‘India is in a premier position to offer eye treatment to foreign patients’

Medical director of Aditya Jyot Eye Hospital, Dr S Natarajan is a vitreoretinal surgeon with over 20 years of experience in the field of ophthalmology. He is the chairman, scientific committee, All India Ophthalmological Society (AIOS), president of National Society for the Prevention of Blindness and the chairman of Maharashtra Opthalmological Society (MOS). He is the first Indian to be awarded twice by the Vitreous Society, US, like the Honour Award and the Senior Honour Award. In an interview with Shardul Nautiyal, Dr Natarajan discusses how the specialty of ophthalmology has grown with the advent of advanced techniques and the evolution of India as a healthcare hub for treatment of eye.

Please comment on the current eye care scenario of India.

With 10,000 eye doctors in India, the status of eye care and surgery in India is impressive. We have well-qualified doctors and well-equipped eye care centres in smaller towns and metropolitan cities of the country to offer minor to highly specialised eye care treatment.

Indian patients need not to go outside for any kind of eye treatment. With the adoption of newer and advanced techniques in eye surgery, India is in a premier position to also offer eye surgery and treatment to patients coming from foreign countries.

Is low cost of treatment the only reason for overseas patients coming to India?

Cost-effectiveness and quality are the two driving factors behind the flow of foreign patients to the eye care centres in India. We have state-of-the- art equipment for screening and treatment of eyes at some of the best centres in India like Sankar Nethralaya, Chennai, Dr Aggrawal Hospital, Chennai, All India Institute of Medical Sciences (AIIMS), New Delhi, Aravind Eye Hospital, Madurai, LV Prasad Eye Institute, Hyderabad, Aditya Jyot Eye Hospital, Mumbai, among others.

The treatment offered to the foreign patients is on par with international standards and made possible with the use of state-of-the-art equipment and drugs. We have adopted financially viable business models for our eye care centres in India to make eye care affordable to the common man.

Can you elaborate on the business model and costs associated with eye treatments in AJEH?

We have a separate charitable wing of AJEH at Dadar to offer eye treatment to the poor and state of the art eye care and treatment centre at Wadala to offer preventive and total eye care treatment.

About cost of treatment, Photodynamic therapy for the treatment of Age Related Macular Degeneration (AMD) costs Rs 25,000 to the patient and Rs 75,000 is the cost of the dye required in the treatment, normal LASIK costs around Rs 27,000 and customised Lasik costs around Rs 40,000, with the help of a machine called as Aberrometer, which gives super vision. Eye treatments by simple laser can be done at a cost of Rs 750 to Rs 2,000 per sitting.

Which treatments attract the maximum chunk of patients?

The patient inflow is more for the treatment of diabetic retinopathy. In India, with the epidemic increase in diabetes mellitus (affecting approximately 32 million), diabetic retinopathy is a cause of great concern. Visual disability from diabetes represents a significant public health problem, as one in four diabetic subjects develop retinopathy.

AJEH registers two foreign patients weekly from developed countries like the UK and the US and developing countries like Tanzania, East Africa, Mauritius and Sri Lanka. The waiting list of patients in National Health Services of the UK makes India an ideal eye care destination.

AJEH has taken up the membership of the Federation of Indian Chambers of Commerce and Industry and Medical Tourism Council of Maharashtra (FICCI-MCTM) tie-up to give a fillip to medical tourism.

What are the latest therapeutic and diagnostic advancements in eye care?

The advanced technique, which India is spearheading is photodynamic therapy, which though practiced in very few centres in the country is popular in almost all the metropolitan cities of the country. The technique is meant to offer treatment for Age Related Macular Degeneration (AMD), a disorder in which the vision starts to deteriorate with age.

A machine called as preferential hyperacuity perimetery(PHP) helps in the early detection of the complication of macular degeneration or AMD.

This is a breakthrough for visually impaired elder people for testing Age - Related Macular Degeneration (AMD). In the elderly people, with age, their vision starts to deteriorate until the person has complete loss of vision. This machine, non-invasively, checks the eye for this degeneration and then advises the doctor on treatment to correct the problem. Introduced by AJEH for the first time in Asia, this machine comprehensively diagnoses all eye and retina problems.

What are the other advanced investigative and therapeutic techniques?

Optical Coherence Tomography (OCT) is one of the high resolution, non-invasive imaging techniques used for obtaining the thickness and profile of different parts of the retina. It is useful in diagnosing glaucoma and a variety of retinal diseases including diabetic macular oedema, age-related macular degeneration (AMD), epiretinal membranes and retinal inflammatory diseases.

Other technique used in the diagnosis of diabetic retinoathy is the fundus fluorescein angiography(FFA). FFA can also be used to track the progression of disease or efficacy of laser therapy. OCT is useful to patients, where FFA may not be possible.

What are the various programmes and initiatives of the government regarding eye care?

Diabetic retinopathy is a major concern for the Indian population, with projections that out of 60 million diabetics, 25 million will be afflicted with diabetic retinopathy by the year 2020. World Health Organisation (WHO) have jointly launched a programme called as “Right to Sight” in collaboration with the National Society for Prevention of Blindness. The programme addressing child blindness to geriatric blindness will cover screening and treatment of eye diseases. The Government of India is a partner to this, with Andhra Pradesh, Tamil Nadu and Maharashtra being the front runners.

Some advancement have also been made in the field of advanced microscopes for wide angle observation vitreous surgery and cataract surgery, which are in practice for the past 15 years. Endoscopy also called as retina surgery, but applicable for a very few complications, is also a promising area. Endoscopy is currently practised in very few centres globally like America, Japan, Germany and France.

How do you manage the huge load of patients coming from outside Mumbai?

AJEH has a satellite clinic at Juhu, running successfully ever since its inception in the year 2003. The idea of satellite clinics was evolved due to the ever increasing number of patients suffering from eye ailments, who find it inconvenient to commute over long distances to reach AJEH in Dadar. We are also running a completely equipped 16 bed charity hospital in Dadar under the AJEH name, catering to the underprivileged.