Why Optometry for Uganda?

Why Optometry for Uganda?

The Brien Holden Foundation has led the development of the optometry program at Makerere University in Uganda.

How will optometry benefit Uganda?

The population in Uganda as of 2020 is 43 million.

MakerereOptometrists act as the first source of primary eye care to enabling early detection of serious eye conditions and diseases which may need referral. Optometrists will relieve ophthalmologists from the management of basic and common eye conditions, allowing them to focus on their areas of specialty – medical and surgical treatment.

The creation of skilled optometrists will in time increase the efficiency of eye care services in Uganda and improve the health system’s cost-effectiveness.

The eye care need and prevalence of uncorrected refractive error, myopia, cataract, glaucoma, macular degeneration in Uganda:

  • 16 OCO/Cataract surgeons are practising in Uganda and they function in 14 of the 56 districts.
  • At present there are 29 active ophthalmologists, serving a population of roughly 43 million people. Therefore, on average one ophthalmologist does serve a population of more than one million people. Considering the fact that about half do serve in the capital, the ratio for smaller towns and rural areas is even worse.
  • There are about 207 OCO’s in the country and most only do presbyopic corrections. Those who go back for the 3-month OCO refraction course are the only ones who perform objective and subjective refractions.
  • 8 Private Sector Optometrists are based in the capital, while 1 Optometrist is based in Ruharo Eye Centre in Mbarara. All are in private practice and have received their training outside the country.
  • At present there are only two Ophthalmic Nurses in the country.

Secondary level: The 207 OCOs provide basic ophthalmic services, with some based in the regional referral hospitals. There is at least one OCO per district. 50 OCOs were trained in refraction in Phase 1 of NIURE program. The majority performs refractions but some of them hardly practice since they are usually supporting ophthalmologists in the ward/theatre or are out in the field performing clinical duties.

Primary level: Ophthalmic Assistants (OAs) provide eye care services at the county and sub-county levels. A limited amount of RE and LV services are provided in the hospitals. The majority of these services are provided by optometrists in the private sector in Kampala. Only 2 mission hospitals have hospital-based expatriate optometrists and LVTs.

Current status: evolution of optometry development in Uganda

2014: Curriculum approved by National Council of Higher Education. First intake (8 students admitted, 6 enrolled). LFTW starts supporting optometry course coordinator.

2015: 4 students admitted. LFTW supports with set-up of optometry office and equipment for pre-clinic and AVC. BHVI equipment delivered. University identifies space for pre-clinic and AVC.

2016: 4 students admitted. Teaching clinic/Pre-clinic launch with senior management from LFTW. AVC launch with UNSW. MOU signed with BHVIF, UNSW and Makerere University.

2017: 20 students admitted (including 10 government sponsored). Curriculum reviewed to fit in with the revised MBChB curriculum. UNSW IGD team visited Makerere and interacted with students and faculty.

2018: Optometry recognised and gazetted. Registration to begin in June. Pioneer students complete course (May 2018). Start internships. 8 government sponsored students admitted for 2018-19 intake. Private TBC.

2019: Pioneer students graduate (January 2019). Five pioneer students graduated as the first Ugandan-trained optometrists for their country. They start the 25 week internship required by the Government to become a fully registered optometrist.

2020: Second cohort of students graduate (January 2020). Three pioneer students graduate to join the small but determined group of the first Ugandan-trained optometrists for their country. They start the 25 week internship required by the Government to become a fully registered optometrist.

Carl Zeiss Vision and WestGroupe ValuePak Donations Exceed $110,000

Beginning in 2016, WestGroupe and Carl Zeiss Vision Canada pledged to make a donation to Optometry Giving Sight for each of their new ValuePak Frame and Lens packages sold. ValuePak packages include Superflex® Frames with synchrony® Lenses from Carl Zeiss Vision which are manufactured in Canada.
Their generous promotion continues and over $110,000 has been donated through the initiative since its inception.

Successfully Combining Philanthropy with Product Promotion

ValuePak-PhotoWestGroupe and Carl Zeiss Vision’s commitment to help people in need through the sale of each ValuePak pair has made a significant impact on vision in areas of need around the world. Their support has helped fund vital projects such as the establishment of a school of optometry in Vietnam, and equipment for the growing optometry program in Malawi. Both countries are benefiting through newly graduated optometrists who are now providing comprehensive eye exams where there was previously very little or no eye care available.

This is a shining example of a successful product line promotion which at the same time helps people in need to see.

Our sincere thanks to Carl Zeiss Vision and WestGroupe for their support in this way. Their generous involvement is appreciated and makes a difference in the lives of many people.

For more information about ValuePak packages, please contact your Carl Zeiss Vision or WestGroupe rep or call 1-800-268-6489.

Giving Sight to Children in Mexico

Ver-Bien-logoVer Bien para Aprender Mejor has been working in Mexican public schools for more than 21 years, doing screening for refractive errors and delivering eyeglasses to those children who need them. Optometry Giving Sight has been supporting their work for several years and that continues into 2020.
A large team of professional optometrists and teachers perform the screening of the whole population at schools that Ver Bien visits. They travel from Mexico City to states throughout the country. Local state authorities coordinate that that the eye care teams visit every single school in the territory.

Ver Bien establishes agreements with local governments to pay for 50% of the cost of the eyeglasses, with the remainder paid for by Ver Bien with private donations, like that of Optometry Giving Sight. Conditions at schools differ wildly as some can accommodate screenings, exams and dispensing of glasses in classrooms, while other situations exist in very poor conditions and are conducted outside.
ver bienThe goal for Ver Bien in 2020 is to screen 1 million children in public schools in Mexico. They expect to provide over 300,000 pairs of glasses to children who suffer from a refractive error and other issues that can easily be corrected.
In more than 21 years, Ver Bien para Aprender Mejor has delivered more than 5.8 million glasses to children all over Mexico. This gives those students the same opportunities as those students who do not need glasses. Hundreds of thousands of these children have no access to eye health services as they live in very poor rural communities, where families don’t have the resources to pay for eyeglasses.
Correcting children’s vision problems helps to keep school dropouts to a minimum. Children who have left school are more susceptible to searching for an illegal income. For this reason, was included in the World Economic Forum paper “Eyeglasses for Global Development: Bridging the Visual Divide” as a case in point.
The eyeglasses that Ver Bien provides are produced by a Mexican manufacturer according to each child’s need. The children are able to select the frame of their choice from 30 combinations of colors and sizes. The student’s families do not have to pay for the eyeglasses or for the optical services.

U.S. Children Need Eye Exams – Kids See: Success Partnership

kids see successOptometry Giving Sight is very pleased to again be supporting the Vision Impact Institute’s Kids See: Successs program for 2020. This initiative was first launched and supported by Optometry Giving Sight in 2016 to fight for mandatory comprehensive eye exams for children as they enter kindergarten.

A comprehensive eye exam for young children as they enter school and is often overlooked and can be a critical piece to their success as a student. Without this, parents may be sending their children to school with an undetected vision condition that can impair development, interfere with learning, and contribute to behavioral issues. As 80 percent of learning takes place through our eyes, a comprehensive eye exam is the only way to ensure a child can see clearly and has healthy eyes that work properly.

To advocate for every child’s right to see clearly, the Vision Impact Institute created Kids See: Success, with the goal of educating parents, state and city legislatures, child advocacy groups, school nurses, teachers and administrators about the need for mandatory comprehensive eye exams prior to entering kindergarten.

According to the National Center for Children’s Vision and Eye Health, the economic costs of children’s vision disorders amount to $10 billion annually in the United States, taking into account the costs of medical care, vision aids and devices, caregivers, special education, vision screening programs, federal assistance programs and quality of life losses. In addition, children with untreated amblyopia will earn 12% less over their working lifetime than a treated child, according to the Children’s Eye Foundation.

While many states and cities require vision screenings prior to entering school, that is not enough. A comprehensive eye exam from an eye doctor is the best way to determine whether a child’s eyes are healthy and working properly. While vision screenings can detect some problems, more serious vision issues may go undetected, including binocular vision problems and amblyopia (lazy eye), which can cause vision loss in children. However, a comprehensive eye exam can help detect and treat these conditions earlier. A comprehensive eye exam can make the difference between poverty and opportunity, and we want to give all children that opportunity as early as possible.

With one in four children in the U.S. having an undetected vision condition, the Vision Impact Institute’s goal is to drastically improve this statistic and help provide all children with a level playing field. That is why Optometry Giving Sight has supported the Vision Impact Institute / Kids See: Success – to encourage cities and states across the U.S. to require a comprehensive eye exam for children entering kindergarten. Only through a comprehensive eye exam can parents and teachers ensure that a child’s eyes are healthy and working properly, and that he or she is equipped to learn.

Mexico: Alejandra

AlejandraAlejandra has been on a journey of discovery and one that resulted in a beautiful transformation of her young life.

For an active, intelligent and successful student who always liked to perform well in school, it was a matter of concern when, at the age of ten, Alejandra’s class performance started declining.

She said she couldn’t understand why she had problems reading words from the school board and had to depend on other students for help. Recognizing people and signs from a distance was another problem she started having.

“Fear,” she said, is the only word that comes to her mind when Alejandra was asked how she felt. Over time the fear started to turn into distress, and she began to develop the habit of putting her head in her hands and resting like that for a long time – it all seemed to be too much.

Her concerned parents looked for a solution to the difficulty their daughter was experiencing. After having a long discussion with Alejandra’s teachers, they all agreed she was having great trouble seeing well. Unfortunately, eye care services are expensive and not close to Alejandra’s town community.

Together they looked for ways to help Alejandra feel better and be able to continue to join in regular school classes. She sat close to the school board which seemed to help some, but by the afternoon she would resort to holding her head in her hands. Her teacher was sad to see her stop playing school yard games.

Luckily, the following year Alejandra’s school was invited to participate in a school screening program implemented by Ver Bien, supported by funding partner Optometry Giving Sight.

Having a comprehensive eye examination and the correctly prescribed glasses has helped Alejandra greatly improve the quality of her life and allowed her youthful ambitions to open up again. She mentioned her dreams returning.

“My life is easy now,” Alejandra said happily. “I can see all my friends walking to school, so I feel part of life again. And I can see the school board and play catch again, my favorite lunch recess game.”

Uganda: Sheila

sheilaSheila is one of the first female optometrists who graduated from the School of Optometry in Makerere University, Uganda. She graduated in January 2019 and completed her 6-month internship.

Sheila started wearing glasses when she was only 8 years old. She could not see the blackboard in her class and her teacher noticed her struggling. Sheila and her brother both were myopic, and after eye exams at the Hospital they were diagnosed as needing glasses.

“As an optometrist, I need to be able to see my patients properly.” Sheila knows the importance of having glasses, without which she would not have been able to become an optometrist today.

Optometry was not something she knew a lot about as a child or even in high school. As she started learning more about optometry, she realized how blessed she is to become an optometrist and appreciated her learnings even more.

As the first optometry students, Sheila and her friends have fought many battles, but she is thankful and proud that the profession is now recognized in Uganda. “I am among the first female optometrists in Uganda, so it gives me a lot of pride!” She wants to encourage young girls to study optometry because she believes it is a prestigious profession.

She wants to thank all the funders, including Optometry Giving Sight, for providing excellent equipment and lecturers, without which they would not have been able to get through the course and become the first optometrists in Uganda.

Vietnam: Trung

Trung“My new glasses make me feel so happy,” said Trung, a nine-year-old boy from the southern province of Ba Ria-Vung Tau in Vietnam. Trung tells his story of the daily struggles he experienced for several years due to his poor vision.

“For a while now there have been times when I’m at school that I felt dizzy and I couldn’t join in the activities all the other students are doing. I did not feel very happy at those times,” Trung said.

The young boy explained his parents had been told that while he seemed to be experiencing difficulties at school, that this can often happen to children of his age and that he would grow out of it.

Trung“I hoped that I would grow out of it soon,” Trung said. “But now I know that I don’t have to wait anymore. With my new glasses I can see everything very well and so school will be great. Before, I couldn’t see the lesson board even though everyone else could,” he said.

Trung’s mother said his teacher at the school would be very pleased he now has the glasses he needed. “She urged me to bring Trung here to the eye unit and have his eyes checked. She was worried he was falling behind the other students of his age even though she knew he tried to be a good student. Now things will be different,” she said smiling.

Trung was given an eye exam and a pair of glasses through an Optometry Giving Sight funded project.

Uganda: Patrick Teira

1. Why did you choose to study optometry? Could you tell us about your journey into this course?

Pictured: Patrick in the orange t-shirt

Having grown up in a mainly low income neighborhood in one of Kampala’s suburbs in Uganda with a Type 1 Diabetic sister, who I frequently had to escort for her medical visits and checkups, I was early on introduced to some of the complications of the disease. One of the many clinics my sister was advised to regularly visit was the eye clinic at Mengo hospital in Kampala. Being one of the very few eye care facilities in the country, the waiting line was always long and we normally had to wait for days before ever getting attended to. So many people, particularly those who had to travel long distances from the far corners of Uganda to get these eye care services, usually ended up giving up. They were condemned to lives of reduced vision and blindness. I was never able to comprehend why the doctors constantly emphasized the need for my sister to visit the eye department, having grown up in a community where many eye-related conditions are either ignored or blamed on wizardry, witchcraft or superstition, and where most of the local health centers and clinics mainly focus on what are considered to be more fatal diseases like Malaria, HIV/AIDS, tuberculosis and other infectious diseases. 

It was not until one of our career guidance sessions in my final year of secondary school when one of my teachers talked about the newly introduced optometry course at Makerere University. It was then that I formerly got introduced to the optometry profession. In a country which barely has any primary eye care service providers, it is not surprising that it took me that long. Fascinated by how fondly my teacher spoke about the course, I was attracted to do a little research of my own through the Makerere University website and a number of online optometry journals. With all this information I had acquired, I decided to pursue optometry given that it was a virgin and unmapped field where both my impact and skills could be best felt. Through optometry, I realized that I could have the power to improve the lives of so many individuals, with conditions ranging from refractive errors to more fatal conditions like diabetes and hypertension, which are on the rise in the country. Given my real life testimony of how optometry could impact almost every other field of medicine, I grew passionate about the profession and decided to apply for optometry at Makerere University where I got admitted and have literally learned new and exciting things every day.

2. You are one of the very few student optometrists in Uganda-how does it feel to be part of the movement to improve eye health in Uganda?

To be one of the very few student optometrists in Uganda feels exciting and special at the same time. To have this largely unexplored field with vast amounts of unrealized potential and opportunities and so many unfilled gaps in the eye care sector of Uganda literally challenges me to think bigger, to learn and better myself every day of my life.

3. What would you say to anyone thinking of studying optometry?

I would tell anyone thinking of studying optometry to buckle up for a very exciting and interesting journey in their lives where they will have to be motivated, committed and focused as a lifelong readers, where they would constantly appreciate the satisfaction of restoring vision and improving or even saving lives.

4. What do you want to do once you finish your degree?

After I finish my degree, I would like to further my studies and get qualifications that would make me eligible to teach and train more optometrists in Uganda so that we can quickly build up our numbers. This will give us a stronger voice and a bigger impact in the eye care sector of Uganda. I would also like to actively participate and streamline nation-wide research in the optometry field in Uganda. This will help us uncover and expose the numerous deficits in the eye care sector and challenge us to think of rational solutions to solve them.

5. What are your wishes for the future of eye care in Uganda?

I wish to see a future in which optometry as a profession is well recognized, regulated and integrated in both the private and public sectors of Uganda. A future where eye care services are made available to every last corner of the country. A future where no person should be condemned to a life of low-quality vision and preventable blindness. A future where no student has to drop out of school just because of a simple refractive error, and a future where effective and widespread eye care provision eliminates preventable blindness and increases the quality of lives and productivity of every last Ugandan.

Sri Lanka: Nimesha

Nimesha Nimesha, like many young teenage girls, loves school, chatting with her friends and spending time with her family. She has many ideas for what she wants to do when she graduates High School – on the top of the list: Medical School. Unfortunately, unlike other children her age, Nimesha noticed her eyesight deteriorating two years ago and her quality of life also quickly began to deteriorate.

“Although I noticed my eye problem two years ago, there was no one who could come with me to the eye clinic. My mother works full-time and my father passed away four years ago,” she said. Not only that, but Nimesha is part of a large percent of low-income families in Sri Lanka who don’t have access to regular health care and lack substantial employment opportunities.

Nimesha said that when she goes to school, she cannot see the blackboard clearly from where she sits. She added, “I have to hold my textbooks very close to my face in order to read the small font.It is not fair because all I want is to be able to see, work and play like the other girls in my class.”

Nimesha was very excited about being seen by the eye care nurses and optometrists who came to her school. After being screened and further examined by the Brien Holden Foundation team through a program funded by Optometry Giving Sight, she was provided with high prescription glasses. Nimesha now enjoys playing with her friends and studying more effectively, and is no longer alienated by her classmates. She now has equal opportunity to reach her goal of becoming a doctor when she graduates.

Cambodia: Lyhour’s story

lyhour Lyhour is a 14-year-old from Phnom Penh in Cambodia who attended a school screening program that visited his high school. The program was funded by Optometry Giving Sight and supported by the Brien Holden Foundation.

“About three years ago I started having trouble at school and at home being unable to see things clearly. Something changed in my eyes. I had to get very close to everything before it was easy for me to see,” Lyhour said.

“This made my life at school very hard especially as I got older and my vision got worse,” Lyhour explained. “I just wanted to be able to see like the other children in my class.”

Lyhour explained his excitement when he knew the school screening was coming to his school. He described thinking that maybe there was a new solution for his vision problem. “My life became happy again imagining that maybe I don’t have to spend my whole life not being able to see well,” he smiled.

“Today is one of the best days of my life. I can’t explain how I feel. I only have a wait a few more weeks now until my new glasses arrive and then my life will change forever. I’m so happy and excited. My sister wears glasses and is at university. I have always wanted glasses that help me see well, so I can join my sister at university after I leave school. Now I know my dreams will come true. Thank you so much for coming to my school,” Lyhour beamed.

Building capacity in Cambodia

The project in Cambodia has been designed with sustainable strategies and is delivering eye care in a comprehensive and effective way.

LyhourIn providing capacity building in eye health screening, training has been conducted for 25 teachers from 15 schools in Phnom Penh, as well as for 10 staff members at the Ministry of Education, Youth and Sport (MoEYS) School Health Department. Eye screening programs are developing in three schools. This will enable trained staff to be aware of eye problems and recognize them in students, teachers and staff. They now have the capacity to be involved in screening activities and refer students to appropriate services.

“I am really happy to be invited by the Brien Holden Foundation to attend the training,” said Vice School Director Mr. Srouch in Phnom Penh. “I think the course is really good and it has given me the skills to be aware of basic eye problems, what signs to look for and when a referral is needed, and I now know the appropriate places to refer the students to.”

This activity is in line with the action plan of the National Program for Eye Health/Ministry of Health to prevent blindness from refractive errors and provide low-vision services through routine screening of school children at secondary and high school levels. The model of screening developed with the MoEYS and teachers in this project can be used in other areas of Cambodia to meet the goals of the National Plan for the Prevention of Blindness.

School Vice Director Mr. Srouch also added that, “I now know with school screenings, I have the skills to identify students and teachers alike who have refractive error or other eye problems. They can then be referred and fitted with a correct pair of glasses. It is a social and charitable contribution to the community by the Foundation and their funding partner Optometry Giving Sight.”

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