This document discusses primary eye care and the role of ophthalmic officers. It defines primary eye care as the promotion of eye health, prevention and treatment of conditions leading to vision loss, and rehabilitation for the blind. The key activities of primary eye care are outlined as creating awareness, prevention through behaviors and environment, curative activities like treating common eye diseases, and rehabilitation for the incurably blind. Ophthalmic officers are defined as the primary eye care professionals dedicated to vision care. They specialize in eye exams, diagnosis, management of visual disorders, and have roles in hospitals and communities by providing services like refraction, vision therapy, and detection and referral of eye pathology.

1. GOVT. OPHTHALMIC OFFICER’S
ASSOCIATION, MAHARASHTRA (INDIA)
(REG. NO: N.G.P. 4373)
CODE OF ETHICS
“VISION of VISIONARY’S”“VISION of VISIONARY’S”“VISION of VISIONARY’S”“VISION of VISIONARY’S”
“Working together to eliminate avoidable blindness”
Ophthalmic officers
GOVT. OPHTHALMIC OFFICER’S
ASSOCIATION, MAHARASHTRA (INDIA)
(REG. NO: N.G.P. 4373)
PROFESSION
AND
CODE OF ETHICS
“VISION of VISIONARY’S”“VISION of VISIONARY’S”“VISION of VISIONARY’S”“VISION of VISIONARY’S”
Working together to eliminate avoidable blindness”
Ophthalmic officers
Giving Sight
GOVT. OPHTHALMIC OFFICER’S
ASSOCIATION, MAHARASHTRA (INDIA)
Working together to eliminate avoidable blindness”

2. “One of the basic human right is the Right to see. We
have ensure that no citizen goes blind needlessly, or
being blind does not remain so, if by reasonable
development of skill and recourses , his sight can be
prevented from deteriorating ,or if already lost. Can
be restored”
Central council of health & Family welfare Govt.
of India , April 1975)
Honored to support the
Advancement of professional
Ethics in Primary Eye care profession

3. Blindness and Vision Impairment: Global Facts
According to
WORLD HEALTH ORGANISATION
Approximately 314 million people worldwide live with serious vision impairment
Of these, 45 million people are blind and 124 million have low vision Also
included, 153 million people are vision impaired due to uncorrected refractive
errors (near-sightedness, far-sightedness or astigmatism). In most cases, normal
vision could be restored with eyeglasses or contact lenses
Yet 80% of blindness is avoidable - i.e. treatable and/or preventable 90% of
blind people live in low-income countries Restorations of sight, and blindness
prevention strategies are among the most cost-effective interventions in health
care Infectious causes of blindness are decreasing as a result of public health
interventions and socio-economic development. Blinding trachoma now affects
fewer than 80 million people, compared to 360 million in 1985 Aging populations
and lifestyle changes mean that chronic blinding conditions such as diabetic
retinopathy are projected to rise exponentially Women face a significantly
greater risk of vision loss than men Without effective, major intervention, the
number of blind people worldwide has been projected to increase to 76 million
by 2020
Sight test and glasses could dramatically improve the lives of 150 million people with
poor vision A simple sight test and eyeglasses or contact lenses could make a dramatic
difference to the lives of more than 150 million people who are suffering from poor
vision. Children fail at school, adults are unable to work and families are pushed into
poverty as a result of uncorrected visual impairment.
153 million people around the world have uncorrected refractive errors (more commonly
known as near-sightedness, far-sightedness and astigmatism). Refractive errors can be
easily diagnosed, measured and corrected with eyeglasses or contact lenses, yet
millions of people in low and middle income countries do not have access to these basic
services.
Without appropriate optical correction, millions of children are losing educational
opportunities and adults are excluded from productive working lives, with severe
economic and social consequences. Individuals and families are frequently pushed into
a cycle of deepening poverty because of their inability to see well. At least 13 million
children (age 5 to 15) and 45 million working-age adults (age 16 to 49) are affected
globally. Fully 90% of all people with uncorrected refractive errors live in low and middle
income countries.

4. WHO previously estimated that 161 million people were visually impaired from eye
diseases such as cataract, glaucoma and macular degeneration. Uncorrected refractive
errors were not included in these earlier estimates. These latest WHO estimates add to
the previous number and effectively double the estimated total number of visually-
impaired people worldwide, bringing it to some 314 million people globally. The
estimates also confirm that uncorrected refractive errors are a leading cause of visual
impairment worldwide.
As part of the VISION 2020 Global Initiative to eliminate avoidable visual impairment
and blindness worldwide, WHO has been working with its partners to improve access to
affordable eye exams and eyeglasses for people in low and middle income countries.
This new information concerning the prevalence of refractive errors will strengthen the
efforts of the VISION 2020 partnership to raise awareness of the magnitude of the
problem and spur increased commitment for action.
“Correction of refractive errors is a simple and cost-effective intervention in eye care,”
said Dr Serge Resnikoff, Coordinator of WHO’s Chronic Disease Prevention and
Management unit. “Now that we know the extent of the problem of uncorrected
refractive errors, especially in low and middle income countries, we must re-double our
efforts to ensure that every person who needs help is able to receive it.”
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PRIMERY 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. 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 programmers.
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.
Primary eye care activities
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. Current traditional health education
methods carried out in clinics and health centres are not appropriate, hence

5. the impact of such methods are negligible. People from within the community
are very effective in creating awareness.The information given to pass on
includes: The burden blindness brings to individuals who are themselves blind,
and on the family at home and on the community as a whole.The major
blinding diseases which are common in the area and how blindness can be
avoided. Understanding of basic first aid skills in case of accidents and
treatment of the common eye diseases. Offering guidance to the community
on how to arrange transportation and reach the health centre where more help
can be given.
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. Examples
of activities are as follows: Provision of adequate, safe water supplies; personal
hygiene.Construction, use and maintenance of pit latrines and refuse pits;
environmental hygiene. Growing and consumption of foods rich in vitamin A;
nutrition. Recognition and appropriate care of individuals at risk of blinding
diseases; for example, adequate feeding and rehydration of children with
severe measles, malnutrition or diarrhoea. Protection of eyes against injuries.
Immunisation against measles. Screening of antenatal mothers for sexually
transmitted diseases.
Curative activities:
This involves delivery of eye care to all individuals with potentially blinding
disorders in the communities. For example:correction of refractive errors with
provision of glasses and contact lenses 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 , arrangements of eye camps and
referral of curable blinding diseases like cataracts.
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. Clients are
assured that they are not completely useless. With training, skills can be
acquired and they can be functional and not have to rely totally on others.

6. OPHTHALMIC OFFICER
Primary eye care profession
Ophthalmic officer is the full time Primary Eye Care Professional
dedicated to care for the most treasured of human senses – Vision. It is
a dynamic health care professional that provides a wide range of
interesting, rewarding and challenging career opportunities and services
to the community. The profession provides an intellectually stimulating
career with a humanitarian role in today's society. Ophthalmic officers
are primary eye care providers who specialize in the examination and
diagnosis of the eye and the visual system and management of diseases
and disorders of the visual system, as well as the diagnosis of related
systemic conditions and also have vital role in various diagnostic
procedures in hospital as will as community settings.refraction, vision
therapy, contact lenses, low vision aids, visual rehabilitation counseling, detection
of pathology and referral, and emergency ocular treatment are the main
professional tasks.
Through academic and clinical training in medical colleges, ophthalmic
officer acquire knowledge and skills needed to diagnose, treat and
prevent problems of the visual system. Providing health education,
managing preventive regimen, supplying vision care to special groups of
patients are all part of an ophthalmic officers work.
He/She recognize ocular and visual signs of disease understand the
wide range of health problems affecting patients and refer patients to
appropriate specialists. Public health activities include vision screening
for communities, schools and rural part of Maharashtra.
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7. VISION of PROFESSION
PROMOTE:
Promote healthy living and Healthy Sight , and healthy societies, especially for
the poor and those living in disadvantaged populations.
PREVENT :
Prevent blindness and avoid unnecessary disability due to chronic diseases. The
solutions exist now, and many are simple, cheap and cost effective.
TREAT :
Treat refractive error and vision disorders ,using latest available knowledge.
Make treatment available to all, especially those in the poorest settings.
CARE:
Help provide appropriate care by facilitating equitable and good quality eye
and health care for major chronic diseases.
The Mission of ProfessionThe Mission of ProfessionThe Mission of ProfessionThe Mission of Profession
“Our mission is to eliminate Avoidable blindness and visual
impairment through primary eye care Approach to fulfill the vision
and eye care needs of the public through clinical care , research
and education , all of which enhance the quality of life.”

8. JOB CHART OF OPHTHALMIC OFFICER
Original Duty Chart (“National Programme for Prevention of Visual Impairment
and Control of Blindness India” brought out in 1978)
Train staff at peripheral level in eye-care
Treat the patients for eye ailments
Test vision and prescribe glasses
Assist Mobile Units in conducting eye-care camps
Survey the community for early detection of eye defects
Organise community education.
The revisied duties under the National Programme for Control of Blindness (NPCB)
( 2nd meetings of the Committee of Experts held On 8th November, 2010)
ROLE AND RESPONSIBILITY AT PRIMARY LEVEL
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)
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

9. 3. Usage of following medications
a) Mydratics
b) Cycloplegics drugs for refraction
c) Topical anaesthetics for diagnostics
d) Basic antibiotics, pain killers, antihistaminics, antialergics
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
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

10. 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
13. Pre-operative work up
1. Slit lamp examination
2. Biometry: A Scan, Keratometry
3. Blood pressure
4. Checking blood sugar
Operation Theatre & Wards
14. Independently
1. Administration of pre and post operative medications and counselling
2. Sterilization of instruments, equipments
3. Setting up of surgical trolley and other equipments
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
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11. The Oath
With full deliberation I freely and solemnly pledge that:
I will practice the art and science of primary eye care faithfully and
conscientiously, and to the fullest scope of my competence.
I will uphold and honorably promote by example and action the highest
Standards, ethics and ideals of my chosen profession and the honor
of the qualification, diploma in ophthalmic science, Globally known as Optometry
and vision science , which has been granted me.
I will provide professional care for those who seek my services, with
Concern, with compassion and with due regard for their human rights and
dignity.
I will place the treatment of those who seek my care above personal
gain and strive to see that none shall lack for proper care.
I will hold as privileged and inviolable all information entrusted to me
in confidence by my patients.
I will advise my patients fully and honestly of all which may serve to
Restore, maintain or enhance their vision and general health.
I will strive continuously to broaden my knowledge and skills so that
My patients may benefit from all new and efficacious means to
Enhance the care of human vision.
I will share information cordially and unselfishly with my fellow
Ophthalmic officers/ optometrists and other professionals for the benefit of
patients and the
Advancement of human knowledge and welfare.
I will do my utmost to serve my community, my country and
humankind as a citizen as well as an ophthalmic officer .
I hereby commit myself to be steadfast in the performance of this my
Solemn oath and obligation.
______________________________________________________
GOVT. OPHTHALMIC OFFICERS ASSOCIATION MAHARASHTRA . @ 2014