Promoting inclusive eye health, prevention and treatment of blinding eye diseases
The burden of eye conditions and vision impairment is often far greater among SeeYou target groups: children, People living in rural areas, people with low incomes, women, older people, People with disabilities, ethnic minorities and Indigenous populations. People who have disabilities face greater challenges in accessing eye care services than those who do not. Direct costs, including transport to appointments and related pharmaceutical interventions are barriers to accessing care. Acceptance of wearing spectacles is often influenced by factors such as cosmesis, the belief that spectacles identify the wearer as having a disability, or that vision worsens with continued spectacle wear.
Eye care contributes both to the advancement of SDG 3 on health and well-being. SeeYou invest in intergrated people-centered eye care. These are services that are managed and delivered so that people receive a continuum of health interventions covering promotion, prevention, treatment and rehabilitation, to address the full spectrum of eye conditions according to their needs, coordinated across the different levels and sites of care within and beyond the health sector, and that recognizes people as participants and beneficiaries of these services, throughout their life course. Effective interventions are available for health promotion, prevention, treatment and rehabilitation to address the entire range of needs associated with eye conditions and vision impairment across the life course. Some are among the most feasible and cost-effective of all health care interventions to implement. When vision impairment and blindness cannot be treated, everyday functioning can be optimized through rehabilitation interventions.
Through this thematic area SeeYou set for itself three results areas.
- Improved availability of eye care services- different cadres of primary, secondary and tertiary health personnel’s are trained to provide quality and integrated eye care services as well as strong integration of eye care services within primary health care, and ensuring an effective referral pathway to secondary and tertiary care settings for timely treatment of eye conditions.
- Improved accessibility to eye care services- barriers such as disability, age, gender, socioeconomic status, actual and perceived cost of eye care, and poor eye health literacy are addressed to ensure communities and those at risk of blindness have access to eye care services.
- Improved acceptability of eye care services- negative cultural beliefs and practices are addressed and communities and people at risk of affected by eye conditions have the right knowledge information, tools to actively seek eye care services.
- Eye Health promotion
Interventions for health promotion aim to empower people to increase control over their health and its promotive factors through health literacy efforts, rather than by targeting specific risk factors or health conditions. Health promotion campaigns targeting improved awareness of the importance of regular eye examinations and the use of eye care services have been shown to be effective among older populations and those with diabetes. The use of health promotion activities (e.g. posters, brochures and health talks) prior to the implementation of outreach eye screening services, conveying messages such as “get your eyes checked” have similarly been successful in increasing uptake of services. The promotion of eye protective behaviours can also be considered interventions for health promotion and may include compliance with spectacle wear, time spent outdoors, and the use of sunglasses among school-aged students.
- Prevention, treatment and rehabilitation of eye care conditions
Preventive interventions in the field of eye care generally fit into two categories: (i) interventions that aim to prevent the incidence of eye conditions before they occur by targeting the causes and risk factors; and (ii) measures taken to prevent eye conditions that are secondary to other health conditions. Changes in legislation, such as compulsory seat belt use and restrictions on the use of fireworks, as well as targeted to improve awareness of trauma prevention strategies, such as the use of protective eye wear in high-risk activities and are also effective in reducing eye injuries. The treatment of eye conditions targets curing as well as addressing symptoms and progression. Treatment also aims to prevent or slow progression towards vision impairment. Rehabilitation aims to optimize the everyday functioning of those with vision impairment or blindness that cannot be treated in their environment, by maximizing the use of residual vision and providing practical adaptations to address the social, psychological, emotional, and economic consequences of vision impairment. A broad range of vision rehabilitation interventions are available, including optical magnifiers, environmental modification (e.g. improved lighting), reading using Braille, screen readers, smartphone wayfinders, counselling and home skills training, such as orientation and mobility training with white canes to ensure safe ambulation.
- Human resource development and advocacy
There is a growing recognition that delivering comprehensive eye health, in a way that strengthens the health system, will require sufficient people to fulfil each role within the eye health sector, and that they must have the training they need to do their job effectively. Ophthalmologists, ophthalmic nurses, optometrists, opticians and orthoptists are specifically recognised in the current International Standard Classification of Occupations (ISCO-08). Recognition of new kinds of eye care personnel is necessary to ensure that the eye health workforce is recognised, rewarded and supported to address the crisis in service delivery. The governments must be willing to recognise the different types of workers needed and to set up training programmes, professional standards, career paths and salary structures for these workers – all of which are needed to retain workers and ensure they are deployed where they are needed.