1. DIABETETIC RETINOPATHY & GLAUCOMA COSI MEETING
DR. UDAY GAJIWALA
SEWA RURAL, JHAGADIA

2. SERVICE DELIVERY SCENARIO
VERY LITTLE IS BEING DONE AT PRESENT
BUSY WITH CATARACT SURGICAL WORK
AWARENESS ABOUT THESE DISEASES IS VERY LESS EVEN AMONG SERIVCE PROVIDERS
NOT MANY CENTRES ARE PROVIDING THESE SERVICES
HOWEVER FEW APPROACHES HAVE BEEN TRIED AND DOCUMENTED IN RECENT YEARS.

3. MODELS OF SERVICE DELIVERY
OPPORTUNISTIC SCREENING AT BASE HOSPTIAL / DIABETES CLINICS
SPECIALLY TARGETTED DR WORK
TELEMEDICINE NETWORK
REACH OUT
DR SCREENING CAMPS
COMPREHENSIVE SCREENING CAMPS
– COMMUNITY SCREENING – DOOR TO DOOR APPROACH

4. TREATMENT OPTIONS FOR DR FOR GLAUCOMA INTRA VITREAL INJECTIONS
LASER TREATMENT
VITRECTOMY
FOR GLAUCOMA
TOPICAL / ORAL MEDICATION
LASER
SURGERY

5. SERVICE DELIVERY – DR WHO WILL DO IT
PRIMARY LEVEL – ONLY IDENTIFICATION OF DM STATUS
CBR WORKERS
ASHA WORKERS
PHC / CHC STAFF
ANY OTHER GRASS ROOT LEVEL WORKER
SECONDARY LEVEL – IDENTIFICATION AND REFERRAL
TERTIARY LEVEL - TREATMENT

6. SERVICE DELIVERY – GLAUCOMA WHO WILL DO IT
PRIMARY LEVEL – ONLY AWARENESS GENERATION
CBR WORKERS
ASHA WORKERS
PHC / CHC STAFF
ANY OTHER GRASS ROOT LEVEL WORKER
SECONDARY LEVEL – IDENTIFICATION AND REFERRAL
TERTIARY LEVEL - TREATMENT

7. PREVENTION – DR PRIMARY PREVENTION IS NOT POSSIBLE
EARLY IDENTIFICATION IS ESSENTIAL
STRICT CONTROL OF DM – MULTI SYSTEM INVOLVEMENT – ALL CONCERNED NEED TO WORK AS A TEAM
REGULAR FOLLOW UP
LASER APPLICATION TO CONTROL THE PROGRESS OF THE DISEASE
PRESERVE THE RESIDUAL VISION

8. PREVENTION – GLAUCOMA PRIMARY PREVENTION IS NOT POSSIBLE
EARLY DETECTION
STRICT CONTROL
REGULAR FOLLOW UP
GREATER AWARENESS AMONG THE COMMUNITY & SERVICE PROVIDERS
REGULAR GONIOSCOPY, TONOMETRY & CENTRAL FUNDUS EXAMINATION OF ALL PATIENTS ABOVE THE AGE OF 40 YEARS AT YEARLY INTERVAL
PRESERVE THE RESIDUAL VISION

9. PROMOTION - DM AWARENESS GENERATION OPHTHALMOLOGISTS
OPHTHALMIC PARAMEDICS
PHYSICIANS
DIABETOLOGISTS
LABORATORIES
PHARMACISTS
GENERAL COMMUNITY
DIABETIC PATIENTS

10. PROMOTION - GLAUCOMA AWARENESS GENERATION OPHTHALMOLOGISTS
OPHTHALMIC PARAMEDICS
GENERAL COMMUNITY

11. PREVENTION / PROMOTION – WHO WILL DO IT
PRIMARY LEVEL – AWARENESS GENERATION
SECONDARY LEVEL – EARLY DETECTION / AWARENESS GENERATION
TERTIARY LEVEL - ??

12. REHABILITATION PROVISION OF LOW VISION SERVICES
PROVISION OF REHABILITATION SERVICES INCLUDING MOBILITY, DAILY LIVING SKILLS, ECONOMIC REHABILITATION WHERE APPROPRIATE AND EDUCATIONAL SERVICES TO CHILDREN
COVERAGE OF REHABILITATION IS ONLY 4% ACROSS THE COUNTRY

13. REHABILITATION – WHO WILL DO IT
WILL NEED SPECIALLY TRAINED PEOPLE AND ORGANISATION

14. THE REAL PROBLEM LACK OF AWARENESS
PREVALENCE IS LOW – DIRECT INTERVENTIONS ARE VERY COSTLY
COMPARISION WITH CATARACT

15. HOW TO RAISE AWARENESS
FIRST CONDUCT KAP STUDY FOR ALL THE STAKEHOLDERS
ANALYSE THE RESULTS
BASED ON THE RESULTS DESIGN THE APPROACH

16. GENERAL APPROACH TO DEVELOP H. ED. MATERIAL
Method
Media
Mass
Press meeting
Public meeting Public announcement
Radio/television Poster/banner Newspaper Exhibition Chart
Group
Seminar
Lecture/presentation Patient Interaction Group discussion
Power point
Booklet
Pamphlet
Posters
Individual
Patient education Counselling
Flip chart
Leaflet

17. IEC MATERIAL POSTER PAMPHLET BOOKLET VEHICLE STICKER DESKTOP CALENDAR
TEACHING SLIDES
POWER POINT PRESENTATIONS
VIDEO

18. WHAT NEED TO BE DONE
EYE CARE ACTIVITIES NEED TO BE MADE COMPREHENSIVE AT ALL THE LEVELS – BASE HOSPITAL AND OUT REACH
MORE EFFORTS NEED TO BE MADE TO RAISE AWARENESS AT ALL LEVELS
WE NEED INVOLVEMENT OF THE OTHER PLAYERS – LOCAL DEVELOPMENT ORGANISATIONS WHO HAVE STRONG PRESENCE AND GOOD RAPPORT APART FROM OTHER HEALTH CARE WORKERS

19. THANK YOU