His story is a common one. Global estimates suggest that people with moderate to severe vision impairment are about 30 per cent less likely to be employed than those with good eyesight.¹ For lack of a pair of eyeglasses, for want of a simple cataract surgery, millions of people are unable to work. It can keep entire families stuck in the cycle of poverty.

Abraham’s story has a happy ending. After meeting a community health volunteer during a door-to-door eye health screening, he was diagnosed with bilateral cataracts and got sight-restoring surgery on both of his eyes at one of our partner hospitals. He started taking in shoes for repair once again.

But many people won’t get back to work like Abraham did. And that’s because basic eye care isn’t available or accessible to them. According to estimates, about 2.2 billion people worldwide have vision impairment, and in roughly half of those cases, the vision loss could have been prevented or hasn’t yet been treated.²

Lack of access to eye health care

For many people across the globe, the neighbourhood optometry clinic simply doesn’t exist. While people in Western Europe enjoy a ratio of one optometrist to every 3,877 people, countries in central sub-Saharan Africa reported a ratio of one to every 1,198,141 people, according to a 2023 study.³ Even when there is an eye care provider in a nearby city, the barriers to reaching them can be insurmountable for some people living in remote and rural areas. Many can’t afford the bus or train fare, let alone the fees for diagnosis and treatment. And for women and children, travelling alone can be dangerous, so they often need to wait for someone – usually the family breadwinner – to take time off work to escort them. For those with seriously impaired vision or other disabilities, travel might be nearly impossible.

Every day, the community health workers who do eye screenings on our behalf meet people who have previously tried to solve their vision issues without success. Many patients had visited the nearest healthcare provider, often a local dispensary, and were sent home with eyedrops or told their vision couldn’t be treated. Some had bounced around from clinic to clinic, others had resigned themselves to living out their days in blindness. That is why we are working hard to provide eye health care services at the community level.

By connecting people with our partner vision centres and hospitals, helping cover fees and offering safe transportation to the hospital, we can help restore vision to people who may never have gotten treatment otherwise. It’s just one of the ways we are working towards the United Nations Sustainable Development Goal number one: No Poverty. By addressing some of the root causes of poverty, like poor eyesight, we can help people stay employed and stay in school.

How eyeglasses can improve income

The global productivity loss attributed to impaired vision is estimated at $411 billion US annually.⁴ And those effects can be seen on the individual level as well.

A recent study looking at workers with presbyopia between the ages of 35-65 in Bangladesh found that those who had reading glasses made 33 per cent more than those who did not.⁵ The study, published in PLOS ONE, tracked the incomes of more than 10,000 participants who work in near-vision intensive occupations – like tailors, mechanics and carpenters – over eight months. Half of the participants received reading glasses right away, while the control group only got a pair after the eight months of data collection. The eyeglasses themselves cost only about US$3-4 per pair but had the potential to transform the lives of the workers.

Another study of tea pickers with presbyopia in India found similar results in 2018.⁶ In that case, the three-month study found that a pair of reading glasses increased productivity for the plantation workers – who are paid by the kilogram of leaves picked – by about 22 per cent, and 32 per cent for those over the age of 50.

As these studies show, addressing vision loss can increase productivity and provide greater economic opportunities for individuals.

The chicken or the egg

Like many other health issues, it can be difficult to untangle the relationship between low incomes and eye health problems. Poor vision can lead to poverty because people often lose or quit their jobs when they’re no longer capable of doing them effectively or safely.

Take Junmoni in India, for example. The mother of two dreamed of sending her daughter to college with her earnings making handwoven fabrics on her loom. But when her vision became blurry, she had to stop weaving. Money got so tight that she was on the brink of selling her handloom. Fortunately she met a community health worker who told her she just needed to visit the local vision centre to get a pair of eyeglasses. Junmoni now wears her prescription eyeglasses while working at her handloom, her dreams for her daughter back on track.

But just as vision loss can lead to poverty, the opposite may also be true.

An infectious eye disease, called trachoma, continues to cause vision loss and blindness in dozens of countries around the world. It is widespread in some rural areas, and also in regions where there are high rates of poverty. The bacteria spreads through personal contact, via hands, clothes and bedding, and by flies that have been in contact with discharge from an infected person. It is most common in areas where people don’t have access to clean water or have to travel long distances for water.

If left untreated, trachoma causes the eyelashes to turn inward and scratch the cornea, leading to severe pain, vision loss and even blindness.

The spread of trachoma can be managed when people have access to clean water, allowing for more frequent hand and face washing, and the cleaning of clothing and bedding. Antibiotics can also help prevent and treat trachoma in areas where it is endemic.

We work with partners and communities in Ethiopia, Kenya and Zambia to prevent the spread of trachoma by helping establish water boreholes and latrines and administering antibiotics.

Ninety per cent of vision loss is preventable or treatable, but people living in underserved communities are more likely to go blind. In fact, 90 per cent of people with vision loss live in low- and middle-income countries, which is why we’re working in these areas.

Reaching the unreached

Lack of education is another factor that keeps vision loss in lockstep with poverty. Some people don’t seek eye health care simply because they believe their condition is untreatable. Many older patients believe that vision loss, even blindness, is just an inevitable part of aging. In some communities there may be additional fear or distrust of medical authorities based on previous experiences, myths or other cultural stigmas.

By reaching people in their homes and communities through door-to-door eye screenings and eye camps, we can offer basic eye health education and choice to those who might never get treatment otherwise. And in cases where a patient might be hesitant to get surgery, our community-based approach enables health workers to continue counselling patients over weeks and months, reassuring them, explaining the benefits of a procedure and often convincing them to get treatment in the end.

Another way we work to prevent the devastating effects of vision loss is by making sure the youngest people in our project areas learn about eye health. By offering eye screenings and education in schools, organizations like ours can reach thousands of families through their children, who go home brimming with excitement over the vision test they took at school, and what they learned about eye health. By providing children with referrals to the nearest vision centre or partner hospital, the whole family is made aware of the services that are available to them.

Effects on the whole family

The effects of a cataract surgery often ripple down through the beneficiary’s entire family. We hear of many young women who have given up jobs or dropped out of school to care for a senior family member who has gone blind. Once the family member has had their vision restored through cataract surgery, they often regain their independence, freeing up their caregiver to devote that time to work, school or other economic opportunities.

And parents who have had their vision problems corrected, like Junmoni, are better placed to keep their children in school longer, and even send them off to advanced education, potentially lifting future generations out of poverty.

Finally, children with vision problems who get corrective eyeglasses or treatment fare better at school. In fact, prescription eyeglasses have been shown to have a greater impact on academic achievement than other health interventions, like nutrition and deworming programs.⁷ This is why we are currently expanding our school eye health programs, so we can help more children thrive in school so they can get the best possible start on their working lives.

The road ahead

While many organizations like ours are collaborating with partners, governments and funders to address vision loss and blindness, aging populations and population growth mean that the problem will increase if we don’t act quickly. Some estimates say that by 2050, half of the global population will have myopia.⁸

You can help us continue our mission to prevent blindness and restore sight by following us on our social media accounts, signing up for our newsletter and sharing what you’ve learned with friends and family. Join our global community today.

1. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00132-2/fulltext ↩︎
2. https://iris.who.int/bitstream/handle/10665/328717/9789241516570-eng.pdf ↩︎
3. https://www.researchgate.net/publication/375055096_Global_mapping_of_optometry_workforce ↩︎
4. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30488-5/fulltext ↩︎
5. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0296115 ↩︎
6. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30329-2/fulltext ↩︎
7. https://educationcommission.org/updates/providing-eyeglasses-school-age-children-high-impact-investment-education/ ↩︎
8. https://www.essilorseechange.com/wp-content/uploads/2020/02/Eliminating-Poor-Vision-in-a-Generation-Report.pdf ↩︎

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Priya in Nepal can’t remember when she first started having trouble seeing, but her vision kept deteriorating until one day she fell and injured herself while climbing the steep trail leading from the village to her house. Figuring that blindness was an inevitable part of old age, she stayed at home, unable to visit friends and grandchildren. Eventually she couldn’t even reach the outhouse without assistance. She felt like a burden to her family.

Mary, in Kenya, loved school from her very first day in the classroom and dreamed of becoming a teacher someday. After she turned 13, she started having trouble reading the chalk board. She had to copy notes from her friends and couldn’t do her homework in the dim light at her house. Her grades began to slip. She asked her parents to take her to an eye doctor, but money was too tight because they were saving to send her brother to college. By age 15, Mary quit school and decided to get married, her hopes of teaching now crushed.

None of these characters are real, but they represent the millions of women and girls around the world who are living with avoidable vision loss and blindness. We hear stories like these every day.

The prevalence of vision loss is higher among women and girls than it is for men and boys; 55 per cent of people experiencing vision loss are female. And while there are some biological factors at play, the reasons for these discrepancies are largely social.

Why women and girls experience more vision impairment

Women live on average longer than men, and many conditions that rob people of their sight are associated with old age. This includes cataract, presbyopia, glaucoma and age-related macular degeneration. According to estimates, two-thirds of cataract blindness globally occurs in women.

Traditional gender roles are another factor, especially in some regions.

Women and girls are two to four times more likely than men and boys to get trachoma – the leading infectious cause of blindness worldwide. Trachoma is caused by bacteria that spreads through contact on hands and clothing. Small children are especially susceptible, and in turn, they often pass it on to their caretakers. Women and girls may also get infected from household cleaning and doing laundry.

Obstacles to eye health care access

The barriers to health care for women and girls vary widely from region to region, but there are trends that we can observe across the countries where we work. These include:

• Cost and lack of financial decision-making capacity: Men often control the family finances. Women are less likely to work outside the home, meaning that the men and boys in their family who earn an income are often prioritized for spending on treatment.
• Limited healthcare infrastructure: In some regions, particularly in rural areas, inadequate healthcare infrastructure makes it difficult for women and girls to access eye care. The cost or lack of public transportation to the nearest facilities can exacerbate this problem for many women and girls, as can the social taboos and safety risks presented by travelling alone.
• Family responsibilities: Running a household and taking care of family members, duties that often fall on women, can make it challenging for women to take the time they need to get eye care.
• Lack of information: Unequal access to education for women and girls contributes to lower literacy rates and educational levels, which make it more difficult for women to learn about a specific eye condition or find out where they can get it treated.
• Cultural stigmas: Cultural norms and stigmas surrounding health issues, particularly eye health, can dissuade women from getting help. These cultural barriers may result in delayed or avoided medical attention.
• Lack of female healthcare professionals: A shortage of female healthcare professionals in the eye care sector can create discomfort for women and girls, potentially discouraging them from seeking assistance.

Addressing these diverse challenges is crucial for breaking down the barriers that prevent women and girls from accessing essential eye health care services.

Working toward gender equality

Our approach, called the “Hospital-Based Community Eye Health Program Model,” is designed to address inequalities to accessing eye health care, starting at the village level.

Most of the community health workers trained by Operation Eyesight’s partner hospitals are women, which gives them the opportunity to become trusted leaders in their communities and helps them contribute to family finances. They also bring eye health screenings to people’s doorsteps, meaning that women and girls don’t need to travel to get primary eye care and referrals.

Additionally, we work with our partner hospitals to establish vision centres closer to the communities where we work, making it easier for everyone to access diagnosis and treatment. Our partner hospitals also provide safe transportation for patients – usually by bus – to the hospital so that they can get their surgeries without worrying about how they’ll get there.

Finally, by providing surgeries, eyeglasses and other treatments free of charge – or at a highly subsidized rate – we can decrease some of the financial barriers women and girls face. We strive to provide quality eye care services to everyone – regardless of gender, age, ability to pay or other personal circumstances.

Dismantling gender-related eye health myths in the foothills of the Himalayas

In the villages of the Udhampur block in Jammu region, vision problems are often seen as a sign of bad luck. A girl wearing glasses might be told she’ll never have a good marriage, and a baby’s bad eyesight might be blamed on past life sins. A girl with a squint could be seen as a curse for the whole family.

Those are some of the beliefs a recent pilot project took aim at.

Created in partnership with NorQuest College and the Rotary Eye & ENT Hospital, the project provided services through a “Mobile Vision Centre” – a four-wheel-drive van staffed with an eye health team comprised mostly of women. The van roamed the area’s rugged roads, bringing primary eye care and education to people’s doorsteps.

More than 27,000 people received training pertaining to eye health myths during the project duration. A before-and-after survey that checked people’s attitudes and beliefs regarding eye health for girls and women showed dramatic differences after the intervention. With that success in mind, our teams are looking to implement strategies from the project throughout our programs.

Donate today to help us bring quality eye health care to more women and girls.

The post Gender inequalities in vision loss appeared first on Operation Eyesight.

“We learned that patience is very important to handle kids of this age group,” laughs Jyotsna, one of the volunteers from Sagility Health. Smiling, she adds, “the kids were amazing, and they were cooperative, and the event went really well.”

The screening was part of our corporate relations programme, which invites companies to financially support eye health initiatives and provides their employees with the opportunity to participate in programme delivery.

In this case, volunteers from Sagility Health helped organize the excited children into queues, documented the students’ information, and held up the “Tumbling E” eye charts – standard tools used when screening young children for eye conditions. Members of the ophthalmic team from the L V Prasad Eye Institute (LVPEI) were on hand to conduct a more thorough screening on any child identified as having potential vision problems.

In a single day, 16 children received prescriptions for eyeglasses and another three got referrals for further diagnosis at LVPEI. All the children took part in an eye health education session, which included instruction in eye exercises and diet.

In addition to helping with the screening, the Sagility Health volunteers also made donations to cover the cost of the prescription eyeglasses for the students who needed them.

Over the past decade, we’ve been developing a range of school eye health programmes, both in India and in our other countries of work. The idea is to train teachers and volunteers to conduct or assist with eye health screenings right in the classroom. This means we can screen more children, and helps us make sure that girls, often overlooked for eye health care, are getting the same access as their male counterparts. Finally, by reaching out to children, we can help them and their families become familiar with the eye health care available to them, empowering them to seek eye treatment in the future.

Our Head of Resource Mobilization Subhadip Bhattacharya, who organized and attended the event, says he looks forward to facilitating more volunteer projects like this one.

“The energy from the students was palpable,” he says. “They were so excited to participate in the eye screenings. Likewise, the volunteers from Sagility Health had a great time and learned a lot about eye health. This is the first time they participated in a student eye screening volunteer programme, and their enthusiasm was notable. It’s a win-win for us when we can provide eye health screenings to children while also offering an exciting employee experience to our corporate partners.”

Two of the volunteers say they were touched by all the students clamoring for their attention and addressing them as ‘teacher’. “We are feeling very happy,” they say, “We are recollecting our school days.”

To learn more about our corporate relations program, visit: operationeyesightindia.org/corporate-relations

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Vision First for surgery patients in Ghana

We celebrated in Ghana by literally putting Vision First! Our partner hospital, Watborg Eye Services, conducted 305 eye surgeries as part of the celebration, as well as screening for eye problems at Watborg and Saltpond Government Hospital. We also held a media briefing and an eye health promotion, which was well attended by 12 local media houses.

The national launch of WSD was held at Chapel Square, in Ghana’s Cape Coast. In attendance were heads of local departments and agencies, representatives of eye NGOs, and the Regional Director of Ghana Health Service – Central Region, Dr. Alexis Beifubah. As part of the event, Dr. Beifubah presented Operation Eyesight with an award for our contributions to eye health and for organizing activities during WSD 2019.

Clean glasses in Calgary, Canada

In Calgary, we took to downtown’s Stephen Avenue to raise awareness and remind people to put Vision First, joined by volunteers from Encana Corporation. Together, we handed out 1,000 eyeglass cleaning cloths, wished even more people a happy World Sight Day, and reminded everyone to book an eye exam. Canadians might not share the same challenges to eye health as people in other places around the world, but avoidable blindness will only be eliminated when everyone is empowered to take care of their eye health!

Vision First in 22 communities in India

In collaboration with our partners Nepal Eye Hospital, Sri Sankaradeva Nethralaya and Bansara Eye Care Centre, we celebrated WSD by declaring a total of 22 villages free of avoidable blindness. The declaration ceremony was attended by government officialsand stakeholders, and was covered by local print and digital media. Also, our Country Manager for India, Anup Zimba, participated in a walkathon organized by Vision 2020 in Jaipur, along with 700 others.

Outreach puts Vision First in Kenya

In Kenya, we put Vision First by conducting an outreach event to provide eye care services to people in Kirinyaga Country, where we’ve implemented our Hospital-Based Community Eye Health Program model in 150 villages. The result was 36 cataract surgeries and 182 people receiving treatment for different eye issues.

There was also education to emphasize the need to prioritize eye health, especially for women who are often too busy with farm work to seek eye health care. The message to everyone who received outreach was simple – make time to get your eyes screened and treated. That will help everyone lead more healthy and productive lives.

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