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Chief Advisor: Dr. Jagdish Prasad, Director General of Health Services, Editorial Board: Dr. N.K. Agarwal, Deputy Director General (O) & Ms. Sujaya Krishnan, Joint Secretary (NPCB), Ministry of Health and Family Welfare, Dr. A.S. Rathore, Additional Deputy Director General (O), Ms. Gayatri Mishra, Director (NCD), Dr. V. K. Tewari, Health Education Officer (NPCB), Dr. V. Rajshekhar, Eye Specialist, Safdarjung Hospital/MOHFW, Dr. Suman, Temporary Professional (NPCB) and Shri Sanjay Pant, Under Secretary (NCD).
NPCB-India is a quarterly newsletter of the National Programme for Control of Blindness. For further information contact or write: Dr. V. K. Tewari, Health Education Officer, 342-B, A Wing, Nirman Bhawan, New Delhi-110 108. Telefax: 011-23063875 Email: tewari.vijay25@gmail.com This is also available on our website: www.npcb.nic.in
Designed & Printed by: ESSENCE ADVERTISING SERVICES, 45, 1st Floor, Corner Market, Malviya Nagar, New Delhi-110 017 (Quantity of Newsletter: 10,000 nos.)QUARTERLY
INDIANPCBNPCBNPCBNPCB
QUARTERLY July - September 2012
Theme of the Issue: Marching into 12th Five Year Plan
INBOX FEEDBACK / RESPONSE“Eye Donation” article was very informative. Kindly publish a article a Role of Eye Banking Manager in eye donation centre on Eye Bank in detail and the records he or she should maintain.
S. S. Venkateshwar,C/o. C.A.R.I. Junction Road, Bhatu Basthi,
South Andaman, A & N Island-744105. Email: ssvenkateshwar@gmail.com
The material in the quarterly newsletter is prepared meticulously and is informative not only to the community but also to practitioners.
Dr. Suresh Chandra Pant, Sr. Eye Surgeon (Joint Director),
S.S. Jina Base Hospital, Haldwani (Nainital), Uttarakhand.Email: pant.dr.suresh@gmail.com
Excellent service in giving vision to millions of people. If there is no NPCB the country is unimaginable.
Dr. A. Raghava Charyulu, 19-7-87/S2, Gopala Raju Colony, R.C. Road, TIRUPATI,
Chittoor (D.T.), Andhra PradeshEmail: vemanayogi@yahoomail
Dear Sir, I received this issue on Corneal Blindness thru c surgeon, Sonepat. I work as an Eye surgeon at Govt hospital, Sonepat. I found this issue informative. May I request you to send NPCB newsletter at my address.
Dr. N.K. Batra,191-L, Model Town, Sonepat-131001, India
Email: drshbatra@yahoo.com
From Editor's Desk History of NPCB
India was the first country in the world to launch a 100% centrally sponsored programme for
the control of blindness. The programme was started by the Union Ministry of Health on 30th
March 1963 as a Trachoma Control Programme, which was later on subsumed into the
National Programme for Control of Blindness (NPCB). National Programme for control of
Visual Impairment and Blindness was launched in the year 1976 as 100% centrally sponsored
scheme. Later on it was renamed as National Programme for control of Blindness (NPCB).
Since blindness is not just a simple disability affecting the person directly but also has
consequences on the national GDP, which is often neglected or overlooked, it needs to be
tackled through a three-pronged strategy of prevention, intervention and rehabilitation.
The Cabinet Committee on Economic Affairs (CCEA) had approved a budget of 1250 core for
11th five year (2007-2012) plan for NPCB confirming the high level of health care commitment
that MoHFW accorded to blindness control activities in the country. The NPCB is striving hard
to strengthen the Govt. health Institutions, assist NGOs engaged in blindness control services,
and enhance the capacity of health staff involved in delivery of eye care services to the
community as well as provide training to keep them abreast with the advancements in eye care
delivery. During 11th five year plan, a lot of planning had been done with revised targets for
cataract, school eye screening, eye banking, treatment of other eye diseases and infrastructural
and human resource development. Salient features of 11th five year plan, targets and
achievements are as given below in Table. National Programme for Control of Blindness is
expecting enhanced funding for the 12th five year plan as challenges of reaching the unreached
& underprivileged and delivery of the quality eye care services will remain the focus area of
12th five year plan. As we are approaching towards 12th five year plan, we need to analyze
programmes achievement against targets allocated. This will help programme managers in
better planning and implementation of the programme in 12th five year plan.
Institute 2007-08 2008-09 2009-10 2010-11 2011-12 Total
Medical College 40 28 44 2 12 126
Eye Bank 10 16 11 15 30 82
Eye Donation Centre 27 68 20 31 31 177
Eye Wards/OT 0 10 10 06 18 44
Vision centres 378 377 425 387 726 2293
Tele-Ophthalmology Unit 0 10 07 3 7 27
NGO supported 10 13 7 8 15 53
22 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIANATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA 7NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
(Rs. in crore)Budget Allocation and expenditure:
Year Budget allocated (BE/FE) Expenditure
2007-08 171.87 164.95
2008-09 250.00 249.50
2009-10 250.00 252.90
2010-11 260.00 (FE-202.58) 202.41
2011-12 222.00 222.00
NPCB has been achieving targets allocated every year. During the year 2011-12, NPCB
partners namely RIOs, Medical Colleges, District Hospitals, Sub-District Hospitals and NGOs
reportedly performed 63,49,205 surgeries with 95% IOL implantation. In addition to the
quantum of surgeries, NPCB has been stressing on quality aspects all through. Quality of
surgery performed has been the concern area for NPCB. Still a few instances of mass post-
operative eye infection were reported during the past five years from different parts of
country.
The table given below shows the no. of cataract surgeries done against the target given and
the number of eyes affected by post-operative infection:
Year Target Cataract % Surgery Mishaps Total no.
operations with IOL of person
performed affected
under NPCB*
2007-08 50,00,000 54,04,406 94 2 5+12=17
2008-09 60,00,000 58,10,336 94 4 29+11+20+23=83
2009-10 60,00,000 58,10,684 95 1 16
2010-11 60,00,000 60,31,678 95 1 18
2011-12 70,00,000 63,49,205 95 1 46
Total 3,00,00,000 2,94,06,309 95% 9 180
* These cataract operations have been performed by all NPCB partners i.e. RIO, Medical Colleges, District
Hospitals, Sub-District Hospitals, NGOs, Private Eye Hospitals and Private Eye Surgeons. NPCB sponsors a
substantial part of these cataract operations which exceeds 50%.
Maximum no. of mishaps had been reported in 2008-09 year affecting total 83 patients in four eye
camps. However when we look at these figures against the total no. of cataract surgery performed
(2,94,06,309), the percentage of mass infection cases reported comes out to be extremely low. In
the NPCB newsletter for the quarter Oct-Dec, 2011 titled Quality aspects of cataract operations
(available at NPCB website i.e. ) an ideal OT layout as well as guidelines to be
followed were published. These were agreed upon and highly appreciated by eye surgeons from all
over India. NPCB has instructed State Programme Officers (SPOs) and District Programme
Managers (DPMs) that they are not to overlook any of the universal precautions specially those
pertaining to intraocular surgery in their zeal to achieve the given targets.
Achievements & Issues against targets allocated
1. Cataract surgeries:
www.npcb.nic.in
NPCB activities in the quarter (July –September, 2012):
! Sentinel Surveillance Units review meeting was conducted on 13th July, 2012 after a gap of
two years. In the meeting it was decided that SSU should monitor the cataract operations
performed by NGOs. Conduction of multi-centric operational research and more productive
involvement of SSUs in the NPCB were considered.
! Special campaigns for mass awareness were undertaken during Eye Donation Fortnight (25th
August to 8th September 2012) at centre and state level. To make community aware about eye
donation SMSs were also sent throughout the country. Report of the activity along with
photographs was received from the following centres:
— Kozhikode, Kerala
— Patel Eye Bank, S.P. Medical College Bikaner
— State Health Society, Uttarakhand
— Meerut Eye Bank Society, Lala Lajpat Rai Memorial Medical college, Meerut, Uttar
Pradesh
— State Health Society, Manipur
— District Health Society & Govt. regional hospital, Kurnool, Andhra Pradesh
— Advanced Eye Centre, PGIMER, Chandigarh
! Annual review meeting of NPCB with State programme Officers was held on 27 and 28th
Sept. 2012 as a part of review of the programme at the central level. In this meeting
achievements of the NPCB under 11th plan was assessed. Issues and challenges concerning
states were discussed and steps to improve the NPCB working for better achievement of
targets ahead were also discussed.
3NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
During 11th five year plan the stress was on technology up gradation which
includes:
! Providing good screening and diagnostic tools and equipments
! Dedicated OPD, Eye Ward and Eye OT Units
! Fully trained surgical team
! Modern surgical tools and intra-operative patient care apparatus
! Full asepsis at all levels to prevent post operative infection
! High quality pre-sterilized drugs and surgical consumables
! High quality post operative Eye & General care
NPCB had supported trainings in 11 disciplines of ophthalmology for sponsored candidates from all over
the nation.
Testing of vision at school age is crucial because this is the age when foundation of any child’s future is
being laid. Visual health is essential for good quality of life, and desirable economic productivity. A two
days training is being imparted under NPCB, to the school teachers for screening of children suffering
from refractive errors. School teachers do the eye screening for refractive errors and then affected
children are referred to the nearest vision centre/PHC/CHC/District Hospital for accurate prescription
of the spectacle glasses. The list of students requiring spectacle along with their prescriptions is shared
with District Programme Manager and all efforts are made to provide free spectacles to the needy
children at the earliest. Children with other eye diseases like squint, cataract etc when detected are
referred to the nearest sub district or district hospital for further treatment. The SPO of each state
must ask all the DPMs to ensure that school eye screening is conducted in maximum number of
schools in their respective districts and free spectacles are given to needy children as per NPCB norms.
NPCB provides a recurring grant in aid of Rs. 200 for providing free spectacles to the Below Poverty
Line (BPL) throughout the country through the state health
societies. Coordination between Sarva Siksha Abhiyan (SSA)
Programme and NPCB is needed to avoid duplication and to
maximize the benefit as SSA also dispenses free spectacles to the
children. Quality of dispensed spectacle lenses and timely
distribution to the needy children is of utmost concern and timely
delivery must be ensured by SPO/DPM. Every year, the number of
spectacles provided to the school children meets the target
allocated. This can be easily made out by the table given below.
Visual Acuity estimation charts for school children were printed
and distributed throughout the country with the help of SPOs.
The Idea is to create awareness amongst children so that they are
fully aware of their visual needs, deficiencies if any and ways to
overcome them.
School Eye Screening Programme:
Year No. of free spectacles provided to school age group
children with refractive errors
Target Achievement
2007-08 3,00,000 5,12,020
2008-09 3,00,000 4,94,484
2009-10 4,73,472 5,05,843
2010-11 6,00,000 5,48,611
2011-12 6,00,000 6,58,061
2. School Eye Screening Programme
6 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA
New Initiatives in 12th five year plan
! It has been realized that the needs of persons in the age group of 40 years and above for sharp
near vision is also of utmost importance both for women and men. Therefore, NPCB has
proposed that needy persons suffering from presbyopia be provided free glasses to enable them
to perform near work like reading printed material, cooking and other essential daily routine
activities.
! During the month of June each year when majority of schools in India observe summer vacation,
it has been proposed to observe Eye testing fortnight, to urge parents to take their children to
the nearest eye testing facility like Sub-District Hospital, District Hospital, Medical College
hospital, which may not be otherwise possible due to lack of sufficient spare time on the part of
children. Perfect prescription of spectacles is of utmost importance for every child to excel in
studies. Spectacles may later on be procured from the NPCB through DPM or SSA.
! It has been proposed to introduce a multipurpose mobile ophthalmic unit in all districts for entire
country to reach the remote areas not covered by existing facilities and to be involved in all the
following activities:
— Screening eye camp
— School eye screening
— Transporting patients for treatment
— On the spot refraction and provision of spectacles
— Diagnosis of diseases like diabetic retinopathy, glaucoma etc.
— Display of IEC NPCB messages on its outer panels
— Monitoring of NPCB activities by DPMs
! Many of the eye banks opened earlier have become defunct due to lack of initiative, inability to
collect the required no. of corneas and interaction with the State Programme Officer as well as
Central cell of NPCB. To revitalize these eye banks we need to rekindle the desire in the hearts of
the organizers and also to provide the requisite know how, so that they become active again.
Although the zonal eye bank committees do exist but it is not clear how often do they meet and
whether they take up the issue of helping each other in the matter of enhancing eye donation in
their respective territories. A new list of all existing eye banks and those that are active (collecting
cornea >50) is being prepared so as to know the exact quantum of work performed by existing
eye banks and to urge them to perform better in the forthcoming year.
! The Hospital Cornea Retrieval Programme (HRCP) needs to be implemented more zealously in
each and every big city of India. A clause of inclusion of mandatory required request for eye
donation from next of the kin of the deceased in the cause of death certificate issued by hospitals
has been circulated to the Medical Superintendants of big hospitals in Delhi and across the
country during 2011 and needs to be firmly put into practice.
5
3. Eye Banking:
Management of corneal blindness all through the country is one of the foremost issues of National
Programme for Control of Blindness (NPCB). The two major components for dealing with the problem
of corneal blindness are prevention of fresh corneal blindness and elimination of the already existing
corneal blindness. Eye banking is one of the three major activities of NPCB. This is the field where a lot
more needs to be done. NPCB partners reportedly collects about 50,000 corneas in all the states put
together but still falls short of targets/ requirement of about 1.20 lakh corneas to wipe out the backlog
of corneal blindness. Since corneal collection is much below our national requirement, we need to adopt
social practices and techniques that will enhance the corneal collection and utilization. To enhance eye
collection every year NPCB celebrates Eye donation fortnight and world sight day. Along with these,
various other IEC activities that involve TV and Radio Programmes, display of posters and distribution of
pamphlets, rallies involving school children etc are being undertaken and sponsored by NPCB from time
to time. Major lacunae observed leading to poor eye banking and intended to be tackled in the 12th five
year plan are as follows:
! Lack of availability of adequate number of Eye Donation Counselors due to low remuneration leading to
unmotivated staff, hence non achievement of targets. Enhancement in salary and proper training of Eye
donation counselors has been proposed in 12th five year plan.
! Formal training to the Eye Donation Counselor in performing the task (counseling) that needs empathy,
patience, and ability to convey ones thoughts in a convincing manner to the relatives of the deceased, is
a very crucial factor for eye donation. In the absence of formal training to Eye Donation Counselor,
he/she may not able to do justice to the job assigned. Eye Donation Counselors should be technically
and psychologically well trained so that they are able to convince the next of kin of the deceased to
agree for eye donation. Eye Bank Association of India (EBAI) has worked out a one year training course
for Eye donation counselors.
! Integration and networking of eye banks all over the country for maximal utilization of donor tissue, to
know exact number of patients waiting for corneal transplantation, to avoid multiple registrations by the
patients and judicious use of donor material, integration of Eye Banks is the need of the day. Additionally
creation of corneal blind person’s internet directory should be given the utmost priority by all the eye
banks.
! Availability of high quality storage medium: We need to ensure that corneal tissue collected is
preserved well and therefore each and every eye bank should have a ready stock of the preservation
medium i.e. M.K. medium and may be Optisol (new medium). NPCB assures availability of high quality
storage media and encourages research in the same field. Dr. R.P. Eye Centre, AIIMS, new Delhi under
NPCB sponsored project provides it free of cost to all the eye banks with a demand for the same.
! Through various communication media, NPCB has been spreading awareness amongst general
population as well as health personnel, that for better utilization of collected cornea, the eye should be
collected within 2-6 hrs of the death of the diseased.
! NPCB is providing non recurring assistance of Rs. 15 lakhs to the selected eye bank for its up-gradation
and procurement of necessary equipments.
! It is of paramount importance that we know the presence of all corneal transplantation surgeons
in each and every big or small city of India to know about our current availability of corneal
transplantation surgeons. NPCB train eye surgeons in the field of eye banking and keratoplasty to keep
them abreast with the advancements in this field. Refer to page 72-73 of NPCB guidelines for State and
district Health society on NPCB website www.npcb.nic.in for more detailed information.
! NPCB provides incentives to private eye surgeons/ NGOs for rendering free services in treating poor
patients as far as keratoplasty is concerned. Enhancement in GIA has been proposed for 12th five year
plan.
4 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA
4. Status of Implementation of 11th plan new initiatives like treatment
of other eye diseases, construction of dedicated eye ward and eye OT
etc.
! It has been realized that new life style associated diseases like Diabetes, Glaucoma, ROP are
increasing and needs to addressed, and hence scheme for treatment of other eye diseases was
initiated under new initiatives in 11th five year plan. However this has not been advertized and
implemented very effectively at the state level throughout the country. To promote and
maximize the benefit of scheme for the general community, recurring grant in aid for treatment
of other eye diseases which includes diabetic retinopathy, glaucoma management, laser
techniques and corneal transplantation, vitreo retinal surgeries and treatment of childhood
blindness has been proposed to be increased substantially in 12th five year plan from the
current rate of Rs. 1000/ case.
! Each DPM has to explore and advertize the names/ addresses of the ophthalmologists treating
Diabetic retinopathy, Glaucoma. Squint, retinopathy of prematurity, congenital cataract, low
vision, keratoplasty etc. so that a person suffering from any of these eye diseases is guided
properly to approach the concerned ophthalmologist.
! Issue of non appointment of contractual staff has been addressed in 12th five year plan and
their number shall be almost doubled.
! Many North Eastern states have constructed dedicated eye wards and OTs and in other NE
states process is still going on due to difficulties faced by SPOs as the districts were
surrounded by hilly terrain/ remote area with difficult approach.
! Human resource deployment and training: Health personal play a key role in the
implementation of any health programme including NPCB. To cover the deficient staff,
employment of Ophthalmic Surgeon, Ophthalmic Assistant and Eye donation counselor was
included under new initiatives under 11th five year plan. MOHFW has recently substantially
increased the number of MS /DNB seats in the medical Colleges. Financial support for training
of approximately 400-500 eye surgeons in different super-specialties (ECCE/IOL Implantation,
SICS, Phaco Emulsification, Diagnosis and Management of Glaucoma, Eye Banking and Corneal
Transplantation, Oculoplasty, Strabismus (Diagnosis Management both Medical and Surgical),
Low Vision, Pediatric Ophthalmology, Indirect Ophthalmoscpy & Laser Technique and Medical
Retina & Vitreoretinal Surgery) is being provided by NPCB. NPCB allocates an amount up to
Rs. 70,000 per candidate for this purpose which includes training material for the trainee,
expenses of lodging / boarding and TA/DA. Details of training provided year wise are as given
below:
Training of Eye Surgeons:
Year Target No. of eye surgeons trained
2007-08 400 300
2008-09 400 450
2009-10 400 400
2010-11 400 350
2011-12 400 350
NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
5
3. Eye Banking:
Management of corneal blindness all through the country is one of the foremost issues of National
Programme for Control of Blindness (NPCB). The two major components for dealing with the problem
of corneal blindness are prevention of fresh corneal blindness and elimination of the already existing
corneal blindness. Eye banking is one of the three major activities of NPCB. This is the field where a lot
more needs to be done. NPCB partners reportedly collects about 50,000 corneas in all the states put
together but still falls short of targets/ requirement of about 1.20 lakh corneas to wipe out the backlog
of corneal blindness. Since corneal collection is much below our national requirement, we need to adopt
social practices and techniques that will enhance the corneal collection and utilization. To enhance eye
collection every year NPCB celebrates Eye donation fortnight and world sight day. Along with these,
various other IEC activities that involve TV and Radio Programmes, display of posters and distribution of
pamphlets, rallies involving school children etc are being undertaken and sponsored by NPCB from time
to time. Major lacunae observed leading to poor eye banking and intended to be tackled in the 12th five
year plan are as follows:
! Lack of availability of adequate number of Eye Donation Counselors due to low remuneration leading to
unmotivated staff, hence non achievement of targets. Enhancement in salary and proper training of Eye
donation counselors has been proposed in 12th five year plan.
! Formal training to the Eye Donation Counselor in performing the task (counseling) that needs empathy,
patience, and ability to convey ones thoughts in a convincing manner to the relatives of the deceased, is
a very crucial factor for eye donation. In the absence of formal training to Eye Donation Counselor,
he/she may not able to do justice to the job assigned. Eye Donation Counselors should be technically
and psychologically well trained so that they are able to convince the next of kin of the deceased to
agree for eye donation. Eye Bank Association of India (EBAI) has worked out a one year training course
for Eye donation counselors.
! Integration and networking of eye banks all over the country for maximal utilization of donor tissue, to
know exact number of patients waiting for corneal transplantation, to avoid multiple registrations by the
patients and judicious use of donor material, integration of Eye Banks is the need of the day. Additionally
creation of corneal blind person’s internet directory should be given the utmost priority by all the eye
banks.
! Availability of high quality storage medium: We need to ensure that corneal tissue collected is
preserved well and therefore each and every eye bank should have a ready stock of the preservation
medium i.e. M.K. medium and may be Optisol (new medium). NPCB assures availability of high quality
storage media and encourages research in the same field. Dr. R.P. Eye Centre, AIIMS, new Delhi under
NPCB sponsored project provides it free of cost to all the eye banks with a demand for the same.
! Through various communication media, NPCB has been spreading awareness amongst general
population as well as health personnel, that for better utilization of collected cornea, the eye should be
collected within 2-6 hrs of the death of the diseased.
! NPCB is providing non recurring assistance of Rs. 15 lakhs to the selected eye bank for its up-gradation
and procurement of necessary equipments.
! It is of paramount importance that we know the presence of all corneal transplantation surgeons
in each and every big or small city of India to know about our current availability of corneal
transplantation surgeons. NPCB train eye surgeons in the field of eye banking and keratoplasty to keep
them abreast with the advancements in this field. Refer to page 72-73 of NPCB guidelines for State and
district Health society on NPCB website www.npcb.nic.in for more detailed information.
! NPCB provides incentives to private eye surgeons/ NGOs for rendering free services in treating poor
patients as far as keratoplasty is concerned. Enhancement in GIA has been proposed for 12th five year
plan.
4 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA
4. Status of Implementation of 11th plan new initiatives like treatment
of other eye diseases, construction of dedicated eye ward and eye OT
etc.
! It has been realized that new life style associated diseases like Diabetes, Glaucoma, ROP are
increasing and needs to addressed, and hence scheme for treatment of other eye diseases was
initiated under new initiatives in 11th five year plan. However this has not been advertized and
implemented very effectively at the state level throughout the country. To promote and
maximize the benefit of scheme for the general community, recurring grant in aid for treatment
of other eye diseases which includes diabetic retinopathy, glaucoma management, laser
techniques and corneal transplantation, vitreo retinal surgeries and treatment of childhood
blindness has been proposed to be increased substantially in 12th five year plan from the
current rate of Rs. 1000/ case.
! Each DPM has to explore and advertize the names/ addresses of the ophthalmologists treating
Diabetic retinopathy, Glaucoma. Squint, retinopathy of prematurity, congenital cataract, low
vision, keratoplasty etc. so that a person suffering from any of these eye diseases is guided
properly to approach the concerned ophthalmologist.
! Issue of non appointment of contractual staff has been addressed in 12th five year plan and
their number shall be almost doubled.
! Many North Eastern states have constructed dedicated eye wards and OTs and in other NE
states process is still going on due to difficulties faced by SPOs as the districts were
surrounded by hilly terrain/ remote area with difficult approach.
! Human resource deployment and training: Health personal play a key role in the
implementation of any health programme including NPCB. To cover the deficient staff,
employment of Ophthalmic Surgeon, Ophthalmic Assistant and Eye donation counselor was
included under new initiatives under 11th five year plan. MOHFW has recently substantially
increased the number of MS /DNB seats in the medical Colleges. Financial support for training
of approximately 400-500 eye surgeons in different super-specialties (ECCE/IOL Implantation,
SICS, Phaco Emulsification, Diagnosis and Management of Glaucoma, Eye Banking and Corneal
Transplantation, Oculoplasty, Strabismus (Diagnosis Management both Medical and Surgical),
Low Vision, Pediatric Ophthalmology, Indirect Ophthalmoscpy & Laser Technique and Medical
Retina & Vitreoretinal Surgery) is being provided by NPCB. NPCB allocates an amount up to
Rs. 70,000 per candidate for this purpose which includes training material for the trainee,
expenses of lodging / boarding and TA/DA. Details of training provided year wise are as given
below:
Training of Eye Surgeons:
Year Target No. of eye surgeons trained
2007-08 400 300
2008-09 400 450
2009-10 400 400
2010-11 400 350
2011-12 400 350
NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
3NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
During 11th five year plan the stress was on technology up gradation which
includes:
! Providing good screening and diagnostic tools and equipments
! Dedicated OPD, Eye Ward and Eye OT Units
! Fully trained surgical team
! Modern surgical tools and intra-operative patient care apparatus
! Full asepsis at all levels to prevent post operative infection
! High quality pre-sterilized drugs and surgical consumables
! High quality post operative Eye & General care
NPCB had supported trainings in 11 disciplines of ophthalmology for sponsored candidates from all over
the nation.
Testing of vision at school age is crucial because this is the age when foundation of any child’s future is
being laid. Visual health is essential for good quality of life, and desirable economic productivity. A two
days training is being imparted under NPCB, to the school teachers for screening of children suffering
from refractive errors. School teachers do the eye screening for refractive errors and then affected
children are referred to the nearest vision centre/PHC/CHC/District Hospital for accurate prescription
of the spectacle glasses. The list of students requiring spectacle along with their prescriptions is shared
with District Programme Manager and all efforts are made to provide free spectacles to the needy
children at the earliest. Children with other eye diseases like squint, cataract etc when detected are
referred to the nearest sub district or district hospital for further treatment. The SPO of each state
must ask all the DPMs to ensure that school eye screening is conducted in maximum number of
schools in their respective districts and free spectacles are given to needy children as per NPCB norms.
NPCB provides a recurring grant in aid of Rs. 200 for providing free spectacles to the Below Poverty
Line (BPL) throughout the country through the state health
societies. Coordination between Sarva Siksha Abhiyan (SSA)
Programme and NPCB is needed to avoid duplication and to
maximize the benefit as SSA also dispenses free spectacles to the
children. Quality of dispensed spectacle lenses and timely
distribution to the needy children is of utmost concern and timely
delivery must be ensured by SPO/DPM. Every year, the number of
spectacles provided to the school children meets the target
allocated. This can be easily made out by the table given below.
Visual Acuity estimation charts for school children were printed
and distributed throughout the country with the help of SPOs.
The Idea is to create awareness amongst children so that they are
fully aware of their visual needs, deficiencies if any and ways to
overcome them.
School Eye Screening Programme:
Year No. of free spectacles provided to school age group
children with refractive errors
Target Achievement
2007-08 3,00,000 5,12,020
2008-09 3,00,000 4,94,484
2009-10 4,73,472 5,05,843
2010-11 6,00,000 5,48,611
2011-12 6,00,000 6,58,061
2. School Eye Screening Programme
6 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA
New Initiatives in 12th five year plan
! It has been realized that the needs of persons in the age group of 40 years and above for sharp
near vision is also of utmost importance both for women and men. Therefore, NPCB has
proposed that needy persons suffering from presbyopia be provided free glasses to enable them
to perform near work like reading printed material, cooking and other essential daily routine
activities.
! During the month of June each year when majority of schools in India observe summer vacation,
it has been proposed to observe Eye testing fortnight, to urge parents to take their children to
the nearest eye testing facility like Sub-District Hospital, District Hospital, Medical College
hospital, which may not be otherwise possible due to lack of sufficient spare time on the part of
children. Perfect prescription of spectacles is of utmost importance for every child to excel in
studies. Spectacles may later on be procured from the NPCB through DPM or SSA.
! It has been proposed to introduce a multipurpose mobile ophthalmic unit in all districts for entire
country to reach the remote areas not covered by existing facilities and to be involved in all the
following activities:
— Screening eye camp
— School eye screening
— Transporting patients for treatment
— On the spot refraction and provision of spectacles
— Diagnosis of diseases like diabetic retinopathy, glaucoma etc.
— Display of IEC NPCB messages on its outer panels
— Monitoring of NPCB activities by DPMs
! Many of the eye banks opened earlier have become defunct due to lack of initiative, inability to
collect the required no. of corneas and interaction with the State Programme Officer as well as
Central cell of NPCB. To revitalize these eye banks we need to rekindle the desire in the hearts of
the organizers and also to provide the requisite know how, so that they become active again.
Although the zonal eye bank committees do exist but it is not clear how often do they meet and
whether they take up the issue of helping each other in the matter of enhancing eye donation in
their respective territories. A new list of all existing eye banks and those that are active (collecting
cornea >50) is being prepared so as to know the exact quantum of work performed by existing
eye banks and to urge them to perform better in the forthcoming year.
! The Hospital Cornea Retrieval Programme (HRCP) needs to be implemented more zealously in
each and every big city of India. A clause of inclusion of mandatory required request for eye
donation from next of the kin of the deceased in the cause of death certificate issued by hospitals
has been circulated to the Medical Superintendants of big hospitals in Delhi and across the
country during 2011 and needs to be firmly put into practice.
22 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIANATIONAL PROGRAMME FOR CONTROL OF BLINDNESS IN INDIA 7NPCB INDIA NEWSLETTER, JULY - SEPTEMBER 2012
(Rs. in crore)Budget Allocation and expenditure:
Year Budget allocated (BE/FE) Expenditure
2007-08 171.87 164.95
2008-09 250.00 249.50
2009-10 250.00 252.90
2010-11 260.00 (FE-202.58) 202.41
2011-12 222.00 222.00
NPCB has been achieving targets allocated every year. During the year 2011-12, NPCB
partners namely RIOs, Medical Colleges, District Hospitals, Sub-District Hospitals and NGOs
reportedly performed 63,49,205 surgeries with 95% IOL implantation. In addition to the
quantum of surgeries, NPCB has been stressing on quality aspects all through. Quality of
surgery performed has been the concern area for NPCB. Still a few instances of mass post-
operative eye infection were reported during the past five years from different parts of
country.
The table given below shows the no. of cataract surgeries done against the target given and
the number of eyes affected by post-operative infection:
Year Target Cataract % Surgery Mishaps Total no.
operations with IOL of person
performed affected
under NPCB*
2007-08 50,00,000 54,04,406 94 2 5+12=17
2008-09 60,00,000 58,10,336 94 4 29+11+20+23=83
2009-10 60,00,000 58,10,684 95 1 16
2010-11 60,00,000 60,31,678 95 1 18
2011-12 70,00,000 63,49,205 95 1 46
Total 3,00,00,000 2,94,06,309 95% 9 180
* These cataract operations have been performed by all NPCB partners i.e. RIO, Medical Colleges, District
Hospitals, Sub-District Hospitals, NGOs, Private Eye Hospitals and Private Eye Surgeons. NPCB sponsors a
substantial part of these cataract operations which exceeds 50%.
Maximum no. of mishaps had been reported in 2008-09 year affecting total 83 patients in four eye
camps. However when we look at these figures against the total no. of cataract surgery performed
(2,94,06,309), the percentage of mass infection cases reported comes out to be extremely low. In
the NPCB newsletter for the quarter Oct-Dec, 2011 titled Quality aspects of cataract operations
(available at NPCB website i.e. ) an ideal OT layout as well as guidelines to be
followed were published. These were agreed upon and highly appreciated by eye surgeons from all
over India. NPCB has instructed State Programme Officers (SPOs) and District Programme
Managers (DPMs) that they are not to overlook any of the universal precautions specially those
pertaining to intraocular surgery in their zeal to achieve the given targets.
Achievements & Issues against targets allocated
1. Cataract surgeries:
www.npcb.nic.in
NPCB activities in the quarter (July –September, 2012):
! Sentinel Surveillance Units review meeting was conducted on 13th July, 2012 after a gap of
two years. In the meeting it was decided that SSU should monitor the cataract operations
performed by NGOs. Conduction of multi-centric operational research and more productive
involvement of SSUs in the NPCB were considered.
! Special campaigns for mass awareness were undertaken during Eye Donation Fortnight (25th
August to 8th September 2012) at centre and state level. To make community aware about eye
donation SMSs were also sent throughout the country. Report of the activity along with
photographs was received from the following centres:
— Kozhikode, Kerala
— Patel Eye Bank, S.P. Medical College Bikaner
— State Health Society, Uttarakhand
— Meerut Eye Bank Society, Lala Lajpat Rai Memorial Medical college, Meerut, Uttar
Pradesh
— State Health Society, Manipur
— District Health Society & Govt. regional hospital, Kurnool, Andhra Pradesh
— Advanced Eye Centre, PGIMER, Chandigarh
! Annual review meeting of NPCB with State programme Officers was held on 27 and 28th
Sept. 2012 as a part of review of the programme at the central level. In this meeting
achievements of the NPCB under 11th plan was assessed. Issues and challenges concerning
states were discussed and steps to improve the NPCB working for better achievement of
targets ahead were also discussed.
Chief Advisor: Dr. Jagdish Prasad, Director General of Health Services, Editorial Board: Dr. N.K. Agarwal, Deputy Director General (O) & Ms. Sujaya Krishnan, Joint Secretary (NPCB), Ministry of Health and Family Welfare, Dr. A.S. Rathore, Additional Deputy Director General (O), Ms. Gayatri Mishra, Director (NCD), Dr. V. K. Tewari, Health Education Officer (NPCB), Dr. V. Rajshekhar, Eye Specialist, Safdarjung Hospital/MOHFW, Dr. Suman, Temporary Professional (NPCB) and Shri Sanjay Pant, Under Secretary (NCD).
NPCB-India is a quarterly newsletter of the National Programme for Control of Blindness. For further information contact or write: Dr. V. K. Tewari, Health Education Officer, 342-B, A Wing, Nirman Bhawan, New Delhi-110 108. Telefax: 011-23063875 Email: tewari.vijay25@gmail.com This is also available on our website: www.npcb.nic.in
Designed & Printed by: ESSENCE ADVERTISING SERVICES, 45, 1st Floor, Corner Market, Malviya Nagar, New Delhi-110 017 (Quantity of Newsletter: 10,000 nos.)QUARTERLY
INDIANPCBNPCBNPCBNPCB
QUARTERLY July - September 2012
Theme of the Issue: Marching into 12th Five Year Plan
INBOX FEEDBACK / RESPONSE“Eye Donation” article was very informative. Kindly publish a article a Role of Eye Banking Manager in eye donation centre on Eye Bank in detail and the records he or she should maintain.
S. S. Venkateshwar,C/o. C.A.R.I. Junction Road, Bhatu Basthi,
South Andaman, A & N Island-744105. Email: ssvenkateshwar@gmail.com
The material in the quarterly newsletter is prepared meticulously and is informative not only to the community but also to practitioners.
Dr. Suresh Chandra Pant, Sr. Eye Surgeon (Joint Director),
S.S. Jina Base Hospital, Haldwani (Nainital), Uttarakhand.Email: pant.dr.suresh@gmail.com
Excellent service in giving vision to millions of people. If there is no NPCB the country is unimaginable.
Dr. A. Raghava Charyulu, 19-7-87/S2, Gopala Raju Colony, R.C. Road, TIRUPATI,
Chittoor (D.T.), Andhra PradeshEmail: vemanayogi@yahoomail
Dear Sir, I received this issue on Corneal Blindness thru c surgeon, Sonepat. I work as an Eye surgeon at Govt hospital, Sonepat. I found this issue informative. May I request you to send NPCB newsletter at my address.
Dr. N.K. Batra,191-L, Model Town, Sonepat-131001, India
Email: drshbatra@yahoo.com
From Editor's Desk History of NPCB
India was the first country in the world to launch a 100% centrally sponsored programme for
the control of blindness. The programme was started by the Union Ministry of Health on 30th
March 1963 as a Trachoma Control Programme, which was later on subsumed into the
National Programme for Control of Blindness (NPCB). National Programme for control of
Visual Impairment and Blindness was launched in the year 1976 as 100% centrally sponsored
scheme. Later on it was renamed as National Programme for control of Blindness (NPCB).
Since blindness is not just a simple disability affecting the person directly but also has
consequences on the national GDP, which is often neglected or overlooked, it needs to be
tackled through a three-pronged strategy of prevention, intervention and rehabilitation.
The Cabinet Committee on Economic Affairs (CCEA) had approved a budget of 1250 core for
11th five year (2007-2012) plan for NPCB confirming the high level of health care commitment
that MoHFW accorded to blindness control activities in the country. The NPCB is striving hard
to strengthen the Govt. health Institutions, assist NGOs engaged in blindness control services,
and enhance the capacity of health staff involved in delivery of eye care services to the
community as well as provide training to keep them abreast with the advancements in eye care
delivery. During 11th five year plan, a lot of planning had been done with revised targets for
cataract, school eye screening, eye banking, treatment of other eye diseases and infrastructural
and human resource development. Salient features of 11th five year plan, targets and
achievements are as given below in Table. National Programme for Control of Blindness is
expecting enhanced funding for the 12th five year plan as challenges of reaching the unreached
& underprivileged and delivery of the quality eye care services will remain the focus area of
12th five year plan. As we are approaching towards 12th five year plan, we need to analyze
programmes achievement against targets allocated. This will help programme managers in
better planning and implementation of the programme in 12th five year plan.
Institute 2007-08 2008-09 2009-10 2010-11 2011-12 Total
Medical College 40 28 44 2 12 126
Eye Bank 10 16 11 15 30 82
Eye Donation Centre 27 68 20 31 31 177
Eye Wards/OT 0 10 10 06 18 44
Vision centres 378 377 425 387 726 2293
Tele-Ophthalmology Unit 0 10 07 3 7 27
NGO supported 10 13 7 8 15 53