Retinal disorders a public health crisis, need immediate prioritisation, say experts

Economic Times

3 days ago

Synopsis
Mission Vision, a public health initiative, has been launched in India to combat the escalating crisis of vision loss due to Diabetic Retinopathy. The initiative aims to increase awareness, improve screening and treatment access, and integrate eye care into routine diabetes management.
ET Spotlight Dr. Manisha Agarwal (General Secretary, VRSI and HOD, Vitreo Retina Dept, Dr Shroff's Charity Eye Hospital, New Delhi) and Dr. R Kim (President, VRSI and Chief Medical Officer, Aravind Eye Hospital, Madurai) A staggering public health crisis is unfolding in India, the world's diabetes capital, leading to a surge in irreversible vision loss from conditions such as Diabetic Retinopathy (DR).
This disease damages the retina, the eye's crucial 'reel', and often strikes people in their most productive years. Lack of awareness remains a primary concern, with nearly 90% of diabetic patients having never had a retinal exam and seeking help only after permanent damage has occurred. The problem is worsened by a severe shortage of specialists and the failure to integrate eye care into routine diabetes management.
To combat this escalating threat, Mission Vision, a public health initiative by The Vitreo Retinal Society of India (VRSI) and The Times of India, with support from Roche, was launched in July 2025. Under the Mission Vision initiative, a VRSI-led multistakeholder task force called the VIEW (Vision Improvement Experts Working) Council is putting together a comprehensive roadmap to tackle DR and make retinal health a national priority.Strategies to address gaps in awareness, screening, diagnosis and treatment, infrastructure, and capacity-building were discussed. When implemented, these potential solutions could preserve the sight of millions who are at risk today.The following key actionables emerged from the discussion: A clarion call for nationwide awareness
A nationwide awareness campaign, similar to the Pulse Polio programme, is essential to address preventable blindness so that people can take action before it is too late.
Emphasising the need for a collaborative approach, Dr R. Kim, President, VRSI and Chief Medical Officer, Aravind Eye Hospital, Madurai, said, 'There are many people doing a great job of reaching patients, but it is happening in pockets. We must integrate the entire network: primary care physicians, diabetologists, optometrists, and chemists to ensure that every patient with DR is identified early on and taken care of. It is about starting a national conversation where every patient asks for an eye exam. We cannot afford to lose another person's vision to silence.'
To achieve this, the following were suggested:
Multi-stakeholders through different channels to maximise awareness
Implement government mandates to ensure systemic integration
Sensitise and leverage the existing healthcare ecosystem, including community (e.g. ASHA workers)
Collaborate with trusted NGOs for nationwide scale, trust, and reach
Push for mandatory DR screening
Policy reform is crucial to make DR screening a fundamental right for every diabetic patient by 2030. Dr Manisha Agarwal, General Secretary, VRSI and HOD, Vitreo Retina Dept, Dr Shroff's Charity Eye Hospital, New Delhi, said, 'Currently, Ayushman Bharat includes DR screening in 12 states but only upon submission of an OCT photograph, which restricts its use by physicians who may not have an OCT machine. Expansion of DR screening to all states and the implementation of scalable screening models can improve DR detection significantly.'
The experts advocated for making annual DR screening a standard part of diabetes care. To facilitate this, screening must be linked to a patient's digital health ID or Aadhaar for effective tracking and follow-up. While screening and diagnosis are the start of the patient journey, the inclusion of intravitreal injections in Ayushman Bharat can go a long way towards improving access to treatment for DR, said most experts.
Speaking on the need for coordinated action, Roche Pharma's Rajwinder (Rajji) Mehdwan said, 'The question is not if we can eliminate preventable vision loss, but how soon we act to build a future where sight is accessible for all. Roche is committed to bringing its global healthcare ecosystem shaping expertise to make Mission Vision a reality.'
Building a robust screening-to-treatment pathway A robust referral system is needed to ensure patients diagnosed with DR receive proper, timely treatment. Dr Vishali Gupta, Chief of Retina and Uvea Services at PGI, Chandigarh, said, 'One of the biggest hurdles for timely treatment is in getting patients to the right retina specialist, as the referral pathways in these cases are fragmented. There is a need for a holistic national referral pathway so that we all know what a patient's journey looks like and ensure every patient gets access to specialised retinal care that they need.' An accountable, pyramid model and significant upskilling of the healthcare workforce were suggested through the following actions:
Implement uniform postgraduate training so all ophthalmologists can confidently perform dilated retinal exams.
Train ASHA workers for doorstep identification, and skill nurses and primary care physicians to administer prescribed intravitreal injections.
Train technicians to use low-cost, AI-enabled devices for grassroots screening, sending images to central hubs for specialist diagnosis.
Driving systemic change through policy reformExperts recommended following comprehensive policy changes to manage DR, urging the government to recognise its severe economic impact, particularly on young, productive individuals: Integrate DR screening into the national NCD programme via existing health and wellness centres.
Expand Ayushman Bharat's DR screening nationwide, remove the mandatory OCT photo for reimbursement, and add coverage for intravitreal injections so that the best treatment options are made available to patients
Replicate successful state models nationwide, such as Andhra Pradesh's camera distribution to diabetologists and Kerala's Nayan Amritham programme. This comprehensive, multi-sectoral approach, driven by collective will and clear policy, is critical to transforming the landscape of retinal health in India. The ambitious journey to safeguard the vision of millions has begun with Mission Vision, aiming for a future where sight is accessible for all.
Disclaimer: The views and opinions expressed in the story are independent professional judgments of the doctors/experts, and TIL does not take any responsibility for the accuracy of their views. This should not be considered a substitute for medical advice. Please consult your treating physician for more details. This article has been produced by Times Internet's Spotlight team.
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