According to the World Health Organization, there are currently 2.2 billion people who suffer from vision impairment. Of that number, one billion have eye problems that could have been prevented or have yet to be addressed. Despite advancements in medicine and technology, one out of seven people in the world are still needlessly vision impaired. These people suffer from conditions including cataract, diabetic retinopathy, glaucoma, trachoma, macular degeneration and refractive error. If left untreated, these problems could lead to blindness.

In Asia, refractive error is growing problem. Caused mainly by the shape of one’s eyes, refractive error includes a wide range of conditions such as near-sightedness, far-sightedness, astigmatism, and presbyopia. Accounting for 53.4% of cases, the Asia-Pacific region has the highest prevalence of myopia or near-sightedness in the region. In most cases, refractive error can easily be fixed by prescription glasses which cost less than 2 USD in some developing countries.

But the problem is not easily solved by just providing affordable eyeglasses to the masses. It involves the improvement of entire health systems. People need to be educated about eye health issues, health centres need to be equipped, and health professionals need to know how to address refractive error. And when it comes to refractive error, optometrists are at the frontline.

Closer Look: Optometry in Viet Nam
In Viet Nam, The Fred Hollows Foundation worked with Standard Chartered Bank to deliver the Viet Nam Child Eye Care (VNCEC) project. The project provided eye screenings and examinations, free eyeglasses and treatment, and eye care communication activities for school children in three provinces. The VNCEC project also scaled up the eye health workforce by providing clinical education and training for health staff to become ophthalmic nurses, refractionists and opticians.

Optometrists in High Demand
Despite these achievements, the ophthalmic capacity gap still remains large. Eye care service providers are stretched beyond capacity to meet demand, affecting the quality of their services.

medicalIn the project’s three targeted provinces, only 14 ophthalmic nurses, refractionists and opticians served 245,680 school children, of which 34,720 needed comprehensive eye checks for eyeglass prescriptions. This created a bottleneck which extended the waiting time for eye checks that could last for weeks and placed great pressure on the medical team.

A shortage of ophthalmic staff to conduct advanced eye issues may also have contributed to the variable quality of the spectacles distributed to children.

Building the Next Generation of Optometrists
While the number of optometrists, ophthalmic nurses and opticians is not currently meeting demand, some improvements have been made. For example, more than 300 optometry students are currently enrolled in Pham Ngoc Thach and Hanoi Medical University, and the first batch of 60 optometrists supported by Brien Holden Vision Institute (BHVI) graduated in October 2018.

The next challenge is to institutionalise the profession of optometry in Viet Nam. Currently, the optometrist job code is not recognised by the Ministry of Health and the Ministry of Internal Affairs, preventing optometrists from being hired on regular positions with their deserved salary and benefits. To address this, BHVI, ECF and FHF Viet Nam are now working with the Health Strategy and Policy Institute to advocate for the official job code of optometrists in 2020.

World Optometry Day on 23 March is an opportunity to pay tribute to optometrists and the vital role they play in the fight against vision impairment.

More articles:
What is refractive error?
Five things every parents needs to know about refractive error