Clare Gilbert1, Rajan Shukla, Rakesh Kumar, Ajay Khera, G Vs Murthy. 1. Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK; #Indian Institute of Public Health, Hyderabad, Public Health Foundation of India; and $Ministry of Health and Family Welfare, Government of India. Correspondence to: Dr Clare Gilbert, International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. clare.gilbert@lshtm.ac.uk.
Abstract
OBJECTIVE: Control of visual loss from retinopathy of prematurity requires high quality neonatal care, and timely screening and treatment of sight-threatening disease. We assessed services for retinopathy of prematurity provided by ophthalmic training institutions in major Indian cities. METHODS: Eleven cities were purposefully selected and eye-care facilities were evaluated using predefined criteria. Field teams visited these facilities to collect data by interview and observation using structured questionnaires. RESULTS: 30 training institutions were visited (18 public; 12 not-for-profit); 24 (24/30, 80%) provided a service for retinopathy of prematurity in 58 neonatal units (30 public, 28 private). 15/24 (63%) screened in one unit; six (25%) in 2-3 units and three (12%) in >3 units. Not-for-profit facilities (n=9) screened in more units than public facilities (n=15)(mean (range) 4.5 [1-12] vs 1.1 [1-2] units). Indirect ophthalmoscopy by ophthalmologists was the commonest screening modality but only half of these visited the units weekly. Laser was the commonest treatment, but only half treated babies in the neonatal unit. Annual treatments ranged from 1-200 (mean 39). CONCLUSION: Eye-care services for retinopathy of prematurity need to expand, particularly in the government sector.
OBJECTIVE: Control of visual loss from retinopathy of prematurity requires high quality neonatal care, and timely screening and treatment of sight-threatening disease. We assessed services for retinopathy of prematurity provided by ophthalmic training institutions in major Indian cities. METHODS: Eleven cities were purposefully selected and eye-care facilities were evaluated using predefined criteria. Field teams visited these facilities to collect data by interview and observation using structured questionnaires. RESULTS: 30 training institutions were visited (18 public; 12 not-for-profit); 24 (24/30, 80%) provided a service for retinopathy of prematurity in 58 neonatal units (30 public, 28 private). 15/24 (63%) screened in one unit; six (25%) in 2-3 units and three (12%) in >3 units. Not-for-profit facilities (n=9) screened in more units than public facilities (n=15)(mean (range) 4.5 [1-12] vs 1.1 [1-2] units). Indirect ophthalmoscopy by ophthalmologists was the commonest screening modality but only half of these visited the units weekly. Laser was the commonest treatment, but only half treated babies in the neonatal unit. Annual treatments ranged from 1-200 (mean 39). CONCLUSION: Eye-care services for retinopathy of prematurity need to expand, particularly in the government sector.
Authors: Clare Gilbert; Rajan Shukla; G V S Murthy; Bala V M Santosha; Anirudh G Gudlavalleti; Srividya Mukpalkar; Pavani Yamarthi; Suneetha Pendyala; Anusha Puppala; Supriya Edla; Tripura Batchu Journal: Indian J Ophthalmol Date: 2020-02 Impact factor: 1.848