Developing pediatric eye care program in Nepal: Insurmountable Mountains can be reduced to mole hills. The Orbis experience in Nepal.

Abstract Background: Nepal straddles the Himalayas mountains and its geography has posed a challenge to delivering eye care in children. This manuscript describes the pediatric eye care facilities developed, and children examined and treated under the Orbis International’s childhood blindness initiative. Methods: Between 2010-2017 Orbis International had supported the Nepal Netra Jyoti Sangh (NNJS) and Tilganga Institute of Ophthalmology (TIO) to develop pediatric eye care centers in major hospitals, along with their outreach. This manuscript looks at the impact of that intervention. Reports of Nepal Netra Jyoti Sangh, Tilganga Institute of Ophthalmology and Orbis International were studied, along with publications on ophthalmology from Nepal. Eight child friendly pediatric eye care centers were set-up in eight hospitals and their pediatric eye care teams were trained under this project. An outreach program was designed especially for children’s eye problems in the form of health promotion and screening. The project monitored outcomes and promoted research. Results: Between the years 2010–17, a total of 1,281,153 children had been examined in eight pediatric eye centres (an average of 20,018 per centre per year, range 10,729 –39,485) and the average outpatient per month per centre was 1668 (range 894 - 3,290). Between the years 2010 – 2017, a total of 42,430 children had been operated upon in eight hospitals (an average of 663 children per hospital per year, range from 96 – 1,465) and the average pediatric eye surgery per month per hospital was 55 (ranged from 8 to 122). In the years 2018 & 2019 (21 months) post-project, all the 8 hospitals had operated on 14,252 children (average of 1,782 per hospital, range 185 - 4438) and the average pediatric eye surgery per month per hospital was 85 (range 9 to 211). Nineteen publications on pediatric eye care were published in indexed journals. Conclusion: Orbis childhood blindness amelioration initiative in Nepal resulted in more than a million children examined, and >50,000 children underwent eye surgeries in the 8 pediatric eye care centres and the good service continued after the project was over.