Practice scope and job confidence of two-year trained optometry technicians in Eritrea

Illuminating Perspectives: Navigating Eye Care Access in Sub-Saharan Africa Through the Social Determinants of Health

Ensuring access to proper eye health services is not only a fundamental human right but also crucial for preserving an individual's quality of life, preventing blindness, and promoting overall well-being. This is especially true in low-income countries like Sub-Saharan Africa (SSA) where recognizing the intricate relationship between access to healthcare and social determinants of health (SDOH ) is crucial to addressing health disparities. The goal of this study was to elucidate and highlight not only the barriers millions face in obtaining eye care but also pave the way for interventions and policies aimed at creating equitable access across diverse populations. To do this, a scoping review was conducted across the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed databases for studies meeting the search terms and inclusion criteria. The results show that intervention strategies that increase vision care must extend beyond the healthcare sector to address the multifaceted challenges. Collaborating with stakeholders involved in addressing broader livelihood issues, such as food security, education, and SDOH, becomes imperative to ensure comprehensive and sustainable improvements in vision care accessibility in SSA.

Barriers to the Diagnosis and Management of Keratoconus Among Optometrists in Kenya

Background

Early diagnosis and management of keratoconus (KC) are important for limiting visual complications of the disease. This study aimed to explore the perspectives of optometrists on the barriers to effective diagnosis and management of KC in Kenya.

Methods

An online questionnaire was distributed to optometrists in Kenya to collect data on barriers to the diagnosis and management of KC.

Results

The majority (60.9%) of optometrists were confident in retinoscopy and subjective refraction. Fewer were confident in the use of keratometers (46.4%) and corneal topographers (24.9%) and in the fitting of rigid gas permeable (RGP) contact lenses (25.0%). The most commonly reported barriers to improving their knowledge and skills were, limited continuous professional development opportunities (87.4%), high costs of conferences (86.1%) and the lack of diagnostic tools (79.5%). Impediments cited to diagnosing and managing KC effectively were a lack of national guidelines (64.9%), patient education material (71.5%), equipment (58.9%) and RGP supply (68.2%) and cost (67.5%). Most commonly reported barriers related to patients were compliance (91.4%), affordability (90.7%), RGP discomfort (89.4%), willingness to pay (88.1%) and the lack of patient education about KC (87.4%).

Conclusion

This study showed that the lack of national guidelines, essential equipment and adequate practitioner knowledge and skills were barriers to KC diagnosis and management. Regulation of optometric education and clinical practice, development of national guidelines for diagnosis and management of KC, up-skilling of practitioners and cost-effective solutions for equipment procurement and maintenance may improve both access to, and quality of, care to patients with KC.