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The Business of Sight: Why India’s Eye-Care Market Is Consolidating Fast

Naresh Nunna by Naresh Nunna
3 weeks ago
in Science News
0
Health worker using a handheld retinal camera on an elderly patient at a rural eye camp

AI-assisted retinal screening and laser-assisted cataract surgery are reshaping Indian eye care, as hospital chains expand into smaller towns.

Private equity, stock-market listings and laser-assisted surgery are transforming Indian ophthalmology. The demand is undeniable. The question is whether consolidation will widen access in smaller towns or simply concentrate premium care where money already is.

A market built on demographics

Few medical specialties are as well suited to scale as ophthalmology. Cataract surgery, the most common procedure, is standardised, high-volume and highly effective. Demand is relentless: India’s population is ageing, diabetes is widespread, and screen-heavy lifestyles are pushing up rates of myopia among the young.

Market research firm Grand View Research projects India’s eye-care market to grow from about 12.8 billion US dollars in 2025 to around 31.2 billion dollars by 2033. Such projections are estimates, but the direction is not in dispute.

The consolidators

Organised chains are moving quickly to capture that demand. Dr Agarwal’s Health Care, India’s largest eye-care chain by revenue, listed on the stock exchanges in February 2025 and its board has approved a merger with its listed sister entity to simplify the group’s structure. ASG Eye Hospitals, which took control of the distressed Vasan Eye Care through a 526-crore-rupee resolution plan cleared in 2023, has signalled plans for a public listing. Hyderabad-based Maxivision Eye Hospitals, founded in 1996 and backed by Quadria Capital, operates more than 90 centres across six states, has taken a major stake in Mumbai’s Ojas group of eye hospitals and is reported to be preparing an IPO for 2027. Centre for Sight and others are expanding too.

The model is familiar from other healthcare sectors: acquire established local practices, standardise clinical protocols and procurement, invest in equipment no single practice could afford, and spread corporate overheads across a large network. For surgeons, joining a chain can bring capital and technology; for investors, single-speciality hospitals offer predictable volumes and strong margins.

Technology moves up the value chain

Chains are also shifting their mix towards premium procedures. Dr Agarwal’s reported that in the first quarter of FY26, high-end cataract surgeries made up 25.5 per cent of its cataract volume, while what it terms robotic cataract surgeries grew 72 per cent year on year to 1,160 procedures.

The terminology deserves precision. In Indian eye care, “robotic” cataract surgery usually refers to femtosecond laser-assisted cataract surgery (FLACS), in which a computer-guided laser, steered by real-time imaging, makes the corneal incisions, opens the lens capsule and softens the cataract before the surgeon completes the procedure. It improves precision and reproducibility in some steps, though clinical studies have not shown consistently better visual outcomes than skilled conventional phacoemulsification, and it costs considerably more. Refractive procedures such as SMILE and premium intraocular lenses are other growth areas.

Diagnostics go digital

The most consequential technology shift may be in screening rather than surgery. Diabetic retinopathy, damage to the retina caused by diabetes, can lead to irreversible blindness, yet it is largely preventable if detected early. Studies in India have found that around 17 per cent of people with diabetes have retinopathy, while only about 10 per cent have ever had a retinal examination.

Artificial intelligence is helping to close that gap. Aravind Eye Hospital worked with Google to develop a deep-learning model for retinopathy detection, now being licensed to partners in India. In December 2025, a government-backed programme began AI-driven community screening using MadhuNetrAI, a tool developed at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, which grades images from handheld fundus cameras and refers patients needing specialist care. Portable devices from Indian start-ups bring retinal imaging to clinics and camps far from specialist centres.

Tier-2 and Tier-3 towns

Chains increasingly see their growth in smaller cities, where incomes are rising, health insurance coverage is expanding through schemes such as Ayushman Bharat, and organised eye care has been scarce. Hub-and-spoke models, with surgical hubs supported by vision centres and tele-ophthalmology, allow networks to reach these markets economically.

India also has a proud non-profit tradition that private chains cannot ignore. Institutions such as LV Prasad Eye Institute in Hyderabad and Aravind Eye Care System pioneered high-volume, high-quality, low-cost models that deliver free or subsidised surgery to the poor, cross-funded by paying patients. These remain global benchmarks for affordable excellence.

The workforce bottleneck

Equipment can be bought; surgeons and allied staff take years to train. India’s ophthalmologists remain concentrated in cities, and rural areas depend heavily on optometrists, ophthalmic assistants and outreach camps. Chains that grow faster than they can train risk diluting quality. The most sustainable networks are investing in fellowship programmes, standardised surgical training and the mid-level eye-care workforce that handles screening, refraction and follow-up.

Paediatric eye care is another emerging frontier. Rising rates of childhood myopia, linked to reduced outdoor time and prolonged near work, are prompting school screening programmes and interest in myopia-control interventions such as low-dose atropine drops and specialised spectacle lenses. Early detection here prevents lifelong visual impairment, and it offers chains a long-term patient relationship.

Consolidation’s double edge

Consolidation can raise clinical standards, spread technology and professionalise management. But it carries risks: pressure to upsell premium lenses and laser procedures, reduced competition in local markets and pricing that excludes those who most need care. Regulators, insurers and professional bodies will need to watch outcome data, pricing transparency and access for low-income patients.

India still carries one of the world’s largest burdens of avoidable blindness. The true measure of the eye-care boom will not be valuations on Dalal Street but how many people in small towns and villages get their sight back.

Teja Balantrapu

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Tags: CataractSurgeryEyeCarefeaturedhealthcareHealthSciencesHyderabadIndiaophthalmologyPrivateEquitysciencenews
Naresh Nunna

Naresh Nunna

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