Achieving Scale: the real challenge for Optometry

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It is important on World Optometry Day we take stock of the relevance and impact of the Optometry profession. Many of us have spent years involved in various eye care projects and campaigns to increase access to refractive services, a key responsibility of optometric services. However the fact that there are still 2.5 billion people in the world who lack vision correction due to the lack of access to eye exams and spectacles magnifies the challenge that still awaits us.

The scale of the problem

Furthermore, by 2050 half of the world’s population is expected to be myopic and 20% of myopes face the risk of vision impairment and blindness due to high myopia. This creates a sense of urgency for introspection. The reality is refractive services have to be prioritized for upscaling and investment in more small projects, while teaching us much, has not achieved the goal of access and affordability to all.

The first question we need to ask is “what is the environment we are confronted with?”:

Lack of human resources despite our best efforts at opening new schools of optometry. At the current pace it will take us more than half a century to achieve the numbers we need. This is further exacerbated by the mal-distribution of existing human resources with rural areas facing a bigger deficit than cities.
Technology is creating new avenues for eye exams and dispensing of spectacles.
Governments, particularly in the developing world, are facing competing needs and must focus on the poorest of the poor to really be able to provide adequate services. Hence public health systems have failed to adequately invest in refractive services development given the enormous need.
Philanthropy dollars are inadequate to provide the resources to ensure effective refractive error programmes are implemented but provide an important adjunct to current efforts.
The price of spectacles has become increasingly affordable and offer an opportunity for creating greater access as well as income generation for service providers in underserved communities.

Upscaling refractive services

In this context Optometry, as well as NGOs, needs to step up and address the need for refractive services. The strategies we adopt have to be flexible and multifaceted but most importantly we have to go from projects to scale. We need solutions that allow us to serve the needs of the entire country, regions or health districts. These solutions must be scalable. In this context we need to analyse the ecosystem and make sure that all facets are taken care of. These include public health delivery, philanthropy and inclusive business. Inclusive business offers us opportunities to scale up rapidly without depending on grants and investment from governments.

These efforts must compliment other efforts in the ecosystem and collaborate with the health system as is needed. We need to focus on building partnerships and coalitions rather than competing as NGOs and professions. I saw the advantage of this as the former Global Director of Our Children’s Vision campaign. We scaled up rapidly due to collective efforts and support. We need to embrace a competencies-based approach to human resource development and utilize this to increase the number of optometrists entering the field through upskilling.

It is an exciting time for Optometry to make a massive difference by embracing change and stepping up to the plate. The tools are available we just need the courage and conviction.