LIFESTYLE - SPORTS & WELLBEING

World Sight Day

Love your eyes…and your children’s



Children need to have close monitoring  of their eyesight through to adulthood, as the rise in short-sightedness among the very young has become a global concern KONSTANTIN_SHISHKIN/Shutterstock

Children need to have close monitoring  of their eyesight through to adulthood, as the rise in short-sightedness among the very young has become a global concern KONSTANTIN_SHISHKIN/Shutterstock

The theme of this year’s World Sight Day, celebrated on 13 October, is #Loveyoureyes. Regular Delano guest contributor Dr Lilani Abeywickrama stresses the need for regular examinations, particularly among children and babies.

This year’s World Sight Day aims to raise awareness on equitable access to ophthalmic care and the prevention of treatable eye conditions globally. It also shifts the focus on empowering individuals to look after their own eye health. The impact of sight loss is not negligible on quality of life but also carries wider socioeconomic consequences. 1 billion people live with a sight impairment that has yet to be treated or that could have been prevented. 90 million children and adolescents suffer with sight loss of which 2 million live with blindness.

Worldwide, the leading causes of visual impairment leading to blindness are uncorrected refractive errors and unoperated or undiagnosed cataract. These affect both adults and children and are curable – however in the latter this heavily relies on timely intervention and screening. What the WHO urges countries to acknowledge and act upon are the disparities and variability between and within nations for the access to adequate eye care and the barriers to these. Though variations in pathology predominantly exist between low- and middle-income countries, uncorrected refractive error remains the greatest concern amongst all populations regardless of income.

The need to push for the integration of eye care as part of universal healthcare coverage in healthcare systems is paramount
Dr Lilani Abeywickrama

Dr Lilani Abeywickrama

The WHO recently published its Report for 2030. Along with member states and other stakeholders in the field, feasible targets for the next decade were set for integrated people-centred eye care (IPEC). The need to push for the integration of eye care as part of universal healthcare coverage in healthcare systems is paramount. There is a call to support countries to provide quality eye care services, screening services (glaucoma, diabetic retinopathy, etc.) and drive compliance with spectacle correction. As our population ages cataracts and presbyopia are set to rise and given current lifestyle factors, myopia will too.

Understand your eyes

Ophthalmologists have been cautioning the public over the soaring rates of myopia in increasingly younger children, leading to other ophthalmic issues such as myopic maculopathy, glaucoma, or retinal detachment earlier in adulthood. Children are being diagnosed with short-sightedness at less than 8 years of age.

Previously prevalent in countries where lengthy hours of schooling indoors were the norm, this phenomenon has now very much become a global concern. With screen time having shot up during the pandemic lockdowns, limiting time outdoors and exposure to natural light, short-sightedness has risen dramatically. The myopia epidemic is not something that can be neglected. It may seem trivial to prescribe a pair of glasses. However, the issue is much deeper than that. In children it can be difficult to identify early and, in many countries, the sheer cost or access to obtain these spectacles is a barrier to treatment. Additionally, adherence to spectacle wear is poor due to lack of awareness.

Cataracts is known to most for its quick surgical turnover and prompt recovery – in adults. This is not the case in children. Screening and early diagnosis are paramount in the treatment from an early age to obtain the best visual outcome and avoid amblyopia. The surgery is not risk-free and unlike adults carries many post-operative sequelae. Children need close monitoring through to adulthood.

With screen time having shot up during the pandemic lockdowns, limiting time outdoors and exposure to natural light, short-sightedness has risen dramatically
Dr Lilani Abeywickrama

Dr Lilani Abeywickrama

In most of Europe congenital cataract screening is performed within the first days of birth and has been so for nearly two decades, given the simplicity of the screening test. Luxembourg has recently adopted this practice in the last year. In the developing world, health disparities exist as this simple procedure is not readily available to all, often equipment for diagnosis is lacking as are the required medically trained staff. We are not where we need to be in terms of universal ophthalmic healthcare.

Cherish your eyes

Babies do not have the faculty of signalling that their vision is failing. Instead, when their sight is impaired, one notices an obvious squint, delays in language development, delayed motor responses all of which could lead to lifelong impairment. The importance of screening early bypasses having to even wait for such detrimental signs. This is the role of every healthcare professional a child meets along its care pathway (neonatologist, paediatrician, GP, ophthalmologist, nurse, the list goes on). Children at school are sometimes picked up by teachers due to poor academic performance. If an individual slips through the screening net, into later life this translates to social and professional difficulties in adulthood. The burden of visual impairment causes anxiety, depression, social isolation, and issues with mobility. Rendering participation in the workforce extremely difficult for such individuals let alone living independently. Uncorrected myopia and presbyopia in adults alone cost global productivity losses close to $270 billion.

The 2030 report details the WHO global eye care targets as an increase in effective cataract surgery coverage and an increase in effective refractive error coverage. The aim: equitable high quality ophthalmic care for all at no financial load to the individual. Populations that are traditionally disadvantaged are shown in this report to continue to remain so. Strategies to increase access and affordability to people from rural areas, those with low-incomes, ethnic minorities, women, and the elderly are paramount. The most cost-effective of healthcare interventions is the correction of sight. Yet, we are failing those with unmet needs due to a lack of trained personnel, resources, and funding (eye care is not considered a priority by some governments). Challenges the report included were those of acceptability and affordability. Often the costs of eye services or accessing these are high and out of pocket for patients and in parallel the fear of operation or the adherence to spectacle wear are hurdles for appropriate treatment.

Examine your eyes

A patient once said to me “I did not realise how much my eyes meant to me until I began to lose vision.” As simplistic as it sounds, it carries a certain gravitas. We take our vision, our health, for granted when all is functioning well. We forget routine appointments and become complacent with our care.

You can act today as an individual. Make sure you and your loved ones are regularly examined. Part of raising awareness on this day is to make a pledge for a sight test to combat the disparities in care. Last year the international agency for the prevention of blindness (IAPB) saw a grand total of 3.5 million eye test pledges. This year World Sight Day hopes to do even better and is aiming for over 5 million sight tests.

Dr Lilani Abeywickrama is a trained ophthalmologist. Her main interest is advocating for health, technology and medical affairs. She currently works in the field of health and medical management in Luxembourg.