Elevating Vitreo-retinal Care in India: Through educational initiatives, VRSI strives to prevent avoidable blindness

As one of the largest retina societies worldwide, the Vitreo-Retina Society of India (VRSI) has rightly earned its reputation as a thought leader in the field, thanks to its high-quality annual conferences, dedication to increasing public awareness of retinal diseases, and contributions to scientific literature. 

Over the past three decades, VRSI has grown exponentially. Founded in 1992 by 20 dedicated vitreo-retinal specialists, the society now boasts more than 1,500 members across India — including 90% of the country’s actively practicing vitreoretinal specialists. This includes an elected executive committee: President Dr. N. S. Muralidhar, Vice President Dr. R. Kim, Scientific Convenor Dr. Mahesh P. Shanmugam, General Secretary Dr. Manisha Agarwal, and Treasurer Dr. Prashant Bawankule, along with other executive members. 

Together, the executive committee and its members work to elevate the standard of vitreo-retinal care and resources in India, focusing on two main areas: Public health and continuing education.  

Addressing preventable blindness in India

According to VRSI, the society contributes to public health by taking initiatives to alleviate preventable blindness from retinal pathologies.

Retinopathy of prematurity (ROP) is one condition where VRSI focuses its resources. This is crucial because India has the highest number of premature births in the world — and further, the country is currently facing an ROP epidemic that has even penetrated into its peripheral rural districts. According to a 2019 paper,1 the incidence of ROP in different regions across India has been reported to range from 38% to 47%.

Another retinal pathology receiving well-deserved attention from VRSI is diabetic retinopathy (DR). Currently, about 77 million people have diabetes in India, and this number is predicted to drastically increase to 125 million by 2045. Worryingly, at least three million people are at risk or already have vision loss due to vision-threatening diabetic retinopathy (VTDR) in India.2 

With these numbers, it’s clear that intervention is needed to prevent avoidable blindness — and VRSI is actively working to increase public awareness through social media, skill transfer workshops and webinars. VRSI also collaborates with other ophthalmic societies, such as the All India Ophthalmological Society (AIOS), in this effort.

Advancing medical education and scientific studies

Creating opportunities for continued medical education is another primary objective of the VRSI. Members are informed of the latest developments in vitreo-retina through quarterly newsletters, each providing timely scientific information on a selected topic in retina. Meanwhile, monthly Retina Roundups share new data and trial results to further add to the group’s collective knowledge and establish best practices.

Another valuable resource is the VRSI Study Group, which conducts collaborative research in retina. One recent paper from the group, Incidence of post vitrectomy endophthalmitis in India — A multicentric  study by VRSI Study Group, was published in Eye (London) and highlighted a hot topic in India: The reuse of single-use instruments. 

In developing countries, it’s common practice to resterilize single-use instruments — this not only makes surgery more affordable for patients, but also reduces the procedure’s environmental impact. However, these benefits aside, this reuse also raises concerns for post-vitrectomy endophthalmitis (PVE), which is reported to be between 0.02% and 0.84%. Therefore, Shah and colleagues evaluated the incidence of PVE amid existing sterilization practices of reused instruments in multiple vitreo-retinal centers in India.

In total, 25 centers were sent a questionnaire that asked for details regarding the institution itself; the number of vitrectomies performed each year; sterilization practices followed preoperatively, intraoperatively and postoperatively; incidence of endophthalmitis; and instrument reuse policies.

They learned that nearly 80% of centers changed most instruments after every case; the remainder reused, with cutters being reused a mean 4.7 times before being discarded. For the number of times an instrument could be reused before being discarded, 76% followed a performance-based protocol, while the remaining 24% had a fixed protocol.

The investigators noted 29 cases of endophthalmitis (0.06% mean incidence) out of 47,612 vitrectomies and found no difference in endophthalmitis rates based on various pre-, intra- or postoperative prophylactic measures. This led them to conclude that PVE rates are not significantly different in India, despite the multi-use of single-use instruments. 

Further, they shared that this paper’s purpose was not to suggest an alternate protocol, but to create one in the future bearing these results in mind: To rationalize the use of single-use instruments and thereby, make VR surgery more affordable with a lower carbon footprint.

Sharing knowledge to serve others

For all the good works that VRSI does to support India’s vitreo-retina specialists and the patients they serve, these efforts are perhaps best showcased during the society’s annual meeting. 

Held in a different location throughout India, this high-quality scientific meeting provides an invaluable platform for members to interact and learn from world-renowned experts in the field. It’s also a springboard for collaborative retina research, with more than 500 national and international faculty and delegates in attendance. 

This year’s meeting will be held from December 1 to 3 in Trivandrum, India. Registration is currently open.

For more information about VRSI or to register for the conference, visit


  1. Bowe T, Nyamai L, Ademola-Popoola D, et al. The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela. Digit J Ophthalmol. 2019; 25(4): 49-58.
  1. Raman R, Vasconcelos JC, Rajalakshmi R, et al. Prevalence of diabetic retinopathy in India stratified by known and undiagnosed diabetes, urban-rural locations, and socioeconomic indices: results from the SMART India population-based cross-sectional screening study. Lancet Glob Health. 2022;10(12):e1764-e1773. 
  1. Shah PN, Mishra DK, Shanmugam MP, et al. Incidence of post vitrectomy endophthalmitis in India – A multicentric study by VRSI study Group. Eye (Lond). 2023 Feb 8. [Online ahead of print]

Editor’s Note: A version of this article was first published in PIE Magazine Issue 26.

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