Uzbekistan is situated at the heart of Central Asia with a population of approximately 30 million people. Ophthalmology there has witnessed significant progress over the past few decades since its independence in 1991, reflecting Uzbekistan’s efforts to align its healthcare standards with international norms and provide comprehensive eyecare services to its citizens [1]. However, the field also faces certain challenges that need to be addressed to fully meet the population’s needs.
Ophthalmology in Uzbekistan was established in the Soviet era. During this period, Uzbekistan benefitted from advancements in Soviet medical research and training, which laid the foundation for its modern healthcare infrastructure. Eyecare is provided by community ophthalmologists in the local policlinics (GP practices with resident non-operating subspecialists – ophthalmologist, ENT, paediatrician, dentist, gynaecologist and urologist). Optometry and orthoptics have not developed in Uzbekistan yet, only dispensing opticians, and the bulk of the eyecare is provided by community ophthalmologists who refer complex and surgical pathology to secondary and tertiary referral hospitals.
Figure 1: Newly refurbished RSSMCEM, lead by dynamic and forward thinking Prof Azamat Yusupov.
Notable state-run institutes, such as the Tashkent Institute of Postgraduate Medical Education and the Republican Specialized Scientific Medical Centre of Eye Microsurgery (RSSMCEM), play a leading role in shaping the ophthalmology in Uzbekistan (Figure 1). Additionally, each major city (Tashkent, Samarkand, Bukhara, Ugrench, Termez, Andijan) has a medical university with an ophthalmology department providing undergraduate and postgraduate training in ophthalmology. In parallel to the state service, there is a rapidly growing private sector.
Over the past decade, healthcare facilities have increasingly invested in modern diagnostic tools, such as OCT, fundus cameras and laser treatment devices, mainly in the big institutions and the private sector. The introduction of phacoemulsification techniques for cataract surgery has significantly improved surgical outcomes and reduced recovery times for patients. However, extracapsular cataract extraction is also performed in smaller units. Vitreoretinal surgery is gaining strength, especially in the capital city, but is not readily available in all regions, and funded treatment referrals are offered to selected patients. Neuro-ophthalmology was named as the least developed subspecialty in the country.
Postgraduate training of ophthalmologists is carried out in institutions like the Tashkent Medical Academy and the RSSMCEM. Core training takes two years and involves diagnostics and non-surgical treatments. Further surgical training is offered in selected training centres. Many private hospitals run their own training programmes, too. Collaborative programmes with foreign medical institutions have helped Uzbek doctors to gain international exposure and experience. These collaborations are currently arranged on an individual basis.
Challenges in the ophthalmology sector
Despite positive developments, several challenges remain. A major issue is the disparity in access to quality eyecare between urban and rural regions. While big cities boast modern facilities and well-trained ophthalmologists, rural areas often lack adequate infrastructure and specialist services. This urban-rural divide can lead to delays in the diagnosis and treatment of eye conditions, contributing to preventable vision loss in underserved regions. According to the data from Professor Yusupov, the country’s Chief Ophthalmologist, there were 1835 registered ophthalmologists in Uzbekistan in 2023, of which 2/3 were in state sector and 1/3 in private sector, most of them practicing in the big cities. Around 100 new ophthalmologists are trained each year.
One of the significant public health concerns in Uzbekistan is the prevalence of eye diseases, such as glaucoma, diabetic retinopathy, ocular oncology, childhood blindness and uncorrected refractive errors [2,3]. The country’s ageing population and lifestyle have contributed to an increasing incidence of diabetes, goitre, vasculooclusive disease and their ocular complications [4]. Moreover, untreated cataracts remain one of the leading causes of blindness in the rural areas, making it a key focus for ophthalmic interventions. A particularly high incidence of endemic diseases, such as tuberculosis, parasitic infection, toxic hepatitis and lung disease, is seen in some regions [4], including Karakalpakstan, site of the biggest man-made ecologic disaster in human history, which led to drying up of the Aral Sea and salt storms, with consequent deprivation and mass immigration [5].
To address these challenges, Uzbekistan has initiated various public health programmes aimed at the early detection and treatment of eye diseases. Government-backed initiatives, often in collaboration with international organisations such as the World Health Organization (WHO) have focused on improving access to eyecare, especially in rural areas. Outreach programmes providing free eye check-ups, screenings for children in schools, and mobile eye clinics have been organised regularly by major institutions, instrumental in increasing awareness and offering preventive care. Diabetic retinopathy screening established in the Soviet era lacks the centralised modern technical infrastructure and, in some regions, patient access. Paediatric services are well established with a dedicated Paediatric Medical Institute in Tashkent, but there is patchy retinopathy of prematurity screening, which is mainly available in the capital city Tashkent [6,7].
Moreover, there are still gaps in public awareness about eye health and preventive care. Many individuals do not seek regular eye check-ups due to a lack of awareness or financial constraints. Although the government has made efforts to improve health literacy, more extensive campaigns and educational programmes are needed to reach remote communities.
The training and retention of qualified ophthalmologists also presents challenges. While there are training programmes available, the emigration of skilled professionals in search of better opportunities abroad continues to be a problem. Addressing this issue requires not only improvements in medical education but also better incentives for healthcare workers to stay within the country.
Figure 2: Drs Shohista Saidkasimova and Rahila Zakir visiting RSSMCEM.
Visit to the Republican Specialized Scientific Medical Centre of Eye Microsurgery, October 2024
Two surgeons from the UK, Shohista Saidkasimova, FRCOphth and Rahila Zakir, FRCOphth were supported with a travel grant from the charity Ophthalmic Aid to Eastern Europe (OAEE) and the Sir Edward Lewis Foundation to visit the RSSMCEM centre and attend the IV Annual International Ophthalmology Congress in Tashkent, Uzbekistan on October 4–5, 2024 (Figure 2).
Our visit was facilitated by the host and director of the centre, Prof Azamat Yusupov and his Deputy Prof Muyassar Karimova. RSSMCEM in Tashkent is a dedicated ophthalmology centre employing 58 ophthalmologists, accommodating >50,000 patient attendances per year, carries out >15,000 surgical procedures per year, including 5000 phaco + IOL, 150 ECCEs and 950 vitrectomies per year. This specialised centre is well equipped with diagnostic and surgical equipment and provides a wide range of services, from routine eye examinations to complex surgeries such as corneal transplants and vitreoretinal surgeries.
The RSSMCEM institution benefits from a newly installed electronic patient record system, Medrecords, is very well equipped, and operates on a semi-private arrangement where patients are charged for their care, however low-income families are treated for free with a certificate from their local authority (Figure 3a-b).
Figures 3a–b: Drs S Saidkasimova and R Zakir visiting the RSSMCEM and discussing plans for future collaboration with Prof A Yusupov.
The new training centre boosts simulation facilities with Eyesi, microscopes and phaco machines and runs wet-lab courses on phacoemulsification, collagen crosslinking and additional procedures. It is home to research facilities and an academic committee for MD and PhD students.
Figure 4: Embracing the modern technology: self-check in and ticket collection point at the RSSMCEM reception.
RSSMCEM has several branches in Samarkand, Bukhara, Khiva and Namangan. Regular country-wide webinars are held throughout the year, usually attended by 200–300 doctors from the regions.
The IV Annual International Ophthalmology Congress brought together ophthalmologists from central Asian region – Uzbekistan, Tajikistan, Kazakhstan, Kyrgyzstan and from Switzerland, Türkiye, the US, Russia, the UK, India, and other nations (Figure 5).
Figure 5: International delegates of IOC in Registan Square, Samarkand.
As part of the Congress, a notable and historic event was the signing of a memorandum establishing the ‘Alliance of Ophthalmologists of Central Asia’ by representatives of ophthalmological societies from Central Asian countries. The primary objective of the Alliance will focus on the collaborative fight against glaucoma, a serious public health issue, with the goal of reducing the prevalence of blindness and visual impairment in the region.
The conference featured over 138 presentations on diagnostic challenges seven in ophthalmology, including glaucoma, vitreoretinal interface disorders, cataracts, laser treatments for various ocular pathologies, and plastic surgery, among others. The event was marked by a warm and collegial atmosphere.
The role of international cooperation and future prospects
International cooperation is keenly sought in hope for enhancing ophthalmology services in Uzbekistan. Partnerships with organisations such as the WHO, World Diabetes Foundation, and many more, have helped the country tackle key challenges like cataract blindness and childhood eye disorders. These partnerships have facilitated the transfer of technology, knowledge and expertise, and have supported local training programmes and public health initiatives.
The Uzbek government has also signed cooperation agreements with countries including South Korea, Türkiye, Russia and others to enhance ophthalmology services.
The future of ophthalmology in Uzbekistan looks promising, given the ongoing healthcare reforms and growing investment in medical infrastructure. The Uzbek government’s ambitious healthcare reform plan aims to modernise the healthcare sector, improve access to specialist services, enhance the training of healthcare professionals, and expand the reach of eyecare services, particularly in underserved rural areas.
Furthermore, the integration of telemedicine and mobile health technologies presents new opportunities to bridge the urban-rural divide in eyecare. Teleophthalmology initiatives can help provide timely consultations and follow-ups for patients in remote regions, reducing the burden on urban healthcare centres and improving access to specialised care.
The hosts expressed keen interest in further collaboration and in particular running practical courses on indirect ophthalmoscopy and scleral indentation and others in the future. Also head ophthalmologists from regional universities seek support in setting up vitreoretinal services in the Surkhandarya and Samarkand regions.
Conclusion
Ophthalmology in Uzbekistan has made substantial progress over the years, driven by advancements in technology, international cooperation and government initiatives. However, challenges such as disparities in access, gaps in public awareness, and the retention of skilled professionals continue to pose obstacles to achieving comprehensive eyecare coverage. Addressing these issues requires sustained efforts from both the government and international partners, as well as a continued focus on modernising infrastructure and enhancing training programmes. Colleagues in Uzbekistan are keen to collaborate, and the country has the potential to build a robust and equitable ophthalmology sector that can serve as a model for other nations in the region.
References
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5. https://www.undp.org/uzbekistan/publications/
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6. Robinson MR, Lee Susan S, Hyuncheol Kim, et al. A rabbit model for assessing the ocular barriers to the transscleral delivery of triamcinolone acetonide. Exp Eye Res 2006;82(3):479–87.
7. Khamraeva LS, Khamroeva YA, Muratova IK. Structure of pediatric ophthalmic pathology in Uzbekistan. Vestn Oftalmol 2024;140(2):97.
[All links last accessed May 2025]
Declaration of competing interests: None declared.
