High Volume, High Quality Cataract Surgery

Keywords Cataract, Eye Camp, Manpower and Attitude By the current Indian definition of blindness (vision in the best eye < 6/60), there are over 12 million 1 people blind due to cataract in India. The only population based study places incidence of cataract blindness (based on WHO definition of VA in the best eye of < 3/60) at 3.8 million new cases 2 per year. Even though some argue this to be an over estimate, the current levels 3 of cataract surgery is far below what needs to be done to clear the backlog and take care of the incidence. As our economic status improves leading to changed life styles, the requirement for better vision will be on the rise and people will be demanding cataract surgery earlier than the current definition of blindness. This is already happening in the urban areas amongst the middle and upper class of the society. This phenomenon combined with the rapidly growing older population will increase by many fold, the number of cataract surgeries that need to be done. This challenge will need to be addressed immediately. While increasing our infrastructure of hospital facilities, ophthalmologists and other manpower could be a solution, it is also necessary to explore ways by which the productivity of the current infrastructure can be increased significantly and at the same time providing better quality of services. While an average ophthalmologist in the country may be performing around 300 cataract surgeries there are several ophthalmologists who either as private practioners or as part of an institution perform 1,000 to 2,000 surgeries a year, often of a very high quality, since without good quality it will be difficult to sustain such high patient load. The purpose of the article is to explore the factors that contribute to this and thereby make a contribution to enhance the productivity and quality of the current eye care infrastructure. The process leading to high quality and high volume cataract surgery has two major elements-demand generation and an efficient use of resources to meet the demand, with the whole process governed by a certain attitude. Figure 1 (a) shows the interaction. In the case of industries producing and marketing a product, we always associate good quality with high sales. In fact, whenever a product has a low demand or sales, the first question that is raised is one of quality. However, in health care there is …