AIIMS Survey Finds Private Sector Dominates India's Eye Care; Only 15% Centres Government-Run

India's eye-care system is overwhelmingly dependent on private players, with just 15 per cent of eye centres run by the government and over 70 per cent operated by private institutions, according to a first-of-its-kind national survey led by the All India Institute of Medical Sciences (AIIMS), New Delhi.

The study warns that this dominance of private ownership has left large sections of the population without access to affordable or comprehensive eye care.

The Human Resources and Infrastructure for Ophthalmic Services in India survey, conducted in 2020-21 under Dr Praveen Vashist, Professor and Head of Community Ophthalmology at AIIMS, was carried out in collaboration with the Union Health Ministry, the All India Ophthalmological Society (AIOS) and Vision 2020 India. Published in the Indian Journal of Ophthalmology in November 2025, the study covered nearly 9,000 eye-care institutions, creating the most extensive national database on ophthalmic infrastructure and workforce to date.

Private Players Focus on Profitable Procedures

The survey found that 70.6 per cent of India's eye-care institutions are privately run, 15.6 per cent are government-managed, and 13.8 per cent are operated by non-governmental organisations (NGOs).

"Nearly 60 per cent of cataract surgeries and about 90 per cent of refractive-error corrections are carried out by private centres, while government hospitals handle only 40 per cent and 10 per cent respectively," the study notes. Researchers observed that private facilities largely prioritise profitable services such as refractive surgeries and vision correction, while charitable or public-oriented services like eye banking are concentrated in the government sector.

Only 5.7 per cent of all centres reported having eye banks, and less than one-third (28.3 per cent) provided low-vision rehabilitation services. Only 40.5 per cent of institutes offer 24-hour emergency eye services, and though 87 per cent have functional operation theatres, essential facilities remain unevenly distributed.

Refractive surgery was available at just 20.9 per cent of institutions. The most offered subspecialties were cataract (91.5 per cent), glaucoma (71.5 per cent), squint (42 per cent), oculoplasty (37.3 per cent) and vitreo-retina (33.6 per cent). More advanced procedures such as neuro-ophthalmology (25.4 per cent) and keratoplasty (14.4 per cent) were confined mainly to tertiary hospitals.

Acute Shortage of Specialists and Uneven Distribution

India has 20,944 ophthalmologists, roughly one for every 65,000 people, and 17,856 optometrists or ophthalmic technicians, both far below global standards and national targets. On average, the country has 15 ophthalmologists and 74 eye beds per million population. At secondary-level eye-care centres and above, there are just three ophthalmologists and two optometrists per institution.

Dr Vivek Gupta, Additional Professor of Community Ophthalmology at AIIMS, said that the disparity is not just numerical but in regional distribution. "Eye care remains heavily concentrated in a few regions, leaving millions underserved," he said. In Leh-Ladakh, there are only two ophthalmologists per million people, compared with 94 in Chandigarh. Delhi has one ophthalmologist for every 18,000 residents, while Pondicherry has one for every 8,000. "Every district hospital should have at least one ophthalmologist," he emphasised.

Regional disparities are stark. Puducherry reported the highest density of eye specialists at 127 ophthalmologists per million population, while Ladakh had only two. Delhi, Maharashtra, Goa, and Tamil Nadu meet or exceed the recommended strength of eye-care professionals, whereas Uttar Pradesh, Bihar, Madhya Pradesh, Assam, and West Bengal face severe shortages. Uttar Pradesh alone requires an additional 2,464 ophthalmologists to meet demand.

Even Delhi, Dr. Gupta said, needs stronger infrastructure at the primary level. "Most government dispensaries have medical officers but no ophthalmic technicians. Ideally every dispensary should have one."

The RP Centre at AIIMS currently runs 27 primary eye-care or 'vision centres'-25 of them across Delhi. Officials said there are plans to expand the network to 250 centres. A meeting held on Saturday with state and district programme officers discussed scaling up primary eye-care coverage and introducing the World Health Organization's Refractive Error Situation Analysis Tool (RESAT) across Indian states. "Tests are underway in Delhi to strengthen local eye-care programmes," Dr. Gupta said.

Heavy Burden of Vision Impairment

The findings come against the backdrop of an enormous burden of vision impairment in India. The National Blindness Survey of India (2015-19) estimated that the country has five million blind and 34 million visually impaired individuals. The Longitudinal Ageing Study of India further revealed that 33.8 per cent of adults aged 45 years and above suffer from distance vision impairment or blindness.

India urgently needs more trained eye specialists to detect and treat children's vision problems early, said Dr Rohit Saxena, Professor and In-charge of Paediatric Ophthalmology at the RP Centre, AIIMS.

The report, submitted to the Centre, has called for greater investment in public eye health. "India has made huge progress in cataract surgery," Dr Saxena said. "But to achieve universal eye care, we need to strengthen the public system and expand primary-vision centres so that quality care reaches everyone, not just those who can afford it."

He said that while tertiary-level eye care in India is well established, the situation at the primary and secondary levels remains weak. "We lack trained ophthalmologists, proper equipment, anaesthesia support and expertise to treat children," Dr Saxena noted.

At the national level, only about 25 per cent of hospitals provide paediatric eye-care services, most of them privately run, and just six per cent of ophthalmologists are trained in paediatric care.

Dr Saxena also warned that delayed detection of conditions like myopia and refractive errors reduces the chances of successful treatment. "Early screening at the primary level is essential," he said.

Call for Urgent Reforms

The researchers of the AIIMS-led survey highlighted that financially lucrative services such as refractive surgeries are being prioritised by the private sector, while charitable services like eye banking are primarily in the public domain. They urged immediate policy attention to expand training, infrastructure, and equitable access. They emphasized that India must increase its ophthalmologist and optometrist base substantially to achieve universal eye health coverage.

"We must build capacity at the primary level so that vision problems, especially in children, are detected early," Dr. Gupta said. He also stressed the need for updated data on eye-care infrastructure, noting that the last comprehensive study was done five years ago.

Public-private partnerships, such as those under the Ayushman Bharat scheme-which offers over 40 eye-care packages-are, he said, "critical in improving access and moving towards universal eye health."

The survey led by AIIMS has also contributed to the creation of a dedicated page on the India Vision Atlas, a public web portal linking the national eye-care database with an interactive map. "It allows patients, planners and policymakers to check the availability of eye-care facilities and workforce in any state or district and locate nearby institutions offering specific services," Dr. Gupta said.