The blind are leading the blind when it comes to eye care
Blink and you’ll miss getting the attention you need
Ophthalmic care at 75 clinics in three provinces was so poor that it would probably be best if it wasn’t offered at all, experts say in a report in the online journal PLOS One.
Instead, clinics could simply offer eye health education, while referring patients for specialist care using “well-defined guidelines”.
Experts from the Anova Health Institute, an NGO that works closely with the Department of Health, said more than half of the clinics it visited were not even using eye-test charts properly.
The 10-strong team introduced a six-month programme to improve eye care at 20 clinics, but achieved only patchy success. “The package successfully improved some aspects of care, but further development is warranted together with debate regarding the positioning of eye service at primary health care level,” they said.The eye care at 14 clinics in the Cape Winelands health district, 25 in Johannesburg and 36 in Mopani, Limpopo, fell short of Health Department guidelines in the researchers’ initial assessment.
“Less than half ... had a staff member responsible for ophthalmic care and less than 10% had a designated ophthalmic consulting room,” they said.
“Despite the critical need for specialist referral to hospitals, less than 10% of primary health care facilities ... had meetings with hospitals about eye care.”
None of the Johannesburg clinics used eye-test charts properly, and up to half of the clinics in the north of the country reported running out of nine essential medicines in the previous three months.
When staff were tested on their clinical knowledge of eye care, fewer than a third scored above 50%.
The researchers, led by Rivka Lilian from Anova’s Johannesburg office, said: “Primary eye care services lack the organisation and resources to address the leading causes of visual impairment, namely uncorrected refractive error and cataract.”Even when cataract patients were referred to specialists, “surgery capacity in South Africa is markedly inadequate and there is a lack of commitment by senior management to increase cataract surgery rates”.