optometry, Nepal, eye care, vision, refraction,

1. Optometry- Profession in Nepal
Gauri Shankar Shrestha, M.optom, FIACLE
Assistant Professor

2. Introduction
• Optometry is a health care profession that is
autonomous, educated and regulated
(licensed/Registered)
• Optometrists are the primary healthcare
practitioners of eye and visual system who
provide comprehensive eye and vision care that
includes refraction and dispensing, diagnosis and
management of eye diseases and rehabilitation of
conditions of the visual system.

3. Who are optometrists
• Graduates from +2 science and has completed
the Bachelor of Optometry and vision Science
degree

4. Scope of Optometry
• Refraction and Dispensing
• Contact lens practice-Rose-K, OrthoK,
• Low Vision and rehabilitative optometry
• Orthoptist and vision therapist
• Industrial optometry and environmental
Vision and occupational optometrist
• Primary eye care and therapeutic optometry

5. Scope of Optometry
• Optometry and sports
• Optical industry
• Work in multi-National company
• Academic- teaching
• Research- Vision and optometry

6. Optometry in Nepal
• Newest-1998
• Before 1998
– 1981-OA training
– 1987-ophthalmology training
• Human resources before 1998
– Ophthal
– OAs
– Technicians
– Orthoptists
– Opticians

7. Optometry in Nepal
• 17th Batch
• 66 optometrists graduated
• Foreign candidates: 3

8. Program goal
• To produce competent, compassionate, and
community oriented optometrists who is
capable of
– Providing eye and vision care
– Identify ocular diseases and related systemic
illness
– Refer the ocular emergencies and surgical cases

9. Admission criteria
• 50% aggregates
– ISc biology from Tribhuvan University
– +2 with Biology HSEC
– A-level
• Age: 25 years
• Merit basis on entrance exam

10. Specialty courses
• Ocular diseases
• Refraction and dispensing
• Low vision
• Orthoptics
• Contact lens
• Pediatric optometry
• Geriatric optometry
• Community optometry
• Elective posting-6-8 weeks

11. Professional Career
• Successful independent practitioner (Global
data)
• Opportunity to be self employed either as a
partner or a sole practitioner
• Work at health care institutions
• A responsible position in the community as a
health professional

12. Professional career
• Vision research, teaching and administration
for various professional organizations
• Work with ophthalmologists contributing in
major part of ophthalmic practice
• Work as optometrists in many overseas
countries
• Work in many ophthalmic products industry,
social welfare organizations

13. Role in three levels of eye care
• Primary eye care
– VDC level (limited role)
• Secondary eye care services
– districts level –vision centers-Optometrists major
role
• Tertiary eye care services
– Regional level-hospitals, centers and departments,
Optometrists crucial role

14. Primary eye care services
• Services that are required by many people most
of the time to meet their non-specialized health
problems
• Function as the primary point of entry into the
system
• Role
– A comprehensive range of diagnostics, therapeutics
and preventive services
– Health promotion and maintenance activities
– Health campaigns

15. Primary eye care services
• Referral
– Within vertical dimension from the primary level
to the secondary and tertiary levels
• Aim
– Provision of care to the right patient at the right
time in the right places and for the right reason

16. Secondary eye care services
• relative specialized services provided after
referral to a consultant/specialist
• Main service points
• Vision centers, community hospitals

17. Tertiary eye care services
• Tertiary care
– Highly sophisticated services that require
extensive technical capabilities and
– Are almost always delivered on an in patient basis
• Centralized at a major health complex
• Low frequency of conditions require these
services
• A medical teaching hospital, eye hospitals or
eye centers

18. Responsibilities
• PECC
– Community survey
– School screening
– Health campaign
– Eye camps
– Refraction, dispensing and treatment of common
ocular diseases

19. Responsibility
• Secondary eye care services
– Private/community or vision center oriented eye
care services
– Diagnosis and treatment of common ocular
diseases
– Referral of ocular emergencies, systemic illness, to
medical practitioners/ophthalmologists
– Refraction and spectacle dispensing
– Geriatric and pediatric vision care

20. Responsibility
• Tertiary eye care services
– Contact lens services
– Low vision services and rehabilitation
– Binocular vision services
– Sports vision visual ergonomics
– Social welfare and health organizations
– Ophthalmic products industry

21. Prime responsibility
• Prevention
• Health education
• Health promotion
• Health maintenance
• Diagnosis
• Treatment and rehabilitation
• Counseling
• consultation

22. Demography of Nepalese optometrists
• Total number of graduates-66
– 53.7%- abroad
– 46.3% Nepal
• Educational status
– 11.9%- M.Optom/MPH
– 9% PhD/Post Doc
– 22.4% Pursuing PhD
• Optometrists in Nepal
– 67.7% Institutional/ Hospital based practice
– 32.3% Private practice

23. Nepalese Association of Optometrists
• Optometrists formed an association in 2003
named as “Nepalese Association of Optometrists
(NAO)”
• NAO is involved in school screening, eye check
ups, health campaigns in community
• Current Partners are Optometry Giving Sight, BP
eye Foundation, Volunteer organization for
services of humanity
• NAO is member of World council of Optometry
(WCO), Asia Pacific Council of Optometry (APCO)

24. Program Supported to Nepalese
Optometrists by International agencies
• The Sight Conservation of Children from
Marginalised Communities of Nepal
– Subodh Gyawali, OD, MPH, for OGS
• Eye teaming and co-ordination among school
children of Kathmandu
– Subodh Gyawali, OD, MPH for OGS
• Ocular morbidity among street children of
Kathmandu Valley
– GauriSh Shrestha, M.Optom, FIACLE for WCO

25. International conferences attended by
Nepalese Optometrists
• 2004-Wco conference, Florida
• 2005-Asia pacific conference, Tokyo, Japan
• 2007-APCO Conference in Goa, India
• 2009-APCO conference in HongKong
• 2011-APCO conference in Singapore
• 2012-WCO conference in USA, Chicago
• 2013- APCO conference in South Korea
• 2013-BCA conference in UK
• 2014-AAO conference in USA, Denver
• 2014-IOA conference in India

26. Nepalese Optometrists research
papers in International peer reviewed
Journals
• Journal of optometry
• Clinical and experimental optometry
• Optometry and visual science
• Ophthalmic epidemiology
• British Journal of Ophthalmology
• Cornea
• Investigative ophthalmology and visual sciences
• The ocular surface

27. Nepalese Optometrists research
papers in International peer reviewed
Journals
• Nanomedicine: Nanotechnology, biology and
medicine
• Bone marrow transplantation
• Perception
• Journal of Vision
• Journal of cognitive psychology
• Indian journal of ophthalmology
• Contact lens and anterior eye

28. Nepalese Optometrists research
papers in International peer reviewed
Journals
• Optometry and visual performance
• Behavioral optometry
• Clinical and experimental ophthalmology
• Graves archive of clinical and experimental
ophthalmology
• Ophthalmology congress
• Ophthalmic and physiological optics
• Ophthalmology

29. Nepalese Optometrists research
papers in International peer reviewed
Journals
• Health and quality of life outcome
• JAMA ophthalmology
• Journal of glaucoma
• Quality of life research
• Community eye health journal
• Current eye research
• BMJ case reports

30. Nepalese Optometrists research
papers in national peer reviewed
Journals
• Nepal medical college journals
• Nepalese journal of Ophthalmology
• Journal of Institute of Medicine
• Nepal medical college journal
• Journal of Chitwan medical college
• Journal of Nepal medical Association
• Health Renaissance
• Medical Journal of Shree Birendra Hospital

31. Thank you