Practising Optometry in Naija

Optom
In 1981 the American version of Optometry was introduced in A.B.S.U & the first set OD (Doctor of Optometry) was inducted in 1987, since then the scope of practice entered on the fast drive. From lens prescription & glazing, to the dispensing of topical agents, then to the long term co-management of such chronic diseases with ocular co-morbidity like Diabetes, Hypertension, Rheumatoid Arthritis etc; finally today some Optometrists are venturing into minor ocular surgeries!
Eye care management is a complex and expensive procedure...but blindness is more expensive! Governments worldwide, often subsidizes the expensiveness of eye care management which the long run effect is the massive reduction in blindness and improved activities of daily living. It is not so in Naija.
Eye care is not a government priority in Naija. The trail blazing success in Optometry, which gives more than 75% of eye care services in this country, are mostly the private sector initiatives. More than 80% of Optometric practices in Naija are owned by private individuals. In southern Naija alone, 90% of Optometric clinics are run by individuals.
Government hospitals that run a well equiped Optometric eye centres can only be found in Abuja, Lagos and maybe in Portharcourt and Enugu etc. The reason is partly on the government's insensitivity to the health sector, partly the squabble between the very few Ophthalmologists practising in this country and optometrists practising locally; partly to the almost precarious regulatory board of ours - NOA & ODOBN (Nigerian Optometrist Association & Optometrists and Dispensing Optician Board of Nigeria).
Despite these odds, private practises especially in the rural & semi-rural areas, had to rely on obsolete equipments like the schiotz Tonometers etc in managing cases in those areas. The lack of credit facilities to site such Optometric centres in those areas are almost non available except from private donations or loans that attract 30% to 40% interest rates. In such circumstance, the cost of providing services to these rural and semi-rual areas comes with a high tag which these superstitious people could hardly affort. Inshort, pracising Optometry in the rural areas or semi-rural areas in Naija is an uphill task...in those areas, avoidable causes of blindness is winning!
Vision 2020 initiatives which were planned with the rurals & semi-rurals had been highjacked for personal aggrandizement. The cost of standard eye equipments are very prohibitive and there is a huge interllectual drain in this field to other countries where praticising Optometry is rewarding. This has allowed the untrained Opticians to take over especially in the south and by the horrible Ophthalmic nurses in the north of Naija.
More rural dwellers and semi-rural individuals are fast lossing the battle to avoidable causes of blindness, while Vision 2020 is less than 9 years from today! Is Vision 2020 a mirage or a reality?
Optometry has a role to play here as usual, we are asking all the factors contributing to this disgaceful loss in the battle for 'right to sight'. We have a stake here, yes, in restoring sight to the blind!
Dr Victor Ezebuiroh.