Dr Leo DP Cubillan, MD, MPH
Director
Philippine Eye Research Institute
National Institutes of Health
UP Manila
Preventing Blindness Through Research
*A member organization of NCSP
Eye Care Services Challenges in the Philippines
a. Pre-Pandemic
b. During Pandemic
Eye Care Services Opportunities in the
Philippines
a. During Pandemic
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
PRE-PANDEMIC CHALLENGES

Philippine Eye Disease Study (PEDS)
National Prevalence of Visual impairment = 1.98%
Major Causes of Visual Impairment
• Cataract: 1.06% (1.112M Filipinos)
• Requiring surgery: 333,639 Filipinos
• Uncorrected Errors of Refraction: 0.38% (398,688 Filipinos)
• Glaucoma: 0.27% (283,287 Filipinos)
• Maculopathy/Diabetic Retinopathy: 0.2% (209,836 Filipinos)
National Prevalence of Eye Diseases among Filipinos with
Little to No Visual Impairment (VA of 20/70 or Better)
• Errors of Refraction: 3.26% (3.4M Filipinos)
• Glaucoma: 0.69 (0.7M Filipinos)
• Diabetic Retinopathy: 0.59% (0.6M Filipinos)
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
PRE-PANDEMIC CHALLENGES
Distribution of Ophthalmologists in
the Philippines
Component
Cities &Rest
of the
Country, 599,
41%
Другой,
Metro
Manila
and
652, 44%
228, 15%
Highly
Urbanize
d Cities,
excl
NCR,…
Global Estimated Mean: 31.7 per
million population (<1 ophthalmologist
per million population to 182).
Independent
Component
Cities, 34,…
 1 : 40,000 Metro Manila
 1 : 120,000 rest of the Philippines
1,479
OPHTHALMOLOGISTS
Sources:
(1) http://www.pao.org.ph/Retrieved November 2018
(2) Resnikoff S, Lansingh VC, Washburn L, et al. Estimated number of ophthalmologists worldwide (International Council of Ophthalmology update):
will we meet the needs. British Journal of Ophthalmology 2020;104:588-592.
PRE-PANDEMIC CHALLENGES

Knowledge, Attitudes, Practices and Access (KAPA) to Eye Care
PERI EYE HEALTH SURVEY
60 out of 100
experienced
Eye Problems
in the Past 3
Years
EYE
PROBLEMS
44%
41.6%
23.6%
15.4%
3.6%
Blurring of Vision
Eye Itchiness, with or without discharge
Eye Redness
Eye Pain
Eye Injury/Trauma
REASONS
44% Can’t afford medical fees and medicines
17% Unavailable Eye Doctor
14% Fear of diagnosis and/or medical procedures
25% Other various reasons
PRE-PANDEMIC CHALLENGES
Philippine Eye Health Service:
Kalusugan Pangkalahatan (Universal Health Care)
Access to Eye Care
Prevent Blindness Through
Early Detection and Treatment
Source: Department of Health, 2010b. Universal Health Care Agenda. https://doh.gov.ph/sites/default/files/basic-page/aquino-health-agenda-universal-health-care.pdf
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
PANDEMIC CHALLENGES for Access to Health Care
Almost All Tertiary Hospitals are COVID Hospitals
NON-COVID AREA
Testing
Testing
Out-Patient
Isolation
In-patient
Treatment
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
COVID AREA
PANDEMIC CHALLENGES
Level 3 Hospitals in the Philippines (Feb 2021)
Number of Government Hospitals, 2018
: 463
Ratio of Gov’t Hospitals to Population
: ~250,000
Number of Level 3 Hospitals, Feb 2021
: 107
CAR; 2; 2%
Region 12; 2; 2%
Region 9;
1; 1%
Region 10; 2; 2%
Region 4-A; 1; 1%
BARMM; 1; 1%
Region 8; 2; 2%
Region 5; 3; 3%
Region 4-B; 3; 3%
Region 2; 3; 3%
Region 1; 4; 4%
Region 6; 5; 5%
Region 11; 5;
5%
Region 3; 9; 8%
Region 7; 10;
9%
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
NCR and Rizal; 56; 51%
PANDEMIC CHALLENGES
Registered Deaths and Hospitalization in PH pre-pandemic VS Covid-relate deaths
Registered Deaths in PH pre-pandemic
Registered CoVID Deaths (2020-2021)
PHILIPPINE EYE RESEARCH INSTITUTE since 1965
National Institutes of Health
https://pcij.org/article/2322/dengue-govt-doctors-hospitals-hospitalbr-beds-neer-the-twain-shall-meet
PANDEMIC CHALLENGES

Displacement of Patients in PH Hospitals
PANDEMIC CHALLENGES
Limited Face-to-Face Consultations
Telemedicine/Online Consultation
PANDEMIC CHALLENGES

Usage Difficulty of Consultation Software
PANDEMIC OPPORTUNITIES

Development of software
Approach to
Implementation
Human
Experience
Technological
Opportunity
Sustainability
Marcelo, A. (2019). Telemedicine in developing countries: Perspectives from the Philippines.
Telehealth in the Developing World (pp.27-33)
PANDEMIC OPPORTUNITIES

Support
Universal Health Care(UHC) /
Kalusugan Pangkalahatan (KP):
‘’provision to every Filipino of the highest possible
quality of health care that is accessible, efficient,
equitably distributed, adequately funded, fairly
financed, and appropriately used by an informed
and empowered public’’
https://doh.gov.ph/kalusugang-pangkalahatan
PANDEMIC OPPORTUNITIES

Online Programs