How It Works on the Other Side of the World:
The eye healthcare system in India is an amazingly efficient, and more importantly, effective enterprise. Although there are multiple large scale providers, LV Prasad Eye Institute (LVPEI) was the center of my focus. I was able to get a glimpse into the massive undertaking that the leadership has taken to improve India’s quality of life. The institute is headed by Dr. Rao, a true visionary in his own right. He started the eye center after finishing training in the United States and returning to India. Since then, he and his team have grown LVPEI into a world-class center for excellence in quaternary eye care. Like Wills Eye Hospital, LVPEI is the place you go when nobody else can help you. They provide the highest level of care for some of the most difficult, advanced diseases. Additionally, they have taken on the challenge of curing India’s reversible blindness. With over a dozen secondary surgical centers and countless primary eye care centers, LVPEI is increasingly solving the issue of blindness due to cataracts in India. I had the privilege to visit two of these secondary centers for two separate purposes. Dr. Jagadesh Reddy, a former Wills Eye cornea fellow, took me to visit a rural secondary center located about 10 hours away from Hyderabad by train. People travel, sometimes on foot, from the surrounding areas to get their eyes examined at these secondary centers. Many must come with loved ones to guide them due to their poor vision. The other secondary site was with Dr. Vipin Das. His team was rolling out new digital tablets for the Electronic Medical Record he designed, allowing for easier testing and documentation during primary eye care screenings in remote areas of India. Both of these visits showed me the power of outreach and how technology can make a huge impact on healthcare delivery. This delivery system allows them to triage eye diseases and escalate care based on the severity.
Back at the main campus in Hyderabad, I was able to see how their financial model allows them to provide free care to the indigent. They have adopted good quality, cheaper materials for surgery that lack some of the more expensive features that typical cataract surgery uses. These include intraocular lens implants and the gels we use during cataract surgery. Even with these low cost methods, the burden of free care is too great for sustainability. In response to this, LVPEI and other Indian hospitals have developed a tiered system. Those that cannot pay do not, and are subsidized by the patients selecting more expensive surgical packages that have more bells and whistles. The higher payments allow for subsidization of the free care, leading to sustainability. Although this system might not be needed in the developed world, it is an innovative and sustainable way to provide high level of care to all members of society in developing countries. As I continue on to future sites, I will take the knowledge I learned at LVPEI regarding surgical materials, technique, and financially sustainable models with me. Reversible blindness from cataracts will be a thing of the past if the developing world can follow the lead of these innovative Indian surgeons.