ophthalmic officer in primary eye care

2. Introduction
1. Comprehensive health care includes
the activities of health promotion,
diseaseprevention, curative measures at
the timeof illness, and rehabilitation if
the damage caused by the disease is
disabling. This type of health care may
be made available, accessible,affordable
to the poorest rural population and
should be sustainable.

3. Primary eye care :
Primary eye care is a vital component in primary health care and
includes the promotion of eye health care, the prevention and
treatment of conditions that may lead to visual loss, as well as the
rehabilitation of those who are already blind.
Primary eye care (PEC) is the most basic eye care
available to individuals and families wherever they
live and whatever their socio-economic condition.

4. The aim of primary eye care is to change
the pattern of eye care services, currently
often limited to the central hospitals and
eye units in the cities, to countrywide
blindness prevention programmes.

5. Primary eye care is the primary health care approach
to the prevention of blindness and it should be an
integral part of primary health care. Primary health
care is defined as essential health care based on
methods and technology that are practical and
scientifically sound, as well as socially acceptable;
accessible to the community, affordable for the
community with good community participation.

6. In most developing countries like india avoidable
blindness constitutes a major public health
problem. There are distinct, closely related
components in the primary health care approach
to blindness prevention

7. Primary eye care activities are
The essential components of primary
eye care are:
1. Promotive
2. Preventive
3. Curative
4. Rehabilitative
Such care can be provided by
OPHTHALMIC OFFICERS

8. Creating awareness (promotive). This is the
strengthening of community awareness and co-operation
to promote health within the family unit. Appropriate
information is disseminated to as many people in the
community as possible.

9. Prevention: This includes stimulation of individuals
and their community to participate in activities in
blindness prevention; social and community
development that promotes health through changes in
behaviour and environment and leads to the reduction
or elimination of factors contributing to ocular disease.

10. Curative activities: This involves delivery of eye care to all
individuals with potentially blinding disorders in the
communities. For example:
First aid treatment and/or timely referral of patients with
injuries.
Identification and treatment/referral of common eye
diseases.
Identification and referral of patients with potentially
blinding diseases for appropriate management.
Identification and referral of curable blinding diseases like
cataracts.

11. Rehabilitation activities: What happens to those
who are incurably blind? Do we merely sympathise
with them and their families? Since primary eye
care is mainly concerned with the community level,
the issue of rehabilitation becomes very important.

13. To have a successful primary eye careTo have a successful primary eye careTo have a successful primary eye careTo have a successful primary eye care
programmeprogrammeprogrammeprogramme,,,,
there needs to be coordinatedthere needs to be coordinatedthere needs to be coordinatedthere needs to be coordinated
teamwork.teamwork.teamwork.teamwork.
There should be regular interactionThere should be regular interactionThere should be regular interactionThere should be regular interaction
between the full time eye providers.between the full time eye providers.between the full time eye providers.between the full time eye providers.

15. @ ROLE AND RESPONSIBILITY
Of OPHTHALMIC OFFICER AT PRIMARY LEVEL
( Revised )
1. Screening and identification of eye diseases at Primary
level:
a) Cataract
b) Uncorrected refractive errors
c) Glaucoma
d) Childhood blindness
e) Diabetic retinopathy
f) Squint
g) Trachoma
h) Corneal opacity
i) Uveitis
j) Screening for colour vision (not for issuing certificate)

16. 2. Treatment/ Medical intervention at Primary level
(PHC) of the following common eye diseases
a) Trachoma
b) Conjunctivitis
c) Allergies of eye lids and conjunctiva
d) Dry eye
e) Eyelid problems (blepharitis, stye, chalazion)
f) Vitamin A Deficiency
g) Lacrimal system Disorder,
h) Superficial corneal abraison
@ ROLE AND RESPONSIBILITY
Of OPHTHALMIC OFFICER AT
PRIMARY LEVEL

17. 3. Usage of following medications
a) Mydratics
b) Cycloplegics drugs for refraction
c) Topical anaesthetics for diagnostics
d) Basic antibiotics, pain killers,
antihistaminics, antialergics
@ ROLE AND RESPONSIBILITY
Of OPHTHALMIC OFFICER AT
PRIMARY LEVEL

18. @ ROLE AND RESPONSIBILITY
Of OPHTHALMIC OFFICER AT PRIMARY LEVEL
4. Refraction & prescription of spectacles,
5. Dispensing of spectacles
6. Identify, initiate primary medical treatment (as per the
protocol) and refer to an Ophthalmologist immediately in
the following emergency cases:
a) Chemical burns
b) Perforating injuries of eyeball or lids
c) Corneal infections
d) Gluocoma
7. Minor surgical procedures
a) Epilation for Trichiasis
b) Superficial foreign body removal

19. 8. Enucleation of the eye in cornea donation after proper training
9. Follow up of post operative cases
10. Referral
11. Health education and training at Primary level:
For all Primary level functionaries and Volunteers
12. Organization and management at Primary level
a) Documentation
b) Counseling
c) Screening camps
d) School eye health
e) Health education sessions
f) Coordination with other departments (ICDS, social justice,
primary health)
g) Tele-ophthalmology
h) Epidemics
@ ROLE AND RESPONSIBILITY
Of OPHTHALMIC OFFICER AT
PRIMARY LEVEL

20. Role & Responsibility at Secondary Level
In the out patient department
1. Record complaints, history, preliminary anterior segment eye
examination
2. Assessment of vision
3. Refraction : Manual & automated
a. Dilatation for refraction
b. Prescription of glasses
4. Tonometry(shiotz, applanation, non-contact tonometry)
5. Evaluation of lacrimal duct patency
6. Visual fields testing
7. Diplopia and hess charting
8. Binocular vision testing
9. Contact lens fitting, Low vision aids trial after getting
appropriate training
10. Non invasive investigating techniques after training from a
recognised institute
11. Prosthetic eye implant fitting
12. Coordination with primary level

21. 13. Pre-operative work up
1. Slit lamp examination
2. Biometry: A Scan, Keratometry
3. Blood pressure
Operation Theatre & Wards
14. Independently
1. Administration of pre and post operative medications and counselling
15. Under Supervision
1. Administration of local anaesthesia under supervision of ophthalmic surgeon
2. Intramuscular and intradermal injections
3. Assist in surgery: draping of the patient, handing over instruments and
handling surgical supplies

22. ophthalmic officers front line in
eye care ….serving the community
saving the sight………..