Refractive error is an unfinished agenda of global public health with almost 88.4 million people with moderate or severe distance vision impairment or blindness due to unaddressed refractive error and 826 million people with near vision impairment caused by unaddressed presbyopia. This figure is amongst the 1 billion people with avoidable vision impairment or blindness.
Optometrists are undoubtedly the specialised health care professionals in charge of managing the refractive error in the world. Determination and correction of refractive error is the most common reason patients seek optometry services; binocular vision analysis and correction with either spectacles or contact lenses. Their service has become more significant now than ever with the alarming rise in refractive error, especially myopia in these few years. Studies suggest that this rise in myopia is significantly associated with the virtual shift in the lifestyle of children and adults in response to the COVID-19 pandemic.
There are three groups of eye health professionals recognised by the World Health Organization (WHO); ophthalmologist, optometrist and allied ophthalmic personnel. The World Council of Optometry defines optometry as a ‘…health care profession that is autonomous, educated, and regulated (licensed or registered), and optometrists are the primary health care practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection or diagnosis and management of disease in the eye, and the rehabilitation of conditions of the visual system .
An optometrist has as a minimum completed a bachelor’s degree or equivalent education from a tertiary level educational institution and is categorized minimally in the category of the global competency-based model of the scope of practice in Optometry which includes optical technology services, visual function services and investigation, examination and evaluation of the eye and adnexa, and associated systemic factors, to detect, diagnose and manage diseases. All other formal or informal cadres that fall below this level (e.g., optometric technicians, optometric assistants, opticians, refractionists) are not entitled to call themselves optometrists’ .
Optometrist as a core eye health professional has a critical role in 2030 In Sight, the sectors’ strategy for the next decade. 2030 In Sight aims to see a world in which no-one experiences unnecessary or preventable sight loss and everyone can achieve their full potential; eye care and rehabilitation services are accessible, inclusive and affordable to everyone, everywhere, whenever they are needed; and people understand the importance of caring for their own eye health and demand access to services, free from the weight of any social stigma. The three pillars of the strategy are: Elevate vision as a fundamental economic, social and development issue; Integrate eye health in wider health care systems; and activate patient, consumer and market change. Optometrists are an important part of the force that can give this strategy a push to overcome the hurdle and turn the goal into reality by 2030.
Many countries in the world are working hard to ensure recognition and to get optometric education and practice to international standards. Their resilience and commitment to providing top-quality primary eye care to the patients is outstanding. This World Optometry Day can be utilised as an excellent opportunity to showcase their potentialities at the policy-making level and strive for the recognition they need, and deserve, at the national as well as regional level. Both the number and the distribution of optometrists is a challenge in delivering eye health services. Sub-Saharan Africa faces a shortage of optometrists with 2 of them per million population while there are 156 per million in high-income North America .
WHO is developing the Eye Care Competency Framework, a tool to provide a global standard of eye care competencies that will assist in workforce planning and development, informing education institutions in preparing workers for practice, and setting practice standards for employers, policymakers and regulatory bodies. This framework will be a key mechanism to align the eye care workforce with population needs. Implementation of the Eye Care Competency Framework is critical in the countries to achieve uniformity in the service delivery and ensure that all aspects of eye health services are within reach of people in need.
In the face of a billion vision impairment challenges worldwide, World Optometry Day is an excellent opportunity to be grateful to optometrists and their efforts in preventing avoidable vision impairment and blindness in the world. In addition to managing eye problems and bolstering the elimination of avoidable blindness from the world, optometrists’ contributions in research, policy, advocacy and community awareness are noteworthy. The integration of optometry into the health system of every country is critical to ensure that there are clear routes to the right care. For this World Optometry Day, let’s ensure we continue to care for our vision along with optometrists, the eye health professional for comprehensive eye care.