Address at the a Golden Jubilee Celebrations of the Indian Journal of Opthalmology

Importance of Scientific Journalism

I am delighted to participate in the Golden Jubilee celebrations of the Indian Journal of Ophthalmology. I greet the organizers, ophthalmologists, distinguished medical practitioners, medical technologists, and medical editors on this occasion. There is an urgent need to improve the quality of technical journalism in the country. In this respect, the Indian Journal of Ophthalmology has done an excellent job and has become an important component of all the ophthalmologists. Survival and growth of a scientific and technical journal depends on how the journal conducts review before publication? How national or international authors perceive the quality of the journal for presenting there articles? How the journal becomes a forum for discussion on important technical issues and the incentives provided by the journal for attracting quality papers. I have selected the topic 'Importance of Scientific Journalism'.

Healthcare Technology Vision

You may be aware, a Healthcare Technology vision document was evolved as part of Technology Vision 2020, a few years back. Prof M. S. Valiathan led the team in evolving the Healthcare vision document. A number of experts in the area of ophthalmology were involved in the task teams. Many important issues were brought in the document. It is said that in India, minimum 20 million people in a billion population are visually handicapped, while 25 million people are partially visually handicapped. The population growth coupled with increase in life expectancy will only lead to increase in the number of blind and visually handicapped. 80% of the cause of blindness is due to cataract. The other causes have been identified as cornea, glaucoma, diabetes and other vitreo retinal disorders and vitamin-A deficiency etc. The expert team had identified preventive technologies, diagnostic technologies and curative corrective technologies. One of the major recommendations is to develop eye lasers with slit lamps for post glaucoma and cataract patients treatment and large-scale production of cost effective Vitamin-A tablets. Recently, laser treatment for diabetic retinopathy to arrest eye bleeding has been added. Above all, education and management system for eye care and also creating a human feeling to increase large number of eligible eye donors has been recommended.

A national mission for fast track treatment method has to be evolved involving mission-oriented doctors throughout the country. This team should organize series of eye camps, reinforcing many eye hospitals with technology to increase the treated population. In doing so, integration of minds is possible and governmental support can be made easier. India already has a national programme for control of blindness and also Vision 2020 : The Right to Sight initiative (Global). Throughout the country and also around the world, each and everyone is sympathetic to the visually handicapped who need vision and prevention of blindness. This service oriented attitude towards visually handicapped can bring together a number of partners in the national mission.

Need for indigenous medical devices & systems

You are aware that approximately twenty six percent of our population is still below the poverty line and medical care has to be provided to a large population. I was discussing this problem with some of my doctor friends and those connected with health care. I realized that the major problem in Indian health care delivery system including the area of ophthalmology is the near total dependency in medical imports of diagnostic and therapeutic equipment and devices including consumables. Every year, about Rs 3000 crores plus worth of medical devices and equipment are being imported. While the common man seldom buys anything imported, he is made to purchase or pay partly for the cost of the imported gadgets for healthcare. This clearly brings out that, we need to create an infrastructure capable to produce our own medical devices, consumables and equipment, based on the technology available and to be developed within the country, at affordable cost.

Basic research need to focus in the areas of - molecular genetics of inherited eye diseases, microbiology of eye infections, biochemical features of cataract, and stem cell technology for reconstruction of the damaged ocular outer surface. Our clinical research need to study the suitability of drugs and lenses, as also prospective and retrospective research on problems seen in the clinic. The Stem Cell technology is at the cutting edge, practised by no more than three or four centres across the globe. It involves the harvesting of stem cells from the limbus of the eye and explant - culturing them such that the resultant material can be used to reconstruct the damaged outer surface of the eye, thus enabling it to better accept a corneal graft. The L.V. Prasad Eye Institute, has succeeded in translating this technology from the Petri dish to the patient's eye. Such advanced technologies need to be effectively deployed to provide critical eye care to the majority of the population.

Stem Cell: For Restoration of Vision

The recent identification and characterization of progenitors with stem cell properties has opened new avenues that may be useful for treating functional impairments caused by the death of specific cell population. Stromal and neuronal degeneration are the causes of deblitating visual impairment associated with many ocular diseases, such as degenerative diseases of cornea, retinitis pigmentosa (RP), age- related macular degeneration (AMD) and glaucoma. The stem cells may help restore vision in patient who have these diseases, by repopulating or rescuing the damaged ocular surface cells or retinal cells from further degeneration.

The stem cell team of LV Prasad Eye Institute has administered stem cells in the affected region of the eye for over 125 patients and all of them are performing very well. Apart from India these patients have come from Bangladesh and Nepal. The research in these frontier areas are facilitated by quality research publications. Indian Journal of Ophthalmology is providing notable service in this direction for the last 5 decades.

Role of medical journalism

I have gone through a few issues of Indian journal of Ophthalmology and found that the articles are interesting, educative and has been written based on intensive research. One of articles on progression of Ocular hypertension to primary open angle glaucoma is based a population study. The interesting feature is that the study has been carried out worldwide reporting and estimated 68.8 million people are getting affected by Glaucoma and 7 million bilaterally visually handicapped due to the disease, the extrapolating data from the rest of Asia an estimated 8 million Indians have Glaucoma with the 1:1 ration of primary open angle Glaucoma to primary angle closure Glaucoma. The reported prevalence of Ocular hypertension in population studies worldwide varies from 11 to 13 percent. This type of study is useful not only to the Indian community but can be applied for extrapolation in any part of the world.

I also read some interesting article on gene therapy in medicine, ophthalmic complications and management of Stevens-Johnson syndrome at tertiary eye care center. These articles indicate the urge for scientist to report their findings to the medical community through this journal.

Medical journalism is a vital instrument for disseminating important medical experiences and research results for promoting improved healthcare and medical research. Indian journal of ophthalmology under the Editorship of noted doctors has performed this function effectively over the last 5 decades. The current readership of the journal is over 10,000 and has both national and international readers. The scientific excellence and the efficacy of the review process is brought out by the fact that the average waiting time for publication of an article is four months and the acceptance rate is 37%. Also the Indian Journal of Ophthalmology is the only Peer Reviewed and Indexed Ophthalmology Journal from India. The Indian Journal of Ophthalmology can consider making it as an open access journal which will create more number of subscribers. The journal of ophthalmology can report every quarter, the reduction in visually handicapped population in the country and the world to track the efficacy of the programme of "Global Vision 2020".

Conclusion

We have the best of doctors and technologists in India. We have core competence in design and software engineering. Emerging technologies in virtual reality and micro machines will transform the healthcare scenario. This transformation should lead to helping the people who cannot afford the modern medical care. To improve the availability of eye care facility to the rural masses, I recommend provision of mobile eye clinics by all the eye care centres. Also I find major eye care centres are available only in southern part of India. L.V. Prasad Eye Institute, Sankara Nethralaya and Arvind Eye Hospital and other reputed eye care institutions should create eye care facility in rest of the country to cover the length and breadth of the nation.

I am sure that the partnership of ophthalmologists, vision scientists and science editors will lead to high quality research in ophthalmology enabling India to succeed in the mission of "Vision for All".

May God Bless you.