Outreach Program Department at TIO aims to reach to the unreached population and ensure equity in eye care service delivery. There is a high prevalence of blindness and visual impairment in rural districts of Nepal it is because the majority of the population living in rural areas has no or very limited access to eye health services. Recognizing that a significant proportion of eye health problems of the community that needs to be corrected or cured at the community level, the Tilganga Institute of Ophthalmology (TIO) has established Outreach Program Department. The main objective of this department is to expand the eye health services in the unreached areas of Nepal and neighboring countries and increase service coverage.
District Eye Care Program
TIO has developed a model of district eye care program to combat avoidable blindness and visual impairment in the remote and underserved areas where blindness and visual impairment hit the community the hardest. TIO establishes basic infrastructures for eye care in districts where there are no eye care service facilities. The selection criteria for the district includes geographical location or remoteness, population density, the prevalence of blindness and visual impairment, the existence of eye care service providers, potential partner, and the local level resources and partnership. TIO has established community eye centers, community eye hospitals, rural and urban eye clinics in the hilly and mountainous districts of Nepal. To address short-term service needs, TIO conducts outreach micro-surgical eye clinics and screening eye camps in the program districts. This program has been found to be an important asset of TIO in addressing the inequity in the eye health system of districts, District eye care program increases peoples access to quality and affordable eye health services and increase uptake of eye health services at their locality. Further TIO has witnessed the change in the quality of life of thousands of people living in a rural community with the successful implementation of the program.
Community Eye Hospital
The Community Eye Hospital (CEH) is a secondary level eye care center. The CEH is led by Ophthalmologist with the support team of 20 to 30 staffs. The main objective of CEH is to provide high quality cataract surgery service in the population catchment of over 500,000. TIO has been running two CEHs in Chymasing of Bhaktapur and Hetauda of Makawanpur districts. Both CEHs were upgraded from the CEC after running over eight years.
Community Eye Centre
From the clinical perspectives, Community Eye Center (CEC) represents the first level in the eye care system. They perform basic services of eye care interventions (primary eye care) for early detection and treatment of common eye diseases including refractive errors and act as a referral centre to secondary and tertiary level eye care center for advance treatment. Each CEC conducts outreach programs such as screening eye camps, school eye screenings, diabetic retinopathy screening. Of the total patients served 60% patients are examined and treated through outreach programs and 40 patients are walk in patients at CEC facility. As a part of strengthening local eye health capacity basic eye care training is provided to community health workers, Female Community Health Volunteers and school teachers. CECs also engage in raising awareness in eye heath and promote services at the local level.
Tilganga Institute of Ophthalmology has 16 Community eye centres.
Rural Eye Clinic and Urban Eye Clinics
Eye health services are rarely available in local government level such as Rural Municipality and Municipality in majority of districts. TIO has provisioned to expand and integrte eye health services into the local level of the existing CEC districts in partnership with Local government. Both eye clinics are served by ophthalmic assistant as a staff of local government. TIO and CEC provide technical support in establishing and running the Rural and Urban Eye Clinics. This service modality is introduced by TIO in the financial support of The Fred Hollows Foundation and Himalayan Cataract Project in 2019. This modality is a pilot project of TIO as a model for integration of primary eye health service with local level government in Nepal.
Screening programs are divided into 2 groups, Community screening and school screening eye camps.
Community Screening: Community screening camps are designed to screen for all kinds of common ocular disorders, with focusing on screening major blinding eye diseases such as Cataract and refractive errors. Simple refractive errors and minor eye problems are treated at the camp site with medicine or spectacles. Operable cataract patients screened from this type of screening clinics are referred to the TIO/CEH or CEC OMEC for the cataract surgery.