Category: News

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.

Optometrists 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.

Ver 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.
 
The 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.

Optometry 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.