Eye health and dynamics of the modern world

This year, World Sight Day was observed on October 13 to draw our attention to the reality of vision impairments and blindness globally. The World Health Organization (WHO) in collaboration with the International Agency for Prevention of Blindness (IAPB) stated this a special day to recognize the good work done by thousands of research and practice optometrists, ophthalmologists, opticians, and orthoptists all over the world working towards protecting and improving human sight, and treatment of eye diseases and visual impairments.

Globally, according to WHO, at least 1 billion people live with near or distance vision impairment that could have been prevented or has yet to be addressed. Also, 90 percent of people with blindness live in low income countries.

The theme for the World Sight Day this year is “Love your Eyes”. This is a timely recommendation, as modern lifestyles, nutrition, climate and technology pose a lot of danger to human eye health globally. Eye health is crucial for the overall socioeconomic progress as it is not only about sight; but about the ‘vision’ of the future. That is why it is an important aspect of holistic health and wellbeing as specified in the global Sustainable Development Goals.

A society without good eye health is in a lot of danger, as chances are that efficiency will be reduced in its productive activities, triggering an impact in its quality of life. Severe vision impairments in children can result in low achievements in school. It can also be a cause of depression in adults. Good eye health impacts directly our survival and quality of life. This is the reason in most cases blindness is linked with poverty and inequality existing especially in low-income countries.

Also Read: Maintaining eye health as you age

Affordability and inclusion

As we commemorate this day, there are two questions that are relevant to the reality of our country Tanzania. First, is eye health accessible, inclusive and affordable for all? Second, are average Tanzanians, in towns and in villages, educated on appropriate eye care especially in relation to visual technologies, work environments and climate change?

Regarding the first question, many people shun from eye clinics because of the cost of treatment, they rather choose to bear the pain and trust the natural healing process. Concerning the latter, it is not news that most people go to eye clinics when they have complicated issues already, while such escalations could have been prevented had they been sensitized to attend eye clinics regularly or promptly upon noticing anything unusual with their eyes.

According to WHO access to quality eye care globally is still an issue as many governments have not yet prioritized it in their integral human empowerment and development schemes. Research by Thomas Bisika et al. (and others) published in African Journal of Traditional, Complementary and Alternative medicine (AJTCAM) found out that unsupervised traditional therapeutic and medical eye care is common in African cultures, giving specific examples from Malawi. Despite the sensitivity of eyes to the external environment, and the hazards involved, it is a hard truth that people still risk putting herbs in their eyes just from hearsay

Also Read: When eye problems come with age

The local situation

Oftentimes eye tests and treatments cost a fortune, making many people from low-income countries unaware of their vision impairments and reluctant to seek medical care.  Sensitization programs are mostly undertaken in urban areas, leaving rural populations unaware of the treatable and preventable eye problems.

Locally, we were able to speak with Dr Barnabas Mshangila, an ophthalmologist and head of eye department at Mbeya Zonal Referral Hospital. According to him most young patients in Tanzania, aging 18 and below, are diagnosed with refractive error conditions, that is, short-sightedness (myopia) and long-sightedness (hypermetropia). These can be corrected by use of glasses. There are also many cases of eye injuries which children sustain while playing or when exposed to hazardous environments.

The middle age group tends to be affected mostly by injuries and trauma caused by road and workplace accidents and diabetic retinopathy. Above the age of fifty, two most common problems are cataract, whereby one’s lens is covered with fog, which is highly influenced by age, and glaucoma which comes with an accumulation of pressure within the eyeball which can later result in total blindness.

Dr Barnabas highlights that communicable eye diseases have remained on a very low scale over a few years, while eye allergies have been on the rise. While allergies on their own cannot impact one's vision, responding to irritation by rubbing has been a notable cause of micro-scratches on the cornea which may result in eye redness, eye-watering, light sensitivity and impaired eyesight.

Dr Barnabas points out that in a decade down the line, Tanzania has seen substantial improvements in eye health care. Mbeya Zonal Referral Hospital, which covers for the southern highlands zone, together with Bugando Medical Center, a referral hospital for Lake Zone regions have been markedly equipped to diagnose and treat cataracts as well as diabetic related eye problems, by use of intravitreal anti-vascular endothelial growth factor (VEGF) as well as laser pan retinal photocoagulation (PRP), among others. This has greatly reduced referral travels to Muhimbili National Hospital in Dar es Salaam and Kilimanjaro Christian Medical Centre (KCMC) in Kilimanjaro.

Speaking about the department’s community engagements, Dr Barnabas said: “Here in the Southern Highlands Zone, we organize outreach missions every week, visiting periphery hospitals and health centres where we do screening and raise awareness of general eye health. Observing World Sight Day we had an awareness programme via radio, and from 10 - 13 October we have free eye screening here at the Mbeya referral hospital eye clinic.” “My advice to the public is that they make an effort to utilize our services, to get their eyes checked at least once a year. This will help to prevent dead-end situations,” he advised.

The outplay of visual technologies

Vision impairment affects people of all ages but concern has been rising on how the youth and young adults’ age groups utilize and interact with these advancements of technology. It is estimated that people who have smartphones spend a screen time of 3-5 hours every day. This is just on the digital gadgets like smartphones but when we add time spent on big screens like televisions, gaming screens, desktop screens, tablets and laptops, the impact is huge and horrifying.

Constant staring at digital screens has been the reason for eye stresses, blurred vision and long-term vision problems like short-sightedness. With these effects, while allowing huge sales of these electronic gadgets, our government needs to devote its human resources in reviewing health and safety standards of these visual technology devices as well as sensitizing the society about eye problems associated with prolonged screen time.

Eye health needs to be indiscriminately prioritized such that it amasses beneficiaries from all over the country. It is a global concern, especially as the world recovers from the shackles of Covid-19 pandemic, which escalated screen time globally. UNICEF researchers apportion pandemic screen time largely to social media and video games. While such were good for that time, prolonging and normalizing such lifestyles, especially for young people, does not do their eyes any good. “Love your Eyes” is a message for everyone.

Additional report by Johnson Mwamasangula