Love Your Eyes

Vision is our most important sense as our eyesight drives our perception. Eye conditions are remarkably common. Those who live long enough will experience at least one eye condition during their lifetime. Vision impairment affects people of all ages. In many instances teachers are the ones who identify that something is wrong with a student as oftentimes students complain that they are unable to read what is written on the whiteboard. Screening for eye conditions should be done at least once per year. Usually some of eye conditions are hereditary and in such cases screening might be required more often. In low- and middle-income settings the burden of vision impairment can be even greater due to fewer opportunities to access the most essential eye care services. In Jamaica, most private ophthalmologists charge approximately $10,000 per visit. A pair of eye glasses can easily cost over a $100,000 and it is not uncommon for many in the societiy to have outdated prescription lens due to the high cost associated with changing them. Additionally, surgeries for eye conditions such as cataracts are also quite expensive. It is not unusual for many patients to pay over $300,000 per eye. We must also be mindful that a significant number of our population do not have health insurance and are on fixed income, these factors also compounds the problem regarding access to affordable eye care services. The prolonged wait in the public health care system adds to the frustrations of many in the society who have no other choice. The fact is diabetes is very common in the population and one of the side effects of this disease is vision impairment. Unfortunately, the COVID-19 pandemic has delayed many medical surgeries and as a result the suffering of many continues. These prices oftentimes serve as barrier for many even those who are employed. Consequently, many eye conditions are not caught early resulting in untold suffering. Globally, at least 2.2 billion people have a near or distance vision impairment. Approximately 1 billion or almost half of these cases, vision impairment could have been prevented or has yet to be addressed. The World Health Organization (WHO) further states that vision impairment poses an enormous global financial burden with the annual global costs of productivity losses associated with vision impairment from uncorrected myopia and presbyopia alone estimated to be US$ 244 billion and US$ 25.4 billion. World Sight Day (WSD) is observed annually on October 13th. This annual event is aim to draw attention to a range of issues surrounding blindness and visual impairment. The day also provides an opportunity to raise awareness about retinal diseases The Day is a significant opportunity to raise awareness of the importance of routine eye examinations, which are crucial for maintaining ocular health, particularly in people who are prone to illness or who have chronic conditions like diabetes. It is seen as one of the most important communication and advocacy events on the eye health calendar. The theme this year for World Sight Day is Love Your Eyes. The day was created by the World Health Organization in collaboration with the International Agency for the Prevention of Blindness Pervasiveness This 1 billion people includes those with moderate or severe distance vision impairment or blindness due to unaddressed refractive error (88.4 million), cataract (94 million), glaucoma (7.7 million), corneal opacities (4.2 million), diabetic retinopathy (3.9 million), and trachoma (2 million), as well as near vision impairment caused by unaddressed presbyopia (826 million) (1). The prevalence of distance vision impairment in low- and middle-income regions is estimated to be four times higher than in high-income regions (1). With regards to near vision, rates of unaddressed near vision impairment are estimated to be greater than 80% in western, eastern and central sub-Saharan Africa, while comparative rates in high-income regions of North America, Australasia, Western Europe, and of Asia-Pacific are reported to be lower than 10% (2). Globally, the leading causes of vision impairment are: uncorrected refractive errors, cataract, age-related macular degeneration, diabetic retinopathy, corneal opacity and trachoma. The WHO argues that there is substantial variation in the causes between and within countries according to the availability of eye care services, their affordability, and the eye care literacy of the population. For example, the proportion of vision impairment attributable to cataract is higher in low- and middle-income countries than high-income countries. In high income countries, diseases such as glaucoma and age-related macular degeneration are more common. Personal impact Young children with early onset severe vision impairment can experience delayed motor, language, emotional, social and cognitive development, with lifelong consequences. School-age children with vision impairment can also experience lower levels of educational achievement. Vision impairment severely impacts quality of life among adult populations. Adults with vision impairment often have lower rates of workforce participation and productivity and higher rates of depression and anxiety. In the case of older adults, vision impairment can contribute to social isolation, difficulty walking, a higher risk of falls and fractures, and a greater likelihood of early entry into nursing or care homes. Economic impact Vision impairment poses an enormous global financial burden. For example, the annual global costs of productivity losses associated with vision impairment from uncorrected myopia and presbyopia alone were estimated to be US$ 244 billion and US$ 25.4 billion, respectively. Treatment Options Each eye condition requires a different, timely response. There are effective interventions covering promotion, prevention, treatment and rehabilitation which address the needs associated with eye conditions and vision impairment; some are among the most cost-effective and feasible of all health care interventions to implement. For example, uncorrected refractive error can be corrected with spectacles or surgery while cataract surgery can restore vision. Treatment is also available for many eye conditions that do not typically cause vision impairment, such as dry eye, conjunctivitis and blepharitis, but generate discomfort and pain. Treatment of these conditions is directed at alleviating the symptoms and preventing the evolution towards more severe diseases. Importantly, the WHO reminds us not to use eye medication which was not prescribed for us as well as to wear eye protection gear when using tools and chemicals which might damage our eyes. Vision rehabilitation is very effective in improving functioning for people with an irreversible vision impairment that can be caused by eye conditions such as diabetic retinopathy, glaucoma, consequences of trauma and age-related macular degeneration. It takes cash to love one's eyes. There needs to be public education campaign to raise awareness in the society regarding the importance of eye examination. Undoubtedly, governments worldwide need to invest more in training health professionals in this specialized field of medicine. Why is it that our eye-care providers are reluctant in giving the Pupillary Distance (PD) measurement for prescriptions? The pupillary distance measures the distance between the centers of your pupils; once the patient has this measurement they can easily purchase an eye glasses online at a fraction of the cost. Finally, there needs to be stronger advocacy and engagement of all stakeholders in calling for universal health insurance which will be able to offset the expenses both for the doctor’s visit and treatment as prescribed. Love you eyes! Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #WorldSightDay #LoveYour Eyes