India is lobbying for a proposed treaty that would allow the visually disabled to import and use accessible books without permission from the copyright owner, according to a report by the Post’s Rama Lakshmi. That’s partly because somewhere between one-quarter and one-half of the world’s blind live in India.

 So why are there so many blind Indians?

Visually impaired children participate in a performance depicting the birth of Jesus Christ during Christmas celebrations at Devnar School for the Blind in Hyderabad, India on Dec. 21, 2011. (Mahesh Kumar A/AP)

 It isn’t just India: About 90 percent of the world's visually impaired live in developing countries, and the reason appears to be an extreme dearth of eye doctors.

While India needs about 115,000 optometrists, it has only about 40,000, largely because of regulation issues and a lack of training programs.

Most of the world’s blindness results from uncorrected refractive errors, such as nearsightedness and farsightedness, and in developing countries another common culprit is cataracts, which cloud the lens of the eye.

Because eye screenings and surgeries play such a key role in preventing blindness, many middle-income countries have been working to expand their eye-care services in recent years.

“Over the last decade, Brazil has been providing eye care services through the national social security system. Since 2009, China has invested over 100 million dollars in cataract surgeries. Since 1995 India has made available funds for eye care service provision for the poorest at district level,” the World Health Organization writes.

Still, the shortage of eye doctors persists, especially in rural areas. A recent study found that rural Indians were at a higher risk of being blind than urban dwellers were.

Because there are so few optometrists, India’s ophthalmologists attempt to keep up with both eye surgeries and eye screenings, with poor results.

"For India, it is vital that ophthalmologists focus on surgeries and optometrists take charge of primary eye care refractive errors,” Ajeet Bhardwaj, a former president of the Asia Pacific Optometrists Organization, told the Times of India. “This is how most developed countries managed to control and eliminate avoidable blindness.”

Some of the country’s entrepreneurs are now attempting to circumvent the doctor issue by creating remote medicine tools.

A Bangalore company called Forus Health invented ‘a single, portable, intelligent, noninvasive, eye pre-screening device’ that can identify major eye problems, the New York Times reported. It can be run by a trained technician, who connects the patients to a doctor by telemedicine.

In addition to — and perhaps because of — the country’s meager eye care workforce, many Indians are also not well-informed about eye health, according to a recent survey by Bausch + Lomb, which was based on 1,000 interviews. One in 10 people in India has never had an eye exam, and the country’s citizens were the most likely among all 11 nationalities surveyed to never have had a screening.

“Many Indians are unaware of common contributors to poor eye health,” the authors wrote. “Indian respondents were surprised to learn that common lifestyle and behavioral factors, such as obesity, dry air and smoking, can contribute to poor eye health.”

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