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Empowering Optometry in India
and we learned a lot about outreach programs, what vision therapy adds to optometric practice, and the factors associated with regulating the profession.
Legislating optometry’s independence in India
APOC 2023 highlights outreach programs, regulatory developments, and improved eye care
by Brooke Herron
As the most populous country in the world, India faces distinct challenges and opportunities in providing optometric care. At the 23rd Asia Pacific Optometric Congress (APOC 2023), held from June 2 to 4 in Gurugram, practitioners from Asia Pacific and beyond addressed developments in eye care, including the benefits of community outreach and the changing regulations surrounding optometry in India.
Although there are many challenges for Indian optometrists, the main challenge lies in regulating the profession, explained Dr. Subodh Dixit, co-chairperson of APOC 2023 and the national president of the Indian Optometric Association. Further issues, like lack of standardized nomenclature (i.e., optometrist, optometrist technician, etc.), also need to be addressed, said Dr. Dixit.
Fortunately, he shared that the Indian Optometric Association is diligently working toward the betterment of optometry in India: “The priority of the Indian Optometric Association is to uplift our profession … where the practice of optometry is totally independent and they are not under supervision.”
And based on the chatter at APOC surrounding optometry’s regulation in the country, this will be a hot topic in India until it's passed.
Integrating vision therapy and optometry
Dr. Cathy Stern, one of the keynote speakers at APOC 2023, is an optometrist and adjunct faculty at the New England College of Optometry (NECO) in Massachusetts, USA. She works as a behavioral optometrist, helping children and adults who have visual issues that are not necessarily eyesight-related through vision therapy and vision rehabilitation.
In many countries around the world, optometry remains an unregulated profession. However, in India, things are changing — thanks to the National Commission for Allied and Healthcare Professions Bill, which will regulate and recognize optometry as a separate healthcare profession through standardized education and practice.
Of course, this doesn’t come without hurdles — providing eye care to 1.4 billion people is not an easy feat. Therefore, community outreach and continued education and integration remain key assets in providing care to underserved populations. So, at APOC 2023, we made it COOKIE magazine’s mission to speak with as many optometrists as possible —
“Vision therapy, to me, is really an extension of everything that we do,” she said. For example, when Dr. Stern examines a patient, she includes tests that reveal how they process visual information.
“Can they move their eyes properly, like to read from a book? Can they work their eyes together so that they don't get tired or get headaches or see double? Can they understand what they're looking at and make a response in a reasonable or appropriate amount of time? If I throw you a ball, are your hands going to be there at the right time to catch it? It’s your visual system that’s directing that action,” she explained.
“If we’re finding that type of vision with a patient, I can ask good history questions and they may even tell me there are certain things that they struggle with. Then I do a few tests — more than just a basic eyesight test — and I can often see just from that that maybe something is going on,” said Dr. Stern.
Correcting some of these issues could simply mean prescribing certain lenses that help patients focus their eyes better. In other cases, Dr. Stern explained that they do active vision therapy.
“They may come to the office once or twice a week and work on certain activities for maybe an hour,” she explained. This can help these patients better develop these skills, along with practice techniques to do at home. On average, she said that she works with patients for six to nine months.
Go where the people are
Dr. Rajeev Prasad, vice president of the Asia Pacific Council of Optometry, has taken direct action to help address unmet needs in India through community outreach programs — and he’s gone about it efficiently. Rather than asking underserved populations to come to them, they’ve set up clinics during India’s holy celebrations, which are attended by hundreds of thousands of people.
For example, in 2019, more than 500,000 people were screened and 150,000 received free prescription glasses during their trip to take a dip in the Ganges River over a major public holiday. Further, he shared that all the glasses were made on-site and provided to patients on the same day. Following this event, he orchestrated a second outreach project in 2021 during COVID.
“It was a challenge, but it was a wonderful experience … it really showed how a pair of glasses can give happiness,” said Dr. Prasad. “There are people who just can't see well, and they also can't afford to go to eye care practitioners to get the services or to pay for a pair of glasses, so that was touching and absolutely amazing.”
Generosity across the (color) spectrum
Drawing inspiration from Dr. Prasad’s outreach programs was Mr. T.J. Waggoner, co-founder and CEO of Waggoner Diagnostics, who gave complimentary color vision tests to every delegate in attendance at APOC 2023. This generosity — about 300 Waggoner Computerized Color Vision
Tests (CCVT) were distributed — was not only about doing something good, but also about creating more awareness and, ultimately, improving eye care by identifying acquired color vision defects.
“We offer the Waggoner Computerized Color Vision Test as a standalone application/software, whereas, our competitors require hardware/software bundles,” said Mr. Waggoner. “Since we can distribute utilizing only software, we think we are doing a disservice to healthcare as a whole if we withhold the Waggoner CCVT. If the top five percent of eye care providers in a country have a hard time paying for the device, I think it’s a no-brainer to provide it to these countries and doctors complimentarily.”
And Mr. Waggoner’s efforts were clearly appreciated at APOC 2023, not only for the value he provided but also for the early disease detection that color vision testing can provide. In fact, he shared that an executive board member from the Asia Pacific Council of Optometry took the test — and it revealed a mild tritan defect in one eye and a moderate tritan defect in the other, which was indicative of her previous macular degeneration diagnosis.
“It’s results like this that get doctors really excited about utilizing color in their practice,” shared Mr. Waggoner, who was also enthusiastic about APOC 2023. “I love going to shows where I’m immersed in the education aspect and get to learn about all of the science coming out of research institutes, while also seeing great technologies they are debuting or still working on. I was always learning something — and to me, that’s quite indicative of a successful conference.”
