Community Based Vision Center
L V Prasad Eye Institute offers comprehensive patient care, sight enhancement and rehabilitation services, training, and high-impact rural eye health programs.
About You
About You
About Your Organization
Organization Name
L V Prasad Eye Institute
Organization Website
Organization Country
India, AP, Hyderabad
Country where this project is creating social impact
India, AP, Hyderabad
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
World Health Organization Collaborating Centre for Prevention of Blindness; Global Resource Center for VISION 2020: The Right to Sight initiative
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Dr. Ramachandra Pararajasegaram currently serves as Co-Chair of the VISION 2020 Human Resource Programme Committee and a member of Advisory Committee of a number of organizations such as the Lions Clubs International, Project Orbis and is at the board of trustees of Sight Savers International and board affiliate of the IAPB. He has had a long career in the World Health Organization’s Prevention of Blindness Programme. His email address is rparar@gmail.com.
Dr. Allen Foster is the Director of the International Centre for Eye Health and the President of CBM, the largest NGO involved in providing services and promoting the rights of people with disability. After completing medical school at the University of Birmingham and went to Tanzania in East Africa working as general doctor with CBM at Mvumi Hospital. Allen helped develop a national eye care plan and with support from Dr Joseph Taylor and CBM established a clinical training programme for doctors and ophthalmic assistants training over 200 people from all over Africa.
Allen has over 150 publications and several international awards, including the “Order of the British Empire (O.B.E.) March 1998. “For services to Ophthalmology in the developing world.” Allen is best known as a passionate advocate and teacher of VISION 2020.
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Innovation
Select the stage that best applies to your solution
Scaling (the next step will be growing impact on a regional or even global scale)
How long have you been in operation?
Operating for more than 5 years
The Need: What problem are you trying to solve?
Access to eye care in rural areas is poor. Even those who can afford high quality eye care need to sometimes travel long distances to access good quality eye care. The underprivileged population does not even have adequate monetary resources to make the trip to the nearest town. Moreover, even a one-day trip translates into loss of wages. Therefore, the poor rarely make the trip to the nearest eye care provider unless and until the eye condition is unmanageable on their own. Preventive eye care remains a dream because of the monetary cost (travel and loss of wages) it imposes on the underprivileged, which is prohibitive. Consequently, there is need for good quality eye care service providers in local communities who can take care of most (if not all) of the typical eye care needs.
The Solution: What is your solution? Be specific!
The Vision Center model strengthens the basic tier of eye care, thereby increasing the uptake of eye care services in rural communities and leading to substantial savings to the community, since 70% of the eye problems in a typical community can be managed at a vision center. Eye problems due to uncorrected refractive errors can be resolved at the Vision Center while those with cataracts and other eye conditions are referred to the nearest secondary or tertiary level center. The Vision Center model, with permanent infrastructure, will eventually result in a positive change in eye health seeking behavior as the examination is available in the local community free of cost. The Vision Center's sustainability is achieved through the sale of spectacles (eye glasses). Each Vision Center serves a population unit of 50,000 and is ideally located at the hub of that unit. A well planned Vision Center can serve anywhere between 15 to 25 people every day and recover its operating costs also.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Typically, a well planned Vision Center screens around 2500 people, prescribes glasses to around 600 people, and dispenses spectacles to around 480 people. In addition, around 600 people are educated about blinding conditions of the eye and referred to the nearest secondary or tertiary level eye care center. Also, each Vision Center screens around 1200 school children every year as part of the center's school screening programs. For example, the LVPEI Vision Center in the village of Ichoda in the backward Adilabad District screens around 220 people every month (on average), gives around 85 prescriptions for eye glasses, dispenses around 75 eye glasses every month and refers around 42 people to the secondary level eye care center for further examination and treatment. With an average monthly income of more than Rs. 18,000, the center is sustainable, covering the salary of the resident vision technician, maintenance expenses, optical supply costs, rent and electricity.
The vision technician is a high school graduate who is trained for one year (six months of class room training and six months of hospital training) at LVPEI before being posted in a vision center. Vision technicians work in and with the local communities to creat awareness, encourage the rural population to visit the vision center and identify conditions that require immediate referral to and treatment at secondary or tertiary level eye care centers. Vision technicians spend three years at the vision center level, after which they are posted at secondary eye centers and then at tertiary eye centers.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
The primary competition to the vision center model is from optical stores and opticians. However, there is often no competition for the eye care screening and referral services provided by vision centers. As a rule, vision centers are not located in villages already served by ophthalmic assistants or ophthalmologists. This is because a majority of the rural areas has no acceess to eye care services. Therefore, a vision center is planned so as to serve a previously unserved population. Competition from optical stores is manageable because vision centers provide a service not available at optical stores. This service includes assessment of visual acuity, refraction, and slit lamp examination by the trained vision technician. These additional services distinguish LVPEI vision centers.
This Entry is about (Issues)
Social Impact
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
LVPEI undertook the landmark Andhra Pradesh Eye Disease Study (APEDS) between 1996 and 2000. This study provided insights into the causes of visual impairment and blindness. Noteworthy is the study's identification of refractive error as the primary contributor to visual impairment (around 45% of visual impairment is caused by refractive error). These findings were the first of their kind and spurred LVPEI to develop an eye care service delivery model to efficiently and efficiently solve the problem of visual impairment caused by refractive error. The vision center model emerged as a cost effective method to serve rural population at the doorstep. LVPEI upended the existing model of providing eye care services at government run primary health care by expanding the scope of the services offered as well as enhancing their quality. LVPEI is one of the first in India (and probably the world) to establish standalone rural vision centers to help eliminate aviodable blindness.
Please describe the goal of your initiative; outline what you are trying to achieve
The Vision Center model seeks to eliminate avoidable blindness by providing affordable and quality eye care to rural populations, including under-served and tribal sections of rural populations. A Community Based Vision Center provides comprehensive eye examination (without dilatation) free of charge and makes cost recovery possible through income received from the sale of spectacles. The vision technician, who runs a vision center, not only screens people but also acts as the optician. The vision technician makes frequent visits to local schools to screen children, apart from visiting local households to create awareness for eye conditions and to identify those in need of eye care services, including cataracts and vision impairment/loss due to refractive error or other eye conditions.
What has been the impact of your solution to date?
As of today, LVPEI's Community Based Vision Centers have screened over 700,000 people and prescribed spectacles to over 225,000 people. All of these vision centers are currently based in Andhra Pradesh and span twelve districts. Plans are underway to establish vision centers in two more districts. Some of the most backward districts of not only Andhra Pradesh but also India are served by LVPEI's Vision Centers. Examples include Adilabad and Vizianagaram. LVPEI has over eighteen vision centers in the backward Adilabad district and over six vision centers in the remote Vizianagaram district of Andhra Pradesh. While the vision centers in Adilabad are connected to the two LVPEI secondary level eye centers in the district, the vision centers in Vizianagaram are connected to the tertiary level eye care center in the neighboring district of Visakhapatnam. Children from over one thousand rural schools have been screened and, if warranted, referred to secondary centers for treatment.
What is your projected impact over the next five years?
Over the next five years, LVPEI expects to add at least fifty more rural vision centers to the seventy five odd centers already in existence. LVPEI expects to have at least one hundred and twenty five vision centers in place before the end of 2015. Each of these centers is expected to screen around 2500 people per year, prescribe glasses to around 600 people, and dispense glasses to around 480 people. Considering an average of 100 vision centers per year over the next five years, the figures translate into screening (eye examinations) of 1,250,000 people (free of charge) over the next five years, prescriptions for around 300,000 people, and 240,000 glasses dispensed. Also, each of these 125 vision centers will employ rural youth as vision technicians and support the rural communities.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Establishment of five new vision centers and laying the groundwork for establishing ten more vision centers.
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1
Establish five new vision centers in locations already identified over the past few months.
Task 2
Conduct due diligence to identify ten more locations that can attract 15-20 people per day.
Task 3
Ensure that the new vision centers generate daily data on people screened and optical sales.
Now think bigger! Identify your 12-month impact milestone
Establishment of ten new vision centers and laying the groundwork for establishing another twenty centers.
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1
Establish ten new vision centers in locations that can attract at least 15-20 people per day.
Task 2
Conduct due diligence to identify twenty more locations that can attract 15-20 people per day.
Task 3
Ensure that the new vision centers generate real time data on people screened and optical sales.
Sustainability
Tell us about your partnerships
Lavelle Fund has supported the establishment of ninety vision centers, seventy of which have already been established in six districts of Andhra Pradesh - Adilabad, Mahabubnagar, Nizamabad, Prakasam, Visakhapatnam, and Vizianagaram. The remaining twenty vision centers will be set up over the next two years. The Church of Latter Day Saints has disbursed funds for the establishment of twenty vision centers. Nine have already been set up in Khammam district. The remaining eleven vision centers will be set up within a year. Funding for the last ten centers will be received early next year.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
LVPEI is planning vision centers in the backward Indian state of Orissa. These centers will accompany a secondary level eye care center that is expected to go live in December 2012. These vision centers will serve populations with little or no access to eye care. Some of the served populations will also belong to tribal areas. In addition, LVPEI will establish Community Based Vision Centers in the backward and tribal Srikakulam district of Andhra Pradesh and add more vision centers in Vizianagaram, which is also a backward district of Andhra Pradesh. Therefore, LVPEI will keep growing.
What type of operating environment and internal organizational factors make your innovation successful?
An operating environment that is transparent and fair is required to monitor the network of highly dispersed vision centers. This is possible by hiring local administrators for a network of ten centers and by generating daily data on people screened and optical sales generated at each center. This data will help identify underperforming vision centers and enable follow-up through the local administrator to improve the vision center performance. Coordination between the different training teams is required to ensure that prospective vision technicians are trained appropriately and equipped with not only the technical knowledge to conduct eye examinations but also the emotional quotient to counsel people with eye problems and also to create awareness among skeptical rural populations.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
One of the areas of support not discussed thus far involves the local community. Support and encouragement from the local community will facilitate the establishment and operations of a vision center and enhance the efforts of the vision technician greatly. Grass roots level support and support of the opinion leaders is required to ensure that the vision center services are accepted and availed.
 | 14 weeks agoRajashekar Varda updated this Competition Entry. |
| 14 weeks agoAkila Maheshwari said: This extremely good work. Since this competition is about crossing borders. I think you should look at setting up one center at least in ... about this Competition Entry. - read more > |
| 15 weeks agoRuchi Dass said: I have myself studies Arvind eye care, Sankar Nethralaya and LVPEI model while doing a research on ROP. LVPEI probably does the maximum ... about this Competition Entry. - read more > |
| 15 weeks agoRajashekar Varda updated this Competition Entry. |
| 15 weeks agoRajashekar Varda said: Thank you for the support and your words of encouragement. Lavelle Fund only finances the infrastructure (except the building) required ... about this Competition Entry. - read more > |
| 15 weeks agoRichard Bartlett said: Congratulations on everything you've achieved - this was enjoyable to read; you've clearly done a lot! You talk about getting funding ... about this Competition Entry. - read more > |
| 16 weeks agoRajashekar Varda updated this Competition Entry. |
| 16 weeks agoRajashekar Varda updated this Competition Entry. |
| 17 weeks agoRajashekar Varda updated this Competition Entry. |
| 17 weeks agoRajashekar Varda submitted this idea. |
