Making Sight Affordable ( Innovations Case Narrative: The Aravind Eye Care System )

Abstract

About 40 million people in the world are blind. The prevalence of blindness in most industrialized countries of Europe and North America varies between 0.15% and 0.25%, compared with blindness rates of nearly 1.5% for the developing coun-tries in Africa, Asia and Latin America. While age-related macular degeneration, diabetic retinopathy, and glaucoma are the dominant causes in developed coun-tries, cataracts are the major cause of blindness in the developing countries, accounting for nearly 75% of all cases in Asia. A cataract forms as the natural lens of the eye clouds over time, and has to be surgically removed and replaced by an artificial one. The causes of cataracts are many, but lack of proper nutrition and the effects of tropical weather are certainly two of the more significant. In 2006, an estimated 20 million people were blind from cataracts worldwide, more than 80% of them in developing countries. In 2006, India had nearly 7 million cataract-blind individuals, with roughly 3.8 million new cases occurring annually. 1 With a population of over a billion, and a per-capita income of about $600/year (PPP $3,600), nearly 25% of Indians were considered to be below the poverty line, but much larger numbers (approximately 50%) were at income levels that would place treatment at private eye clinics beyond their reach. In theory, anyone who is unable to afford payment is eligible for free surgery at government-run district hospitals but in practice, a vast num-ber of poor people prefer to pay a small fee to get better quality care at an NGO. A case narrative describing Aurolab, a subsidiary of Aravind, was published in volume 1, number 3, of Innovations with the title " Making Sight Affordable (Part I). " The Schwab Foundation for Social Entrepreneurship has recognized R.D. Thulasiraj and the late Dr. Govindappa Venkataswamy as Outstanding Social Entrepreneurs.