COVID-19 pandemic learning: An opportunity for planning for the management of uncorrected refractive errors in rural India?

Abstract

Background: COVID-19 pandemic posed challenges to carrying out primary eye care services which
demanded modification to continue serving these underserved rural populations. Objectives: To understand
challenges and opportunities for management of uncorrected refractive errors in rural Maharashtra postunlock
period.
Methods:
Retrospective
analysis
of
data
for
an
ongoing
refractive
errors
management
program

in
rural
Maharashtra
from
January
to
March
2020
and
2021
of
the
same
period
was
compared.
The
service

delivery
model
pre-COVID-19
included
vision
screening,
IOP
measurement,
and
torchlight
evaluation
before

referring

for a comprehensive eye exam. Post unlocks, the protocol was altered by additionally dispensing
ready readers on the spot and referral was for prescription refractive error and ocular morbidity. Results:
Door-to-door screening showed 9% (p = 0.0003) increase in the number of people reached with the COVID19
safety
protocol.
177
more
people
were
reached
with
10
%
lesser
households
in
the
post-unlock
period.
18%

increase
in
members
screened
per
household
was
observed.
The
mean
age
of
presentation
during
the
door-todoor
screening
was
(41.27±17.17)
years
pre-COVID-19
and
39.66
±
16.94)
years]
post-unlock.
The
number

of

cataracts referred, pre-COVID-19 and post-unlock was 451 and 374 respectively. More male members
were available for door-to-door screening (1: 1.7 before lockdown and 1:1.3 post-unlock). Conclusion: Due
to reverse migration, younger people were more available in rural households post-unlock. The learning’s can
help in planning for primary eye care activities if the period of reverse migration can be mapped in advance.