P2B148: Establishment of the First Ever Pediatric Eye-clinic in the Indian State of Tripura with American Academy of Pediatrics Grant Funding. a Program Evaluation

Background: The northeastern state of Tripura has an area of 6500 square miles and a population of 3.6 million, out of which 74% live in rural areas. Lack of funding for infrastructure, remoteness of the areas, and acute shortage of ophthalmologists are reasons behind scarce eye care facilities in the state. At the time of writing this article Tripura had a total of 24 ophthalmologists catering to the needs of 3.6 million residents without any dedicated Eye clinic for children. Vision problems in children need to be addressed in a timely manner to avoid limitations of communication, play, reading, and learning, and ultimately their long-term neurodevelopmental outcomes. Through funding provided by the American Academy of Pediatrics (AAP) - International Community Access to Child Health (ICATCH) program, this project was initiated as the first eye clinic exclusively for children in the state of Tripura.

Methods: This is a descriptive program evaluation of a new pediatric eye clinic in the setting of a semi-urban hospital affiliated with a medical school in the suburbs of the capital of the state, Agartala. The clinic was inaugurated on 12th November 2021. The children are evaluated in the clinic for free. Patients are not charged for testing or for eyeglasses for correction of refractive errors if needed. The team conducted two health camps in renowned High-schools which involved evaluating children and providing necessary medications/eyeglasses for free. Three workshops were conducted in this period to raise awareness about common pediatric eye diseases with special emphasis on the timing of referral to the ophthalmologist, attended by community health workers, medical students, nurses, and optometrists from different parts of the state.

Results: Since its inception, 747 children visited the eye clinic with an average visitation of 47 patients per month. The median age of the patients was 1 year (Range: 1 month to 17 years). Conjunctivitis was the most common diagnosis made in the clinic (48%) followed by refractive error (10.6%) while Nasolacrimal duct blockage and blunt trauma, both at 6.8%, were the third most common diagnoses (Table 1). Allergic conjunctivitis was the most common form of conjunctivitis (59.3%). Free medications were provided to 618 children (84.8%) while free refractive correction eyeglasses were provided to 81 (10.8%) children who needed them. In the two school eye checkup camps conducted so far by the group, 293 children were evaluated, and 47 prescription eyeglasses were provided free of cost to the children. In the three workshops, 36, 60 and 48 participants respectively, took part in the proceedings.

Conclusion: A dedicated pediatric eye clinic was successfully established in Tripura, India with AAP ICATCH grant funding making an impact on the health of the children in the community.