Three things you need to know about eye health awareness

A girl in Pakistan holds an eye health awareness poster

1) Awareness about eye care is essential for managing eye conditions and reducing vision impairment.

Almost everyone will need help with their vision at some point in their life. Even then, there is a general lack of awareness and knowledge about eye conditions and good eye health practices, leading to lack of demand for eye care services, and subsequently financial and political will. A large proportion of individuals remain undiagnosed because many eye conditions are often asymptomatic in their early stages.[1]

What did the WHO World Report on Vision say about eye health awareness?

For integrated people-centred eye care to accelerate actions and meet the global challenges we need to raise awareness and engage and empower people and communities about eye care needs.[1]

What did the Lancet Global Commission on Global Eye Health say about health promotion?

The eye health sector has traditionally focused on treatment and rehabilitation, and underused health promotion and prevention strategies to lessen the impact of eye disease and reduce inequality.[2]

2) Increased health literacy can empower individuals and communities to actively engage with and use the eye care services they need.

Health literacy is how people access, understand, appraise, remember and use health information and services.
The WHO has recently published a series of reports on health literacy development for the prevention and control of noncommunicable diseases. These reports state that five health literacy actions are key to people successfully turning health information into health knowledge.[3]

People access information in different ways
People have different levels of knowledge and understanding of eye health
People have different abilities to decide which information is trustworthy or relevant
Health knowledge needs to be remembered and retrieved when needed
Using knowledge involves daily decisions about prevention, managing symptoms and making or attending appointments

3) What are the priority areas for health promotion and education?

Eye health promotion and education should be delivered across all levels of the health system. At the community and primary care level, there should be a focus on simple and effective education and counselling.[4]

The WHO Package of eye care interventions (PECI) has summarised key evidence-based areas for health promotion and education:

Children

Behavioural change to delay the onset and progression of myopia: Providing information to parents, caregivers and teachers about intensive near vision activity (as a risk factor) and longer time spent outdoors (as a protective factor), to reduce the onset and progression of myopia and high myopia.
Spectacle compliance: Providing information among children, and parents, caregivers and teachers of children and infants, of the importance of compliance to spectacle wear to avoid the negative impact of uncorrected refractive error on academic performance and other aspects of their life.
Nutrition and immunization to prevent secondary eye conditions: Nutritional education regarding a healthy, vitamin A-rich diet, and the importance of measles and rubella immunization and vitamin A supplementation to prevent secondary eye conditions.

Adults

Control of key risk factors for diabetic retinopathy: Education and counselling on the importance of the management and control of key risk factors for diabetic retinopathy, including hyperglycemia, hypertension, and hypercholesterolaemia, and appropriate referral, where indicated.
Lifestyle or behavioural risk factors for eye conditions: Providing information and counselling on the risk factors for various eye conditions, including smoking (age- related macular degeneration, dry eye and cataract); exposure to ultraviolet light (cataract and pterygium); prolonged use of digital devices (dry eye disease); and long-term use of corticosteroids (cataract and glaucoma).
Persons at risk of developing acute angle- closure glaucoma: Providing information and counselling on the symptoms of developing acute angle-closure glaucoma for populations or persons at risk, with instructions to seek immediate ophthalmic attention if symptoms occur.

All ages

Importance of regular comprehensive eye examinations: Raising awareness of the importance of regular eye examinations among high-risk population groups, such as older adults, people with diabetes, those with certain genetic conditions (e.g. sickle cell disease), and those with a family history of glaucoma or age-related macular degeneration.
Adherence to treatment regimen for chronic eye conditions: Counselling around chronic eye conditions (e.g. glaucoma and amblyopia) regarding the importance of adherence to the treatment regimen; this is an important strategy to improve long- term compliance with recommended treatments.
Increasing demand for eye care interventions: Increasing awareness of common vision-related issues and the available interventions that exist to address them (e.g. spectacle-wear and cataract surgery).
Ocular injury prevention: Improving awareness of trauma prevention strategies, including the provision and use of protective equipment (e.g. masks, protective goggles, visors, etc.) in high risk activities and industries (e.g. certain sports, agricultural activities, construction, welding).
Counselling on good eye health practices and prevention strategies for the spread of eye infections: Counselling persons on good eye health practices, avoiding irritants to prevent ocular allergies and inflammation; and measures to prevent the spread of ocular infections including facial cleanliness, hand washing and separate towel use.

(Adapted from WHO Package of eye care interventions [4]

These strategies, if provided in a way that allows people to access, understand, appraise, remember and use the health information and services, will allow people to enjoy increased control over their eye health.

Further resources:

References:

World Health Organization (WHO). World report on vision. Geneva: 2019.
Burton MJ, Ramke J, Marques AP, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health 2021;9:e489–551. doi:10.1016/S2214-109X(20)30488-5
World Health Organization. Health literacy development for the prevention and control of noncommunicable diseases: Volume 1. Overview. Geneva: 2022.
World Health Organization. Package of eye care interventions. Geneva: 2022.

Photo Credits

Khalid Saifullah