The retinal disease is likely to become more common in the developing world. Treatment of retinal conditions is improving, and may be cost effective, even in a developing world eye clinic. Owing to advances in technology, equipment to treat retinal disease, although still expensive, is now much more suitable for use in a developing country. However, a significant limitation remains the shortage of skilled personnel. Ophthalmic education should prepare eye workers not only for the challenges they will face today, but also for future developments. This means that we need more developing world ophthalmologists with sub-specialty training in retinal disease who can train future generations of eye workers4.
A significant barrier was the practice of setting up a screening system without adequate treatment facilities being in place3. In our case, RECON executed skill enhancement, trained, and retrained MEDs of Nepal in capacity building. CME helped in advocacy campaign and retina forces networking. All the trainees, eye doctors, optometrists, ophthalmic assistants, ophthalmic nurses, and physicians were providing education to retina patients about the importance of retina check-up and referring them in need to our retina care centers.
The primary care physicians are often the first medical personnel for patients with diabetes. The knowledge of the attending physicians regarding diabetic retinopathy is crucial as they are the main source of referrals for these patients to ophthalmologists. Various studies around the world have been done to access the diabetic eye disease awareness among physicians. Even in resource-rich settings, many of these studies have suggested that the knowledge and awareness of physicians about diabetic retinopathy is inadequate and have recommended more robust training567.
Most Eye camp is widely practiced in all over Nepal. To add the retinal disease screening at eye camps is very useful for the prevention of retinal diseases. Retina camps were the means of eye health education, eye examinations, fundus photography to patients in our project.
The conclusion from Bhakapur retina study in Nepal highlighted the real world scenario about retinal diseases in Nepal. The high prevalence of retinal diseases, low awareness on major blinding retinal diseases in the population and high risk groups warrants the prompt attention for awareness campaigns, retinal diseases screening, using allied ophthalmic personnel and allied medical personnel using fundus cameras, proper referral network to tertiary eye hospitals,, cross referral with the physician for diseases like diabetes, and hypertension and facilities for treatment of these diseases are required for the prevention of avoidable blindness from these major retinal disorders8.
In our retina camps, apart from direct beneficiaries who got free consultation in retina camps, there were many indirect beneficiaries in the community. Awareness of diabetic and hypertensive retinopathy and other retinal diseases were the main aims of retina camp. This is a good step of advocacy for early detection and prompt treatment to prevent retina related visual blindness in Nepal.
The comprehensive campaigns are necessary to promote increased awareness in a community by involving people from various walks of life in collaboration with community eye centers and eye hospitals. Improving awareness will help in early detection of diseases and reduction in visual impairment and blindness9.