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A text book on Optics and Refraction
The Training in Ophthalmic Assisting Series and Training in Eye Care Support
Services Series were born from the vision and inspiration of one very special man,
Dr. G. Venkataswamy, founder of Aravind Eye Hospitals and guiding light in the
world of eye care and community ophthalmology.
We dedicate this effort to him.
Intelligence and capability are not enough. There must also be the joy of doing
something beautiful. Being of service to God and humanity means going well
beyond the sophistication of the best technology, to the humble demonstration of
courtesy and compassion to each patient.
- Dr. G. Venkataswamy
Ophthalmic Assistant Training SSeries
eries (OATS)
Published by
Aravind Eye Hospitals
& Postgraduate Institute of
Ophthalmology
Madurai - 625 020,
Tamilnadu, India
Phone: (0452) 4356100;
Fax: 91-452-2530984
www.aravind.org
Aravind Eye Care System
First draft
September 2007
Aravind Eye Care System provides this material for educational and
illustrative purposes only. It is not intended to represent the only or best
method or procedure in every case, or to replace the judgment of local
professionals. It is the responsibility of the physician, nurse, manager or
other professional to determine applicable federal status of each material
or process he or she wishes to use, and to use them in compliance with
applicable law(s).
Aravind Eye Care System had made best efforts to provide accurate
information at the time of printing. Aravind Eye Care System, the series
editors, contributors and publisher disclaim all responsibility and liability
for any and all adverse medical or legal effects, including personal, bodily,
property, or business injury, and for damages or loss of any kind
whatsoever, resulting directly or indirectly, whether from negligence or
otherwise, from the use of the recommendations or other information
in this series of modules, from any undetected printing errors or
recommendation errors, from textual misunderstandings by the reader,
or in the light of future discoveries in this field.
Reference to certain drugs, instruments, and other products in this
publication is made for illustrative purposes only and is not intended to
constitute an endorsement.
Aravind Eye Care System solely owns the copyright for the Ophthalmic
Assistant Training Series and does not encourage photocopying or any
other duplication of the manuals.
All photographs and illustrations in this
manual are the efforts of the Aravind
Publications team
This series of modules can be improved with your help. If you have
ideas or suggestions for ways the OATS could better meet your needs,
please write to Aravind Communications, C/O Aravind Eye Hospitals
or email to [email protected] We welcome your comments
and experiences.
Foreword
The discipline of eye care requires a number of appropriately trained personnel working as a team
to deliver comprehensive eye care. The services that are delivered must include the promotion of
eye health, the preservation of sight and the prevention of vision loss, restoration of sight when it
is lost, the enhancement of vision and functional vision, where feasible and facilitation of
rehabilitation through vision substitution. Various cadres of trained personnel, with complementary
skills contribute to the work of the team.
In an ideal world, with infinite resources there would be a temptation to use the most highly
trained personnel to carry out these tasks. This is neither appropriate nor cost effective, given that
human resources for health care comprise the most expensive component of the recurring health
budget.
It has been possible to select, train and deploy different cadres of human resources, to carry
out tasks in a safe and effective manner to help achieve the goal of eliminating avoidable blindness.
One of such cadres is variously referred to as Ophthalmic Assistants, mid level personnel or by
their primary functions, such as Nurses, Refractionists etc. Where they exist and function in a
stipulated manner, it is acknowledged that they constitute an effective backbone for eye care
services. However a critical element to their success lies in the adequacy and appropriateness of
the training imparted to them.
There have been several training programmes put in place around the world to train such
mid-level personnel depending on the one hand, on the human resource needs for eye care in the
country, and the local human resource policies, rules and regulations, on the other.
The Aravind Eye Care System, over the years has developed a cadre of Ophthalmic Assistants
who have specific job descriptions. To enable them to perform effectively as part of the eye care
team, their training has been task oriented with defined requisite knowledge, skills, competencies
and attitudes, to carry out the tasks.
This manual sets out in several sections a step by step method for imparting such task oriented
training through didactic, hands on and practical training in real life situations. The sections
relate to tasks required of such personnel in different settings in the eye care delivery system such
as the out-patient department (general and specialist clinics), wards, operating rooms, optical
departments etc. Considerable emphasis has been paid to diagnostic technology, which is
increasingly a part of the armamentarium in eye care practice.
Finally the manuals include sections for self assessment as well as for continuing monitoring of the
achievements of task oriented objectives. The manual lends itself to translation into local languages
where required proficiency in English may not exist. The Human resource Development team at
Aravind Eye Care System need to be complimented on their efforts to share there wide and
successful experience in this field with others who are already involved in or are planning to
venture into such training programmes, particularly in the context of VISION 2020: the Right
to Sight.
Dr
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ar
ar
ajasegar