Optometry- Profession in Nepal

Gauri Shankar Shrestha, M.optom, FIACLE

Assistant Professor

Introduction

• Optometry is a health care profession that isautonomous, educated and regulated(licensed/Registered)

• Optometrists are the primary healthcarepractitioners of eye and visual system whoprovide comprehensive eye and vision care thatincludes refraction and dispensing, diagnosis andmanagement of eye diseases and rehabilitation ofconditions of the visual system.

Who are optometrists

• Graduates from +2 science and has completed the Bachelor of Optometry and vision Science degree

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

Scope of Optometry

• Optometry and sports

• Optical industry

• Work in multi-National company

• Academic- teaching

• Research- Vision and optometry

Optometry in Nepal

• Newest-1998• Before 1998

– 1981-OA training– 1987-ophthalmology training

• Human resources before 1998– Ophthal– OAs– Technicians– Orthoptists– Opticians

Optometry in Nepal

• 17th Batch

• 66 optometrists graduated

• Foreign candidates: 3

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

Admission criteria

• 50% aggregates

– ISc biology from Tribhuvan University

– +2 with Biology HSEC

– A-level

• Age: 25 years

• Merit basis on entrance exam

Specialty courses

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

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

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

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

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

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

Secondary eye care services

• relative specialized services provided after referral to a consultant/specialist

• Main service points

• Vision centers, community hospitals

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

Responsibilities

• PECC

– Community survey

– School screening

– Health campaign

– Eye camps

– Refraction, dispensing and treatment of common ocular diseases

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

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

Prime responsibility

• Prevention

• Health education

• Health promotion

• Health maintenance

• Diagnosis

• Treatment and rehabilitation

• Counseling

• consultation

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

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)

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

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

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

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

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

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

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

Thank you