY AND AFFORDABLE COST IOL AVAILABLE IN NEPAL%
Year

16. ACADEMIC AND TRAINING PROGRAM
2. Modular
Training
programs
1. Academic
Programs
3. Exposure
Training
program
Hospital Based
(SICS, OPAL ,Glaucoma, Theatre Nurse, etc) -
Community Based
(Eye Health Worker, Primary Health care, PST, DR,TH, FCHV, etc
Elective
medical students,
MBBS,
Optometrist,
Nursing,
Orthoptician
Health Care students
etc - MD OA
Fellowship

17. ACADEMIC & TRAINING Description 1994-2014 During 2015 Remarks
MD Residents 42
13*
Academic *including III yr residents
Fellowship 13 4
Ophthalmic Assistant
132 40
Ophthalmologist
(SICS, Glaucoma, Retina)
354 17
Modular
Allied Health
(Theatrenursing, Glaucoma, Investigation, Refraction etc..)
295 5
(Community based HP/SHP in charge, FCHV, PST, DR, THs)
3732 -
Integrated
Medical Students
(Nursing, MBBS, HA, etc)
4406
426
Exposure
Others 16
Total
8,948
492

18. REFRACTIVE SURGERY UNIT Refractive Surgery till now 2404

20. Number
Year

21. CORNEA EXCISION CENTRE

22. GRIEVED RELATIVES

23. SUB-SPECIALLITY Cornea & External Vitreoretinal Glaucoma Oculoplasty
Uveitis
Pediatric
Neuro ophthalmology
Refractive Surgery
Community Ophthalmology

24. COMMUNITY EYE CENTERS 2014 2014 Name of CEC Male Female Total Dhading
5647
9114
14761
Nuwakot
7112
9283
16395
Rasuwa
1054
1438
2492
Sindhu
3714
5410
9124
Okhaldhunga
2830
3789
6619
Rolpa
3744
4072
7816
Ramechhap
4071
5928
9999
Solu
3320
4793
8113
Bhaktapur
7441
9400
16841
Dolakha
3762
6167
9929
Mustang
1290
1540
Swyambhu
1515
1987
3502
Manang (Est Nov)
116
115
231
Sub Total of CECS
45,616
63,036
1,08,652

25. Tilganga Institute of Ophthalmology
Rasuwa
CEC
Ramechhap CEC
Dhading
Nuwakot
Okhaldhunga CEC
Rolpa
Hetauda
CEH
Bhaktapur CEC
Tilganga Institute of Ophthalmology
Sindhu
Tilganga Eye Centre
Manang CEC

26. HETAUDA: MODEL EYE CENTRE

27. COMMUNITY EYE HOSPITAL - HETAUDA 2014
Target
2014 Achievement
OPD
41000
47060
Outreach OP
10000
11055
School Screening
4000
3529
CEC OPD
1300
2570
No. of Screening Camps 45 44
Surgery
3600
4032
Optical User
12000
15000

28. RESEARCHES Ongoing Proposed Jiri Eye Study Hyperopic Smile
Bhaktapur Retina Study
Corneal Ulceration Study
Review of Diabetic retinopathy
Cataract surgical outcome monitoring
Pediatric Ocular diseases study
Vision related QoL for sight threatening DR
Eye Health system Analysis
Comparison of outcome of phaco vs SICS

29. N=115

30. OPD

31. SURGERY

32. INTERNATIONAL COMMITMENT
CHINA
TAR
QINGHAI
JIANGXY
Sudan
TILGANGA EYE CENTRE
JIANGXY
DPR KOREA
Ghana
Eritrea
Ethopia
PAKISTAN
MYANMAR
INDIA
KALIMPONG
SIKKIM
DARJEELING
MANGARH
VIETNAM
CAMBODIA
THAILAND
BANGLADESH
BHUTAN
INDONESIA

33. TEAM