Short sightedness isn’t a disease, yet myopia is the commonest cause of poor sight worldwide. In the west, it is usually no more than a minor inconvenience alleviated by corrective eyewear, but in countries with poor infrastructure it can make the difference between a successful life and one of poverty and dependence. WHO estimates that 153 million people live with uncorrected refractive errors. The personal costs of short sight are significant. Children may be able to read a book by holding it inches from their face, but they can’t read a blackboard. When they grow up they won’t be able to drive. In an increasingly technological world myopia will be an increasingly serious handicap.
How can these children be provided with spectacles?
The gold standard for primary care eye services is assessment by an optometrist, who checks for eye diseases and can prescribe lenses for refractive errors. (The term optician is apparently falling out of favour and being reserved for dispensing opticians). Every high street in the UK has several optometrists, one for every 10,000 people. Sub-Saharan Africa averages one optometrist per million people. Even relatively sophisticated South Africa, with a population of 41 million, has fewer than 300 optometrists. But refraction is only the start. Optometrists take measurements so the glasses will fit the face. Someone has to make the lenses and fit them in the frames. The spectacles have to be delivered. And they have to be affordable in countries where people on average earn only $1 a day. Refraction services are rarely free of charge. Cheap lenses are usually of poor quality. And how do you provide services and deliver spectacles in the bush?
