optometry.naija: The perspective of the Nigerian Optometrist.

optometry.naija: The perspective of the Nigerian Optometrist.: realblazzer 27 June 2012 at 23:10 I don't think you have critically addressed the role of optometrist in Nigeria under this blog. R...

The perspective of the Nigerian Optometrist.

realblazzer27 June 2012 at 23:10

I don't think you have critically addressed the role of optometrist in Nigeria under this blog.

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Ezebuiroh Victor28 June 2012 at 20:11 You said the truth. I am working on more of those problems. The aim of this blog to summerize the challenges we face and see how it goes. Thanks for your incite. I will be very happy if you can help me throw more light on this.

The above was an exchange I had with @realblazzer in June 2012. 
The truth of the matter is that the role of the Nigerian Optometrist is an overlapping phenomenon, hence I have decided to discuss it as a "perspective", a "concept" vs a "definition"; a "vector" vs a "scalar" quantity. This is not a one fist fit all discussion but a more transparent and honest background analysis of "what" the Optometrist is all about.
Let me refresh your minds a little bit.
Eye health care are pattern of health care services solely designed to cater for the eye. Different categories of personalities are involved in providing eye care services. The Ophthalmologists, the Optometrists, the Ophthalmic nurses, the opticians. The primary function of the eye is vision. 
Vision is a concept of the rods and cones responding to light stimulus such that impressions are sent to the higher centers of the brain to create perspective of the solid world. The role of the Eye care professional (ECP) is to preserve vision. Vision is lost as a result of obstruction like cataract, corneal degeneration; or it could be lost as a result of loss of function like glaucoma, retinopathies. It could also be lost or reduced as a result of optical deficiencies like refractive errors etc.

So what is the perspective of the Nigerian Optometrist in all these?
Ones vision is lost, blindness becomes the default. Optometrists are trained for a period of 6 years primarily to prevent loss of sight and to rehabilitate subnormal vision. They are trained to identify diseases of the eyes that can cause blindness with the use of such diagnostic sets like the retinoscope, ophthalmoscope, Slit-Lamp Biomicroscope (SLB), perimeters, tonometers, flouresine strips, A& B scanners etc... 
Optometrist do not perform surgeries in Nigeria but are required to"... (d) diagnose and manage minor  ocular infections which do not pose a threat to the integrity of the occular or visual system; ..." {Odorbn act, Part VI: Miscellenous. 29. Interpretation}

But in eye disease conditions the use of "minor" as an adjective is a misnomer. A condition as overlooked as conjunctivitis could become keratoconjunctivitis with a sequela of corneal scar and subsequently blindness. And a condition like retinopathy, when well managed, could become "cured". Hence categorizing eye care disease conditions as "major" or "minor" begs the question rather than provide a proper perspective. That being said, the Nigerian Optometrist, just like Optometrists world over, are portals whose role it is to keep out blindness. They have a perspective though. 

The optical property of vision is a function of both the anatomy and physiology of the eyes. There is usually a disruption of either of binocularity, visual acuity, refractive errors, when the normal anatomy and/or physiology of the eye is disrupted. Overtime, Optometrists have being able to juxtapose the optical disfunction with associated anatomic and/or physiologic manifestations to ease diagnosis and to diagnose early such that management commences and irreversible damages to the eyes are nipped in the bud.
Optometry, unlike Ophthalmology, is a means to an end while the later is an end in itself. Optometry is a process which sums up the efforts, overtime, of extrinsic factors to provide intrinsic solutions that are usually non-inversive. 

In Nigeria, there is a huge disconnect, just like in most 3rd world countries, between eye care and general health care; between Ophthalmologists and the Optometrists etc... The result is a lag, a huge lacuna created and a serious health challenge that has taken a supernatural dimension and a health burden that will hunt many generations to come. 
This is the singular reason why African continent is still battling to implement the goals of MDG (Millinium Development Goals), while the UN have gone ahead to introduce Sustainable Development Goals (SDG). The former, MDG, targeted disease, poverty and hunger; and the later, SDG, focuses on economic development, environmental sustainability and social inclusion.

When, for instance, the eye care professionals in Nigeria cannot develop a synergic relationship and policies to reduce blindness and visual handicap, it is not surprise that penultimate days ago as our teachers were celebrating their day, October 5th, they were still deliberating on MDG and not even pre-MDG priorities. This is the stark reality in practically every sector that the efforts of MDG have being employed in our national growth and development.

In conclusion, as much as this response of mine is exhaustive, I wish to reinterate that we should use this year's WSD (World Sight Day) celebration on October 8th 2015 as a sobering moment to reflect on the journey so far.

Let us reflect on how much of the MDG targets we were able to meet. Let us reflect on how much of the MDGs we were not able to meet as a targets missed and quickly look at the post-2015, post-MDG period and SDG priorities such that the Optometrist's perspective to inclusive eye care, strong economic growth in the eye care sector etc are not only developed but they are born.

By the way, the 2015 WSD call for action is: "Eye Care For All."

Do the Optometrists in Nigeria have the necessary tool to tackle the overwhelming challenges visual anomalies? What are the structural basis from which, like a springboard, the Nigerian Optometrist can leap into the future of eye care service provision both in the private and public sector? So many questions with answers so few and far in between.