Envisioning the Invisible: An Urgent Call for a New Eye-Health Revolution in India

RM: What is your perspective on the impact of vision loss and preventable eye diseases in a large country like India?

DV: India crossed 1.43 billion people in 2023, making it the most populous country in the world. Over 65% of Indians still live outside major metropolitan areas, where specialist healthcare—especially ophthalmology—is scarce.

At the same time, India is witnessing:

First, a sharp rise in diabetes, with over 100 million diabetics, many at risk of diabetic retinopathy. Second, a growing elderly population, expected to cross 20% by 2050, increasing vulnerability to glaucoma, cataract, and macular degeneration. And third, millions of school-age children with undiagnosed refractive and colour-vision disorders affecting learning outcomes.

Despite these realities, eye care in India remains largely reactive, clinic-based, and urban-centric. By the time patients reach tertiary hospitals, vision loss is often advanced and irreversible.

RM: How do you see the diagnostic gap?

DV: India’s ophthalmology market is estimated at nearly ₹10,000 crore, yet it remains structurally underserved, especially in rural and semi-urban regions.

Traditional diagnostic equipment, such as fundus cameras, OCT systems, and perimetry devices, is expensive, bulky, and requires trained personnel. This creates three systemic gaps: late detection of eye disease, high cost per diagnosis—making mass screening unviable, and low penetration beyond hospitals and eye camps.

What India needs is not merely more infrastructure, but diagnostic democratisation—the ability to detect disease early, affordably, and at scale.

RM: You are using many technical abbreviations. Can you please make it simpler for our readers?

DV: I am sorry. I must clarify.

A fundus camera is a specialised low-power microscope with a camera, used to capture detailed images of the fundus—the back inner wall of the eye, including the retina, optic nerve, and macula—for diagnosing and monitoring eye conditions like diabetic retinopathy, glaucoma, and macular degeneration.

OCT systems refer to Optical Coherence Tomography devices, advanced non-invasive imaging tools that use near-infrared light to create high-resolution, cross-sectional images of tissue structures in real time. These have revolutionised ophthalmology and are increasingly used in cardiology, surgical guidance, and medical research.

RM: Why do you think new techniques matter?

DV: Innovative diagnostic techniques—particularly those combining AI, cloud computing, and portable hardware—offer a way out of this impasse.

New-generation devices seek to recreate the ophthalmologist’s diagnostic environment in compact, low-touch formats, allowing eye screening to move closer to where people live, work, and study.

One such approach is exemplified by VR/AR-based eye diagnostics integrated with AI-driven retinal imaging, designed to detect not only common eye diseases but also early neurological and systemic conditions. These technologies aim to shift eye care from hospital-centric to population-centric models.

RM: In such a case, early detection is vital, as also the economic logic, is it not?

DV: I completely agree with you. Vision loss is not merely a medical issue—it is an economic one.

The World Bank has repeatedly noted that untreated visual impairment leads to lower workforce participation, reduced educational attainment, and higher long-term healthcare costs.

In India, where informal labour dominates and social security nets are thin, preventable blindness can push families into intergenerational poverty. Early detection through mass screening is therefore not a cost—it is an investment in human capital.

RM: It is often said that eyes say beyond vision; it is, in fact, a health window.

DV: Absolutely. Modern ophthalmic diagnostics are revealing something remarkable.

The retina is not just an eye structure, but a window into systemic health. Retinal scans can provide early signals of diabetes progression, cardiovascular disease, and neurodegenerative disorders such as Alzheimer’s.

This transforms eye screening into a preventive health gateway, aligning seamlessly with India’s push towards predictive and preventive healthcare under national health missions.

RM: For any innovation to succeed in India, it must meet three criteria: affordability, portability, and scalability. Are these technologies designed for Indian realities?

DV: Advanced diagnostic platforms now under development use miniaturised retinal cameras, cloud-based AI analytics, and IoT connectivity for remote diagnosis and monitoring.

Such systems can operate in clinics, schools, factories, and even homes—bridging the rural-urban divide and enabling task-shifting to trained health workers rather than specialists.

Crucially, these techniques are not intended to replace ophthalmologists but to extend their reach, allowing specialists to focus on treatment rather than first-level screening.

RM: How do you see your current association, Dumfries Visionostics, contributing positively to these challenges?

DV: I am happy that organisations such as Dumfries Visionostics are contributing meaningfully to healthcare by focusing on innovative diagnostic solutions.

Their work enhances diagnostic accuracy, supports timely intervention, and raises community awareness about the importance of early detection, laying a foundation for future healthcare advancements.

RM: Thank you very much, Dr Verma, for your time and insights.