Why over 4.25m adult Nigerians are ‘blind’, by ophthalmologists

Ahead of today’s World Sight Day (WSD), ophthalmologists have raised the alarm that over 4.25 million adults in Nigeria, aged 40 and above, suffer from moderate to severe visual impairment or blindness.

WSD is marked every second Thursday of October to raise awareness about retinal diseases and care of the eyes. It is also to support Sightsaver’s work to combat avoidable blindness. The theme of this year’s event is ‘Love Your Eyes’.

The ophthalmologists said cataracts, glaucoma and uncorrected refractive errors are leading causes of blindness. While cataract is the leading cause of blindness (reversible), followed by glaucoma (irreversible), uncorrected refractive errors are the leading cause of visual impairment.

They also decried the situation where Nigeria has 700 ophthalmologists to 200 million people against the World Health Organisation’s (WHO) recommendation of one ophthalmologist for 50,000 people in developing countries.

They warned that the number of people with vision loss is expected to rise from 1.1 billion in 2022 to 1.7 billion by 2050, adding that ageing populations and increased prevalence of non-communicable diseases (NCDs), such as diabetes, could exacerbate eye health issues in years to come. They said natural eye drops clear immature cataracts but are not very effective in patients with uncontrolled diabetes mellitus.

As part of efforts to address the situation, they recommended, among other things, that there is a need for government to prioritise healthcare in Nigeria, improve remuneration for healthcare providers, boost eye-care services in rural communities, scale up awareness at both rural and urban areas and create more revolving funds for the health sector in general.

The experts include a professor of ophthalmology at the College of Medicine, University of Lagos (CMUL)/Lagos University Teaching Hospital (LUTH) Idi-Araba and Chairman, Lagos State Traditional Medicine Board (LSTMB), Adebukola Adefule-Ositelu; and a consultant ophthalmologist and senior lecturer at LUTH, Dr. Olubanke Ilo.

According to the national blindness and visual impairment study, the latest Nigerian survey did so far (2009), it is estimated that 4.25 million adults, aged 40 years and above, have moderate to severe visual impairment or blindness. Prevalence of blindness was 4.2 per cent and severe visual impairment was 1.5 per cent.” Ilo said that based on the WHO action plan for the prevention of avoidable blindness and visual impairments from 2014 to 2019, over 80 per cent of global visual impairment is avoidable (that is preventable or treatable). She said, in spite of this, millions of people remain at risk of vision loss due to a lack of awareness/poor health-seeking attitude. “The average Nigerian waits until he/she has noticed changes in his/her vision or has pain or itching before he/she goes for an eye check. Unfortunately, one of the leading causes of blindness is glaucoma, a disease that is silent and gives no sign until it is too late. And by the time the person notices that his/her vision is impaired, it would have gone too far and too late to reverse,” she said. Ilo added that many of the highly skilled eye care workers, particularly ophthalmologists, are leaving Nigeria for other countries, where there is adequate technology and better remuneration. Ilo said this problem is further compounded by the high cost of health services, poor access to medical facilities, and poor management of the healthcare system, among other challenges facing the practice of medicine and contributing to the paucity of healthcare personnel. “Nigeria, being the most populous country in Africa with about 214 million people, simply does not have enough healthcare practitioners to serve its population with only about eight ophthalmologists to one million people, compared to Europe with about 71 ophthalmologists to one million population. “WHO categorises Nigeria as a group of Sub-Saharan countries in Africa where the estimated prevalence of blindness among those over 50 years of age is one of the highest in the world at nine per cent. The high proportion of avoidable blindness, with half attributable to cataracts alone and uncorrected refractive errors, is responsible for 57 per cent of moderate visual impairments, it then means that appropriate and accessible refraction and surgical services need to be provided. If priority attention is not given, the number of blind and severely visually impaired adults was projected to increase by over 40 per cent over the decade,” she said.

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