The Issues

THE NEED

Globally there are at least 2.2 billion people - just over a quarter of the world's population - who are visually impaired or blind and, out of these, there are at least 1 billion whose visual impairment could have been prevented or has yet to be treated. Sadly this burden is greatest in low and middle-income countries like Kenya.

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Specific groups are also unequally and unfairly affected including women, indigenous people, those with certain disabilities and rural communities. The prevalence of blindness in both eyes in 8 times higher in Sub-Saharan Africa, including Kenya, than in all Western countries.

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Even a simple issue like the need for reading glasses is not being effectively addressed in Kenya. All of us start to need reading glasses as we get older. However, in Sub-Saharan countries like Kenya over 80% of people who need reading glasses do not have them, compared to less than 10% of people in Western countries.

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THE IMPACT

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Visual impairment has significant negative impact on a person’s quality of life and mental health, puts financial pressure on families and has broader economic impact. A child who is unable to read a chalkboard or a book will struggle to learn and complete their education. An adult who cannot work will not be able to support their family. An older person with reduced vision may not be able to maintain their independence.

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THE ISSUES

Access to eye care in Kenya is affected by many factors:

• Shortage of health care professionals, including ophthalmologists and optometrists

• Lack of equipment

• Location of clinics, often urban, and lack of transport for those in rural areas

• Cost of care, lack of funds or greater basic living needs

• Additional challenges due to disability

• Lack of knowledge of condition and/or benefits of treatment

• Mistrust or fear of medical procedures

This results in a low proportion of people receiving the care that they need. On top of this, the eye care profession isn’t regulated in Kenya, meaning that people might attend an appointment at an Opticians and not be seen by a qualified practitioner or they may not receive a full health check of their eyes.

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EYE CONDITIONS

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There are a wide range of eye conditions that we see during our clinics. These are some of the conditions we frequently come across:

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REFRACTIVE ERROR - this is simply a need for glasses in order to be able to see clearly. This may be due to long or short-sightedness or the aging process which causes a need for reading glasses. On our last trip, we provided 1,273 prescription glasses, including 868 pairs made in our on-site glazing laboratory and put together by hand.

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CATARACTS - a clouding of lens in the eye which can be treated with surgery to replace the lens with an artificial one, but will cause blindness if left untreated. This is usually associated with older age, in equatorial countries like Kenya it starts significantly earlier. It is estimated that every year, of those aged 50 years or older in Kenya, 148,280 develop a new, visually impairing cataract, and that 9,540 become blind in both eyes due to cataracts. 

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GLAUCOMA - a loss of vision from the outside in resulting in tunnel vision and eventually blindness if left untreated. This is usually caused by the pressure in the eyes being too high. In most cases, glaucoma can be controlled easily with eye drops or surgery to lower the pressure. Sadly we see too many people who have lost their sight unnecessarily as they have been unable to access treatment or have not had continuity of care, and once the damage is done it cannot be reversed.

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VERNAL CONJUNCTIVITIS - a severe allergic condition which affects children and is exacerbated by heat, dusty environments and the presence of animals in the home. It can cause severe itching, redness and pain and in the most serious cases, can lead to blindness. This is easily controlled with drops, which need to be used long term, and by protecting the eyes from allergens in the environment. The allergy flares up if the drops are stopped so it is vitally important these kids receive their medication regularly.

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