Are eye ailments on the increase?

About ten in every one hundred Rwandans are consulting and seeking treatment or corrective lenses for different eye ailments, experts say.
A man has his eyes checked at Dr Agarwal’s Eye Hospital. (Timothy Kisambira)
A man has his eyes checked at Dr Agarwal’s Eye Hospital. (Timothy Kisambira)

About ten in every one hundred Rwandans are consulting and seeking treatment or corrective lenses for different eye ailments, experts say.

According to Abdallah Uwihoreye, the country director of Vision for a Nation (VFAN), an N.G.O that partners with the Ministry of Health to implement primary eye care, consultation for sight related ailments has been increasing over the past four years.

“We work with 471 health centres countrywide, and each receives 20 to 40 people per day; unlike about four years ago when there used to be two to four, even though it’s difficult to tell what could be driving it now,” he said.

Eye refractive error, cataract, conjunctivitis, bacterial allergies, and glaucoma are the most common. Refractive error is corrected using eye glasses. It is either genetic or caused by old age. According to Uwihoreye, 70 percent of people with eye ailments in Rwanda are above age 40.

“The increase in consultation can partly be attributed to increased roll out of eye care services over the years. While today every public hospital and health center offers some kind of eye care service, about 6 years ago the whole country depended on Kabgayi Hospital and Rwanda Military Hospital,” he said.

Back then, eye care was very expensive with consultation and examination alone costing Rwf 30,000 and above in private facilities. And a pair of eye glasses was Rwf 30,000 and above.

The 2012 census shows that there are 57,000 blind people countrywide.

Today, about 1000 nurses, two from each health center, have been trained by VFAN to provide primary eye care. The organization has so far distributed 200,000 eye glasses to individuals through the Ministry of Health at only Rwf 1,000.

It is also working on a joint project with the ministry that will see lessons on primary eye health care introduced in the syllabi of all the seven nursing schools in the country.

In recent years, there have also been drives either by the Army, NGOs or private institutions, aimed at enhancing eye health. For instance in September, 2012, over 7,000 inmates got free eye treatment, courtesy of doctors from Rwanda Defence Forces.

The 40-day drive that covered all prison facilities in the countrywide also saw 145 inmates referred to the military hospital for surgery while 4,134 were given eye glasses.

In the past one week, about 80 people selected across the country with eye cataracts got free surgical procedures at Ruhengeri Hospital courtesy of Barraquer Foundation, a Spanish-based non-profit organisation whose goal is to provide eye care.

Focus Ahorukomeye, 65, from Shyira Sector in Nyabihu District, could not hide excitement after regaining his sight last Sunday, after years of impaired vision.

“I was a burden to society. I used a walking stick to move whenever I had no guide. I was treated and now I can see clearly, I am thankful to the doctors who treated me and hope my life is going to change,” Ahorukomeye said.

Improved infrastructure

Eye care infrastructure has also seen a big boost in recent years. For instance, January 2013 saw one of the major global eye care centres, Dr Agarwal’s Eye Hospital based in India, open shop here.

The facility, which cost about $6 million handles complicated eye cases like retina surgery, hi-tech cataract surgery, glaucoma, paediatric ophthalmology and corneal transplantation.

In April this year, the facility introduced another hybrid service, a type of eye sight correction surgery that before could only done in South Africa as far as the Sub-Saharan Africa is concerned. 

The procedure called, refractive error correction, is done by planting artificial contact lens in a patient’s eyes so as to permanently cure short/long sightedness. In other words it’s a perfect replacement for spectacles.

Dr Ashvin Agarwal, a cornea and refractive surgeon working with the same hospital, said that lens implant costs about $1,500 for each eye. This now saves patients from travelling to South Africa, where similar care cost of $4,000 per eye.

The same hospital in October last year offered free eye treatment to about 200 drivers in Kigali,  as part of activities to mark world sight day.

The public transport drivers did not only receive treatment, but reading glasses and eye drops.
 
Challenges

Uwihoreye says that many people with eye ailments in rural areas have a habit of using herbs, which sometimes results in blindness despite the presence of health facilities.

As of October last year, Rwanda had only 14 qualified ophthalmology specialists, 40 ophthalmology technicians and 986 nurses trained to provide eye care services.

The World Health Organisation (WHO) statistics show that 95 percent of people with refractive error in sub-Saharan region do not have access to eye glasses.

As of August this year, the WHO estimated that 285 million people are visually impaired worldwide, 39 million are blind and 246 have low vision, and about 90 percent of the world’s visually impaired live in low-income settings.

It added that 82 percent of people living with blindness are aged 50 and above. And uncorrected refractive errors are the main cause of moderate and severe visual impairment; cataracts remain the leading cause of blindness in middle- and low-income countries.

The number of people visually impaired from infectious diseases has reduced in the last 20 years according to global estimates work. And 80 percent of all visual impairment can be prevented or cured.

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