The start of the second decade of this century has a particular significance for those involved in eye care, being half way to 2020 and the Vision 2020 target to eliminate avoidable blindness. Globally, some 45 million people are blind and about another 600 million are visually impaired, of these nearly 500 million simply need a refraction and spectacles. While 90 per cent of blind people live in low income countries, there is still avoidable blindness in the developed world - a major challenge for those who deliver eye care.
In the developing world, the emphasis has changed from groups of practitioners establishing eye camps and carrying out eye exams or surgery and then disappearing, leaving no infrastructure behind. The emphasis now is on sustainability, using volunteer skills to build local capacity based on co-ordinated national plans for the training of eye care personnel and the building of vision centres. None of this can happen without support from donors and volunteers. For 25 years Vision Aid Overseas has been active in this work, initially sending volunteers to man eye camps and supplying recycled spectacles and now moving towards more sustainable solutions. Internationally Optometry Giving Sight raises funds to support sustainable refractive error and low vision projects and it is gratifying to see the two organisations starting to co-operate in the UK. There is also a role for optometry and optics in the aftermath of disasters such as the recent earthquake in Haiti. The experience gained in Sri Lanka after the devastating tsunami in 2004, when Australian optometrists went to replace lost spectacles and found that many people had no access to any form of eye care at all, is also likely to be the case in Haiti.
The Vision 2020 challenge in this country is very different. The UK Vision Strategy set out the need for greater investment to prevent and treat avoidable sight loss and visual impairment and in June 2009 the RNIB published figures for the current economic impact of partial sight and blindness in the UK adult population. With the professional organisations and eye care non-governmental organisations signed up, it is now up to government to provide resources to implement its recommendations. With a general election due, there is an opportunity to lobby political parties to do more than pay lip service to the proposals. Optometry can play a pivotal role in the achievement of Vision 2020 aspirations in the UK, but ony if the government can be convinced, in the way the Scots have, that there will be a positive return on its investment. Regrettably the continued price war between supermarkets and retail optical stores will do little to either raise the profile of the optometrists and dispensing opticians as professionals or to present a convincing argument for proper funding of the eye exam. ?