From one room, ophthalmologist builds eye hospital network

Vikas Mahatme

Like many ophthalmologists in India, Vikas Mahatme, MBBS, MS, started his practice humbly, with little money but a strong desire to help others. What began as his one-room, one-man operation in 1986 evolved into one of the most extensive charitable ophthalmic hospitals in the country, the Mahatme Eye Bank and Eye Hospital, in Nagpur.

In January, Dr. Mahatme was awarded the Padma Shri, one of India’s highest honors, for his ongoing commitment to serving those in need.

“Getting awards like Padma Shri comes for the good social work that we have been doing for the community, and good work is not possible without a devoted, likeminded, spirited team,” Dr. Mahatme told Ocular Surgery News. “I am extremely fortunate to have a team like this.”

That team works in one of the most active eye hospital networks in the central India region, with facilities and blindness control programs in Mumbai, Amravati, Yavatmal, Gondia and Mandla, as well as Nagpur. As medical director and chief eye surgeon, Dr. Mahatme leads a team of 12 ophthalmologists in Nagpur and three in Mumbai.

Dr. Mahatme is proud of the fact that his hospitals can offer many of its services free of charge. At the Nagpur hospital, more than 40% of patients receive state-of-the-art care for free; last year, the number of free eye surgeries totaled 5,400.

“I wish to offer the best possible treatment to all my patients, irrespective of their financial affordability. I feel that for the want of money, not a single patient of treatable blindness should be refused,” Dr. Mahatme said.

Expertise and innovation

Dr. Mahatme received his medical degree in ophthalmology from Nagpur University in 1983. He lectured at the Government Medical College in Nagpur until 1985, then founded the Mahatme Eye Hospital in 1986. He is a member of many ophthalmological societies, including the All India Ophthalmological Society, the American Academy of Ophthalmology, the Academy of Medical Sciences and the National Society for Prevention of Blindness.

As a faculty surgeon, Dr. Mahatme has conducted innumerable phaco and skill-transfer workshops, and he has performed live surgical demonstrations in India and abroad. He has performed more than 70,000 cataract surgeries and 35,000 phaco cataract surgeries, and he has compiled his techniques into a book, Step by Step Phaco Tips & Tricks, published in 2005. He developed the “woodcutter’s nucleus cracking” phacoemulsification technique, in which a phaco tip is used instead of a chopper to divide the nucleus. The technique works especially well on hard nuclei and is gaining popularity in India and abroad, he said.

Other contributions to the field include a filtration-enhancing knot used in trabeculectomy, as well as developing pigment for cosmetic corneal tattooing. Dr. Mahatme also received the Colonel Rangachari Award and Gold Medal for his research on rectal mucous membrane graft for dry eye.

“Nowadays I prefer to motivate and guide other team members to carry out research,” he said. “We want to do more research in community ophthalmology, especially regarding assessing knowledge, attitude and practice related to visual problems.”

Postgraduate training

The Mahatme Eye Bank and Eye Hospital provides postgraduate courses and training for ophthalmologists. It is the only center in central India recognized by the International Council of Ophthalmology as an examination assessment center. The hospital offers several fellowships and hands-on programs that attract local eye physicians as well as those abroad. Dr. Mahatme said these teaching programs keep him “young and cheerful.”

“I am happy to see this institute that I started in a small single room, for the want of finance, grow into a postgraduate training center and also a surgery training center recognized by the International Council of Ophthalmology and government of India,” he said.

In addition to clinical training courses, Dr. Mahatme runs training courses for ophthalmic technicians, hospital assistants and computer technicians. He has also developed hospital management software that supports the hospital’s fully computerized network.

Eye bank

When Dr. Mahatme founded the Mahatme Eye Bank in 1987, 1 year after establishing the hospital, there was little progress being made in eye banking. Now the Mahatme Eye Bank is one of the most active eye banks in the region, providing corneas free of charge to eye surgeons nationwide. It is a member of the Eye Bank Association of India, with a close association with Orbis, and has been particularly successful in corneal retrieval and keratoplasty. Dr. Mahatme is an executive committee member representing Maharashtra in the Eye Bank Association of India.

His commitment to eye donation made him instrumental in obtaining an eye donation pledge card from India’s president, Pratibha Patil. According to Dr. Mahatme, the president made her pledge at Mahatme Eye Bank after listening to him speak about the importance of eye donation.

“She is perhaps the first president to have done so,” he said. “Now people are aware of eye donation, and society gets benefitted. This gives tremendous satisfaction.”

Community outreach

A year-round community outreach program is a hallmark of the Mahatme Eye Bank and Eye Hospital.

“Every day our vehicle goes to the remote villages or tribal areas or slums. After screening, needy patients are brought to the base hospital in Nagpur and operated free of cost,” Dr. Mahatme said. “After surgery they are brought back to their homes with 2 months of postoperative medicines and eye drops in their hand. The institute bears all the expenses of transport, stay, food, preoperative, operative and postoperative care. Over 40% patients are treated free of cost, and in last 3 years the hospital has performed 22,677 surgeries, out of which 13,465 were done totally free.”

Those who can afford surgery are required to pay for it; funds from paying patients subsidize surgery for those who cannot pay.

“This is how the program is kept viable,” Dr. Mahatme said. “The work can be enhanced if some likeminded organizations, NGOs and people come forward and join our hands.”

Dr. Mahatme also oversees blindness control programs within the hospital network. A mobile eye care unit, Van for Vision, services the Gondia region, a tribal area earmarked for cataract surgery. Van for Vision is a collaboration with Sightsavers International, Impact India and the Volkart Foundation. This mobile health care clinic is equipped with the latest technology for identifying vision impairment. Several projects have also been done in collaboration with HelpAge India.

“Community outreach programs, eye checkups, screening camps and free surgeries for needy patients have also been started at the Mumbai hospital, the Mahatme Health and Happiness Hospital,” Dr. Mahatme said.

Future of the field

Dr. Mahatme acknowledged India’s embrace of the rapid advancements in the field over the last 2 decades.

“It’s a great journey because we have been able to provide better and better services to mankind,” he said. “We are now able to reach the community and provide them with services regarding major blindness-causing diseases. We have adopted the new technology very fast. … The future is going to be more technology-oriented and equipment-oriented. Indian ophthalmologists are extremely skilled surgeons. Probably this is because we operate on many, many patients here.”

The focus now, he said, is on curable conditions, such as cataract.

“But in the future we need to create awareness regarding diabetic retinopathy, glaucoma and prevention of eye diseases. Telemedicine will be of great help in creating awareness and treating patients. For all community-oriented projects, paramedical ophthalmic technicians and others will be a great asset,” he said.

He cited awareness and prevention of eye diseases, growing equipment costs, and affordability as challenges that need to be addressed in the future. What will not change in the future, however, is his commitment to serving others.

“I have learned to enjoy every aspect of my life, especially ophthalmology, because it brings me so close to people,” Dr. Mahatme said. “I might have received much appreciation as an internationally reputed phaco surgeon, but deep within, if you ask me, I feel the joy when after surgery a patient expresses with gratitude, ‘Thank you doctor for giving me vision.’ This is one moment in my life that I wish to experience again and again.” – by Carey Cowles

• Vikas Mahatme, MBBS, MS, can be reached at Mahatme Eye Bank and Eye Hospital, 16, Central Excise Colony, Ring Road, Nagpur 440 015, Maharashtra, India; +91-937-3108028, +91-712-2234345/2222556; e-mail: manager@mahatmehospital.com, vm@mahatmehospital.com; Web site: www.mahatmehospital.com, www.mahatmehospital.org.