What do they do?
A young man came to the emergency department of a city hospital with no vision in both eyes due to perforated eyeballs resulting from a car accident. A CT scan was done followed by microsurgery, to remove glass splinters and other foreign particles from the eyes. Two weeks after this, the ophthalmologist operated on the patient to remove the traumatic cataract, a natural consequence of such accidents. The opaque lenses of the damaged eyes were replaced with intra-ocular lens implants. At the end of a month, following the operation, the patient’s vision was restored completely.
An “ophthalmologist in India acts as both general physician and surgeon,” says Dr Parul Sharma, a senior eye surgeon heading the ophthalmology unit of Max Hospital, Gurgaon, who treated the young man mentioned in the case study. Sharma had primarily wanted to be a surgeon and zeroed in on ophthalmology “as it is very satisfying professionally, and takes lesser time to self-train as compared to other superspecialised surgical branches.”
Sharma completed her MBBS from Jawaharlal Nehru Medical College, Aligarh Muslim University, in the year 1993 and MS from the same institution in 1998.
She did her senior residency in Ram Manohar Lohia Hospital, New Delhi, for three years before doing short-term fellowships from Moorfield Eye Hospital,
London, and L V Prasad Eye Institute, Hyderabad. Her field of specialisation is cataract, refractive (freedom from glasses) and glaucoma.
Ophthalmologists examine the eye with special equipment and check visual acuity (the ability to see). If a patient’s visual acuity is less than normal, the ophthalmologist usually does a check to determine whether the decrease in vision can be corrected with glasses. If glasses don’t help the ophthalmologist performs the necessary operation such as removal of cataracts (clouding of the lens of an eye). S/he may perform other types of operation that include surgery to correct strabismus (eye misalignment) or other muscle imbalances of the eye, corneal transplants, and surgery to control glaucoma (increase in fluid in the eye). By examining the retina (back layer of the eye) s/he may discover signs of such diseases as diabetes, AIDS, and certain forms of anaemia that may cause changes in the appearance of the retina.
“Ophthalmology is a growing field with advancing technology, sophisticated equipment and sub and superspecialisation in techniques and healthcare procedures,” says Dr Rajan Malik, medical director, Drishti Eye Laser Centre, New Delhi. And the scope of work of an ophthalmologist in India is enormous. “About 16 million blind persons and more than 60 million visually impaired live in the country, giving ophthalmologists an opportunity to treat the most challenging eye diseases,” says Sharma.
There is, however, a shortage of ophthalmologists in the country. “Nearly 900 ophthalmologists are trained in India every year. At present there are about 14,000 trained ophthalmologists in the country. It has been estimated that India needs 25,000 ophthalmologists by 2020,” says Malik. Agrees Sharma. “The problem is twofold — one, the number of ophthalmologists is low and two, they are not evenly distributed among the urban and rural sectors,” she says.
Dr R Sahai, CMO, Safdarjung Hospital, New Delhi, considers the concentration of ophthalmologists in urban areas as a challenge that needs to be addressed immediately. However, the future of the profession, experts feel, is bright.
