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Creating Access
Arch Ophthalmol. 1999 Oct;117(10):1393-9.
Low uptake of eye services in rural India: a challenge for programs of blindness prevention.
Fletcher AE, Donoghue M, Devavaram J, Thulasiraj RD, Scott S, Abdalla M, et al.
This study investigates why eye care services are underutilised in rural India despite their availability, identifying both supply-side and demand-side barriers. Its findings remain highly relevant for programme designers working to close the gap between service provision and actual uptake.
Ophthalmic Epidemiol. 2013 Oct;20(5):308-14.
Cluster randomized trial to compare spectacle delivery systems at outreach eye camps in South India.
Ramasamy D, Joseph S, Valaguru V, Mitta VP, Ravilla TD, Cotch MF.
This cluster randomised trial compares different models for delivering spectacles at outreach camps in south India, assessing their effectiveness in ensuring patients actually receive and use their prescribed correction. It provides evidence to guide programme managers on the most effective spectacle delivery strategy for outreach settings.
Bull World Health Organ. 2023 Dec 1;101(12):786-799.
The case for investment in eye health: systematic review and economic modelling analysis.
Wong B, Singh K, Everett B, O'Brien KS, Ravalli T, Khanna RC, Chase H, Frick KD.
This systematic review and economic modelling study makes a compelling financial case for investing in eye health, demonstrating substantial returns in terms of productivity and welfare gains. It provides hospital leaders and policymakers with the evidence needed to advocate for increased funding for eye care programmes.
Lancet Reg Health Southeast Asia. 2022;7:100089.
Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost-effectiveness at Scale.
Wong B, Singh K, Khanna RC, Ravilla T, Kuyyadiyil S, Sabherwal S, Sil A, Dole K, Chase H, Frick KD.
This Lancet study compares the cost-effectiveness of different case-finding strategies for cataract and refractive error at scale across India. It provides a practical evidence base for programme planners choosing between outreach models, camp approaches, and facility-based detection.
Indian J Ophthalmol. 2022 Oct;70(11):3470-3475.
The economic and social costs of visual impairment and blindness in India.
Wong B, Singh K, Khanna RK, Ravilla T, Shalinder S, Sil A, Dole K, Jain E, Chase H.
This study quantifies the economic and social burden of visual impairment and blindness in India, translating health outcomes into monetary terms relevant to policymakers and health economists. It strengthens the investment case for eye care by demonstrating its broader socioeconomic impact.
PLOS Glob Public Health. 2023 Feb 22;3(2):e0000631.
Cataract services for all: Strategies for equitable access from a global modified Delphi process.
Ramke J, Silva JC, Gichangi M, Ravilla T, Burn H, Buchan JC, Welch V, Gilbert CE, Burton MJ; Cataract Access Study Group.
This global expert consensus study identifies and prioritises strategies to improve equitable access to cataract surgical services across diverse settings. It provides a globally endorsed framework for hospitals and health systems working to remove barriers to cataract care.
BMC Ophthalmol. 2017 Jun 19;17(1):96.
Impact of systematic capacity building on cataract surgical service development in 25 hospitals.
Judson K, Courtright P, Thulasiraj RD, Khanna R, Bassett K.
This study evaluates the outcomes of a structured capacity building programme across 25 eye hospitals, measuring improvements in cataract surgical volume, quality, and sustainability. It provides evidence for the effectiveness of systematic mentorship and technical assistance in strengthening eye care delivery.
Am J Ophthalmol. 2015 Oct;160(4):619-627.e1.
Demand for Tertiary Eye Care Services in Developing Countries.
Subburaman G-BB, Hariharan L, Ravilla TD, Ravilla RD, Kempen JH.
This study analyses patterns of demand for tertiary eye care services in developing country settings, identifying the factors that drive patients to seek specialist care. It offers insights for hospitals planning referral pathways and capacity at different levels of the eye care system.
World J Surg. 2015 Jan;39(1):10-20.
Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training.
Shrime MG, Sleemi A, Ravilla TD.
This systematic review evaluates charitable surgical programmes on dimensions of effectiveness, cost, sustainability, and training impact, providing a critical assessment of their role in global eye and surgical care. It is a useful reference for hospitals and NGOs seeking evidence to guide the design of philanthropic surgical initiatives.
Ophthalmic Epidemiol. 2013 Apr;20(2):96-101.
Gender issues in a cataract surgical population in South India.
Joseph S, Ravilla T, Bassett K.
This study examines gender disparities among patients presenting for cataract surgery in south India, revealing that women are significantly under-represented despite higher prevalence of cataract blindness. It provides actionable evidence for hospitals and programme managers committed to gender-equitable care.
Int Ophthalmol. 1991 May;15(3):175-83.
The cost effectiveness of strategies to reduce barriers to cataract surgery. The Operations Research Group.
Ellwein LB, Lepkowski JM, Thulasiraj RD, Brilliant GE.
This operations research study compares the cost-effectiveness of different strategies for reducing barriers to cataract surgery uptake in south India. It is a foundational reference for programme planners, demonstrating how targeted interventions can increase surgical coverage in a cost-efficient manner.
Arch Ophthalmol. 1991 Apr;109(4):584-9.
Social determinants of cataract surgery utilization in south India. The Operations Research Group.
Brilliant GE, Lepkowski JM, Zurita B, Thulasiraj RD.
This study identifies the social, demographic, and economic factors that determine whether individuals in south India seek and receive cataract surgery. Its findings provide a socioeconomic lens for understanding surgical coverage gaps that remains highly relevant for current programme design.
Community Eye Health. 2007 Dec;20(64):66-67.
Advocacy to Improve the Delivery of Eye Care.
Thulasiraj RD.
This article outlines how advocacy can be used as a tool to improve the delivery of eye care, targeting both policymakers and community influencers. It provides practical guidance for eye hospital leaders on building external support for strengthened eye care systems.
Indian J Ophthalmol. 2012 Oct;60(5):376-9.
Advocacy for eye care.
Ravilla TD, Ramasamy D.
This article makes the case for structured advocacy as a critical component of eye care delivery, describing approaches used to influence policy, funding, and community behaviour. It is a key reference for hospital and programme leaders seeking to strengthen the enabling environment for eye health.
Community Eye Health. 2022;35(115):35-36.
Community involvement in eye care: a health systems perspective.
Yasmin S, Faal H, Ravilla T, Murthy GVS, Shamanna BR.
This article explores the role of community engagement in strengthening eye care delivery, viewed through a health systems lens. It provides practical insights for programme managers on how to embed community involvement as a structural element rather than an add-on to eye care services.
Community Eye Health. 2022;35(115):27-28.
Demand-side financing: can it help deliver eye care for all?
Shamanna BR, Murthy GVS, Ravilla T, Jones I.
This article examines demand-side financing mechanisms such as vouchers and subsidies as tools to improve access to eye care for underserved populations. It offers a policy-level analysis relevant to governments and hospitals designing financially inclusive care delivery models.
Indian J Ophthalmol. 2024 May 1;72(Suppl 3):S473-S481.
A practical model for effective eye care delivery in Southeast Asian rural communities: A proposal built based on experts' recommendations.
Liu R, Sule AA, Shannon CS, Ravilla T, et al.
This expert consensus paper proposes a contextually adapted model for delivering effective eye care to rural communities in Southeast Asia. It translates global evidence and local expertise into actionable recommendations for hospitals and health systems operating in resource-constrained rural settings.
Int Ophthalmol. 2017 Mar 2.
Is the 2015 eye care service delivery profile in Southeast Asia closer to universal eye health need!
Das T, Ackland P, Correia M, Hanutsaha P, Mahipala P, Nukella PB, Pokharel GP, Raihan A, Rao GN, Thulasiraj RD, et al.
This regional study benchmarks the eye care service delivery landscape in Southeast Asia against universal eye health targets, identifying the gaps that remain. It provides policymakers and regional planners with a clear picture of where investment and system strengthening are most urgently needed.
Middle East Afr J Ophthalmol. 2011 Apr;18(2):102-8.
How can hospital programs be strengthened to enhance achievement of vision 2020 objectives?
Ravilla T, Joseph S.
This paper reviews the strengths and weaknesses of hospital-based eye care programmes in the context of Vision 2020 targets, offering practical recommendations for improvement. It is a useful strategic reference for hospital managers assessing and redesigning their service delivery models.
Ophthalmology. 1997 Apr;104(4):571-2.
A long-term approach to eliminate cataract blindness.
Robin AL, Natchiar G, Thulasiraj RD, Venkataswamy G.
This commentary articulates a long-term strategic vision for eliminating cataract blindness through sustained, high-volume, quality service delivery rather than short-term campaigns. It provides a foundational perspective for hospital leaders committed to systemic rather than episodic approaches to blindness prevention.
Arch Ophthalmol. 1994 Jul;112(7):987-93.
Attacking the backlog of India's curable blind. The Aravind Eye Hospital model.
Natchiar GN, Robin AL, Thulasiraj RD, Venkataswamy G.
This landmark paper describes the Aravind model for rapidly scaling cataract surgical services to address India's backlog of curable blindness, combining high volume with quality and financial sustainability. It remains one of the most cited references in global eye care for its demonstration of what is achievable with the right operational model.
Community Eye Health. 2010 Dec;23(74):50-2.
Managing information in eye care programmes: the health systems perspective.
Faal H, Cook C, Thulasiraj R.
This article discusses the role of health information systems in managing eye care programmes effectively, highlighting the importance of data for planning, monitoring, and accountability. It provides practical guidance for programme managers on building information systems that support evidence-based decision-making.
Health Aff (Millwood). 2008 Aug;27(4):964-76.
Specialty care systems: a pioneering vision for global health.
Bhandari A, Dratler S, Rauke K, Thulasiraj RD.
This Health Affairs paper analyses the Aravind model as a template for specialty care delivery in global health, examining how it achieves scale, quality, and financial sustainability simultaneously. It is a seminal reference for hospital leaders and global health policymakers exploring models that can deliver specialist care at population scale.
Innovations. 2007;2(4):35-49.
Making sight affordable (innovations case narrative: the Aravind eye care system).
Rangan VK, Thulasiraj RD.
This case narrative documents the Aravind Eye Care System's innovative approach to making high-quality cataract surgery financially accessible to all, regardless of ability to pay. It provides a detailed account of the cross-subsidisation and operational efficiency strategies that underpin the model's sustainability.
Cataract Refract Surg Today. 2006;6:45-47.
Aravind Eye Care System: developing sustainable eye care.
Ravindran RD, Thulasiraj RD.
This article outlines the principles behind Aravind's approach to building a financially and operationally sustainable eye care system, applicable to any setting seeking long-term viability. It offers hospital administrators a strategic framework for balancing mission-driven care with institutional sustainability.
Ophthalmol Glaucoma. 2025 Jul 5.
Identifying Barriers and Improving Adherence to Follow-up of Childhood Glaucoma in South India.
Pillai MR, Puthuran GV, Friedman DS, Valaguru V, Rahmathullah R, Ganesh SP, Rajendran J, Mani I, Krishnadas R, Papadopoulos M.
This study identifies the specific barriers that prevent families from adhering to follow-up care for children with glaucoma and proposes targeted strategies to address them. It provides evidence-based recommendations for hospitals seeking to improve retention in care for paediatric chronic eye disease patients.
Am J Ophthalmol. 2022 May;237:259-266.
Community health workers for prevention of corneal ulcers in South India: a cluster-randomized trial.
Srinivasan M, Ravilla T, Vijayakumar V, Yesunesan D, Mani I, Whitcher JP, Oldenburg CE, O'Brien KS, Lietman TM, Keenan JD.
This cluster-randomised trial evaluates the effectiveness of training community health workers to identify and refer corneal ulcer cases in south India, testing a task-sharing model for prevention of corneal blindness. It provides robust evidence for integrating community health workers into eye care delivery as a low-cost strategy to reach remote populations.
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