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.

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.

I feel like my life can being now

EmmanuelcoverEmmanuel goes to school for the first time

Emmanuel is a 12 year old boy who didn’t attend school. He wished every day he could go with the other children in the village but he had been nearly blind since birth. He spent his days in his village which he knew well enough to get around. His local community tried to look out for him to help him stay safe.

His mother was very unhappy about Emmanuel not being able to go to school. She also wished he could help out with the daily chores as she worked every day in the fields on the family farm. His grandparents used to mind Emmanuel during the day so his mother could work, but his grandmother was becoming more concerned as her eye sight was beginning to dim.

Emmanuel had a cousin, Yusuf, who was very kind to him and used to take time to tell him stories about school and other villages that Emmanuel could not visit. It was Yusuf who helped save Emmanuel from lifelong blindness.

Yusuf had good eyes and was very interested in school. He learnt one day that his teacher had been trained in screening the school children’s eyesight. Yusuf had his eyes tested like all the other children, and all the while he thought of his cousin Emmanuel. He told his teacher about Emmanuel and sadly described his blindness.

Some weeks later the teacher asked again about Emmanuel and gave him a note to take home to his Aunty, Emmanuel’s mother. A few days later the teacher came home with Yusuf to meet Emmanuel. Yusuf was so happy he smiled the whole time. In the village he found Emmanuel’s mother so the teacher could talk to her.


Albino Children in Africa

albino in africa“Compromised in every which way”.

Albinism is a congenital disorder that is characterised by the partial or complete absence of pigment in the skin, eyes and hair. The disorder has a very high prevalence in Tanzania with 1 in every 1,200 people suffering from it. In contrast, the usual occurrence in the rest of the world is around 1 per 14,000. Tragically, many Tanzanian families with an albino child believe they have been cursed and must dispose of the child far from home or abandon them to an orphanage.

Unfortunately, albinos in Tanzania have another deadlier threat to deal with, as Dr. Moes Nasser from Vision Source in Houston discovered on a recent visit to Mitindo orphanage, which is in the same region where he grew up.

Watch the interview with Dr. Nasser here.

“There is a myth in Tanzania that if you own a body part of an albino, you’ll become rich and famous,” said Dr. Nasser. “I’m told that sometimes these albinos are kidnapped and their arms and legs are chopped off, even their organs are removed and they get sold for US$10,000 for each body part. So these albinos are compromised in every which way.”

Compounding these serious threats to life, people with albinism are sensitive to light and are almost universally near-sighted with stigmatism.

“They need to wear sunglasses and a hat.”

At the orphanage, Dr. Nasser observed an albino girl playing with a piece of string that she had found on the floor. When she dropped that string she could not see enough to pick it up. She was struggling to clasp it multiple times.

moesfacepic“So can you imagine what a pair of glasses will do to them? It will transform their quality of life.”

Dr. Nasser examined 70 children and of these 68 needed glasses.

“Some of the patients were very high near-sighted, up to minus 15. Hopefully we’ll get the glasses there very soon.”

The glasses were in fact delivered in October with the help of Dr. Nasser’s brother, Azim, who lives in Kenya. He arranged to have the prescriptions filled and delivered to the children.

“We are so blessed that we have been able to do our little part,” said Dr. Nasser.

Optometry Giving Sight and CooperVision funded the One Bright Vision program in Tanzania which screened close to 100,000 people in 2013 and 2014. That project was managed and implemented by Brien Holden Vision Institute. Dr. Nasser is a regular visitor to the region and always takes time out to provide vision correction to people in need, and training and mentoring support to the local eye care professionals in partnership with the Institute.

Cambodia School Eye Health

SeakthyEvery day, my eyes were so sore

Aged 16, Seakthy wanted to excel at school but she couldn’t see things clearly. Without professional eye care she also wrongly believed that her condition was a normal vision development.

“I started having problems with my eyes when I was studying in grade five. I had headaches and my eyes started getting sore and I didn’t want to study anymore,” said Seakthy. “I was unhappy as my performance at school wasn’t good.”

As her conditioned worsened, Seakthy finally confided in her parents.

Fortunately, a School Eye Health Cambodian project was undertaken recently in Phnom Penh. Its aim was to contribute to the elimination of visual impairment due to uncorrected refractive error in school children and teachers in Cambodia through the development and implementation of a comprehensive school eye health screening program.

The School Screening Project is funded by Optometry Giving Sight and BHVI. Implementing partners include BHVI, Royal Government of Cambodia Ministry of Education, Youth and Sport (MoEYS), Department of School Health (DSH) and the Phnom Penh Municipal Department of Education.

“My school principal and teachers announced that the Brien Holden Vision Institute, supported by Optometry Giving Sight, would be performing school screenings here,” said Seakthy. “I thought it is a good opportunity to get my eye tested. After the screening I received a pair of spectacles”.

SeakthySeakthy now wears her spectacles every day. “I cannot do anything without wearing them. I feel very fortunate that I got a free eye exam and spectacles. I can fully focus on my studying and now longer have headaches reading books.”

Seakthy’s studies have improved as well as her confidence to engage in life. “Because of my spectacles I am an outstanding student. I am good at Khmer and English literature and I am a Red Cross Youth representative for my high school. I am happy that I can participate in every activity I want as a result of having good vision. I give thanks to Optometry Giving Sight for supporting this screening activity in Cambodia through which I received a pair of spectacles.”

Overall, the project had 2 School Vision Screening trainings conducted with 30 participants, of whom 10 are MoEYS staff and 20 are teachers. 19,764 students and teachers received eye health screening and 2,225 spectacles were prescribed at 10 schools.

At these schools an awareness of eye health conditions and services presentations were conducted targeting MoEYS staff, school teachers, students and their families.

Since going through this experience Seakthy shares information with her friends, relatives and community about the importance of professional eye checks.

Photos courtesy: Brien Holden Vision Institute

Eye Care in Sri Lanka

NiroshanOptometry Giving Sight has provided substantial financial support over the past 7 years to help enhance access to eye care for people in Sri Lanka. 3 Vision Centres have been established and 7 Sri Lankans have obtained their degrees or diplomas in Optometry.

Over the past year, we have contributed to the efforts of the Brien Holden Vision Institute and the University of Colombo in Sri Lanka to establish the country’s first optometry degree program. As a result, eye care in Sri Lanka is gradually becoming recognised by the government as a priority for the country’s health care sector, and as an important profession in the Sri Lankan health system.

There is much enthusiasm for the optometry program in both the government and private sector, with the first intake of 20 students anticipated in January 2015. Around 40 to 50 students will be enrolled in subsequent years to meet the targets of the National Eye Care Plan.

Once they graduate, the students will join the eye care work force, supporting existing structures, creating new infrastructure and sustaining service delivery across the country, making comprehensive eye health services accessible at primary, secondary and tertiary levels.

Niroshan, who took part in a one-year vision technician course in India with the LV Prasad Eye Institute in 2008, now has more than five years of work experience in the Warakapola Vision Centre. He has provided eye examinations to over 12,000 patients. Over the past three years he has also been working in the National Vision 2020 program eye clinics where he has assisted community eye screening projects on a monthly basis, and in 2011, he undertook a diploma course in optometry at the Sri Lanka Foundation.

He is excited about the introduction of the optometry degree program in Sri Lanka as he knows it will strengthen the overall quality of eye care that will be available to local people.

“Most of the people in local communities lack eye health awareness or basic vision care education, so when they hear about our clinic they come to us with life-long, untreated eye conditions including refractive error,” he said.

“It is very common for young children to have eye conditions which are avoidable with earlier treatment, and unfortunately they lead to a stifled or incomplete education and divergent career paths. A sad fact is that many parents do not even know their children are having problems with their vision”.

Niroshan said he recently treated a young girl who was suffering from eyestrain and frontal lobe headaches.

“I examined her and found she was suffering from severe myopia and keratoconus,’ he said. “I prescribed her a pair of spectacles and gave her a referral for the keratoconus to be investigated. Several months later I heard that she had passed her exams, and the following year she managed to get into the University of her choice. She had previously given up on her goal of tertiary education because of her difficulties in seeing.”

Eye Care for Abrehet in Eritrea

EritreaAbheretAbrehet is an ambitious woman with a love for helping people. These two traits have resulted in her pursuing a profession in the health services – Abrehet works as a maternity nurse in a general hospital.

In order to correctly dispense medicine, Abrehet relies heavily on her sight. Without it, she cannot read the labelling on the bottles and cannot precisely give the women she attends to what they need.

Therefore it was a huge problem when, two years ago, Abrehet’s vision started to fail. “In the last six months in particular, it’s been almost impossible for me to do my work. I cannot read patient records and I cannot read medicine labels. I also can’t see the patients’ veins – so it is difficult for me to give intravenous injections.”

“At home, I really struggle to do any household chores. My life is not going well since my vision started to fade,” she added.

A mother of four, Abrehet also used to help her children with their school-work. “Now, this has stopped,” she said. “I can’t see what is written down, so how can I help my children?” she asked.

After visiting the optometry department at the Asmara School of Health Sciences, Abrehet was examined by a student in the department and diagnosed with refractive error. She was given a pair of glasses from the optical workshop lab that had already been processed by the students as part of their cut and fit training.

“I am so happy and so excited,” said Abrehet. “Now, I will be able to work again – to do the job that I love! I will be able to dispense medicine and read the patient records! I’ll be able to do all the things that a nurse is required to do! Thank you so much!”

EritreaFinalAbrehet was so impressed with the service and the treatment she received that she is now going to encourage all her colleagues to visit the optometry department to get their eyes tested. “For us, our vision is vital for our jobs and for our patients. Regular check-ups are therefore necessary. I will make sure to tell my co-workers to come here to get those tests done,” she said.

“Thank you so much for the help! You have changed my life,” said Abrehet.

The Developing Optometry Services program in Eritrea is a partnership between the Brien Holden Vision Institute, Asmara College of Health Sciences and the Eritrean Ministry of Health with funding support from Optometry Giving Sight.

To date 38 students have graduated as Optometry Technicians and are being deployed in Vision Centres across the country to provide refractive error services to the Eritrean population. Each year around 20 new students enrol in the program.