Premi is one of three children. Her parents and older brother work as day labourers on nearby farms to support the family. Despite their efforts, money is often tight, and a visit to the optometrist would be a stretch for them. Fortunately for Premi, her school was visited by one of our eye screening teams as part of our Vision-centre Based Community Eye Health Project with our partner in the area, the Alakh Mayan Mandir Eye Hospital. Premi was quickly diagnosed with refractive error and received a pair of prescription eyeglasses, free of charge.

The whole family is grateful that this bright young girl can continue her studies, with hope for a brighter future.

Our approach to eye health ensures entire communities – including schoolkids like Premi – get screened for eye conditions and can access treatment at low or no cost. By offering multiple screening opportunities at schools, vision centres, screening camps and right on people’s doorsteps, we make sure nobody falls between the cracks.

Our unique “recipe” for community eye health

Our approach starts at the planning level – working with government and community partners to select a location with a high prevalence of vision loss and low socio-economic status – and a partner hospital with a compatible mission and vision.

Next, we collaborate with partners on an action plan, define the project area and decide on locations for vision centres. Once established, the vision centres act as links between communities and hospitals, providing comprehensive eye exams, dispensing glasses and making referrals to our partner hospital for surgeries.

Then, the training of community health workers begins. These frontline workers, mostly women, learn how to conduct visual acuity tests, identify various eye conditions, make referrals and provide eye health education. For many of our beneficiaries, the relationship with our programs begins and ends with the community health worker – who might visit the same household many times, offering kindness, compassion and counselling to nervous patients, as well as their eye health expertise.

After their training, the community health workers fan out to our various communities of work, doing a baseline door-to-door survey and referring patients to the vision centres and partner hospitals for further diagnosis and treatment.

As we continue our work in the area, our teams organize various screening camps and school screenings to give everyone multiple opportunities to have their eyes checked. Community health workers also continue their door-to-door work, checking in on patients, providing eye health education and troubleshooting any problems patients might face in getting treatment. Teams crunch numbers to monitor progress and evaluate each project, later bringing in external agencies to audit the work.

When the community health volunteers have done their final survey to make sure there are no backlog cases, villages and communities are declared as Avoidable Blindness-Free through public celebrations. At this point, the vision centres have become self-sustaining, so they can continue to deliver quality eye care services beyond the project’s duration.

Providing more than just eye care

The community health workers we employ for our door-to-door surveys can offer much more than just eye health expertise. Many have received additional training in primary health care and can provide advice and referrals for things like immunizations, vitamins, and maternal and newborn health care.

Shakuntala, an Accredited Social Health Activist (ASHA) with the Government of India, spent eight years providing advice to expectant mothers, and offering newborn care support, before she received additional training in primary eye care. With her experience, she can continue to offer referrals and education to mothers while she does her eye health screenings.

In 2024 alone, our community health workers linked more than 50,000 children aged five and under with crucial vitamin A injections, which reduces the severity of childhood illness and increases survival rates, while also helping them develop healthy vision. Also in 2024, we referred more than 16,000 expectant mothers and 12,000 nursing mothers with health facilities for check-ups.  

Moreover, a community health workers frequent visits to a household can help them monitor a patient’s progress not only with an eye condition but with other health problems as well.

Take Bulal in Nepal, for example, a 97-year-old man who has cataracts as well as diabetes. When Meena, an Operation Eyesight-trained community health worker, met Bulal during a door-to-door survey in 2021, she realized that he would need additional support to get the treatment he needed for his low vision. While he had been previously diagnosed with cataracts, the doctor told Bulal that his unstable blood sugar levels – and his high blood pressure – made cataract surgery too risky. Bulal thought he would live out his final days in darkness.

But when Meena heard his story, she set a plan in motion. Over the next few months, with Meena’s support and guidance, Bulal stabilized his sugar levels and brought down his blood pressure so he could safely undergo surgery. His family was grateful to see Bulal restored to his former dignity and independence once he could see clearly again.

From patient to ambassador – spreading the word about eye health

Ntiiti, a mother of five from a remote village in Kenya’s Kajiado County, started losing her vision in 2020. She didn’t know why she couldn’t see clearly and wondered if she was the victim of a curse. Soon, her vision was so poor that she could no longer perform essential day-to-day tasks like making meals, taking care of her children and looking after the family’s cattle.

Help arrived unexpectedly when a community health promoter, whom we’d trained in primary eye care, visited her home while conducting door-to-door screenings. He identified cataracts and sent her to a nearby eye screening camp for a formal diagnosis. At the camp, an ophthalmologist confirmed Ntiiti had bilateral cataracts and referred her for surgery. Ntiiti had never been to a hospital or clinic before, because of the distance to these facilities from her village, but our team helped arrange transportation so that she could get the treatment she needed. Thanks to our generous donors, she received surgeries on both eyes, free of charge.

Amazed by the difference the surgeries made to her life, Ntiiti told everyone in her community who complained of vision or eye problems about her miraculous recovery. Soon, she had her first recruit – a widowed mother of six who was living in total blindness. Ntiiti connected her to the community health promoter and even accompanied her to the hospital for her surgery.

We have many similar stories of patients like Ntiiti who become ambassadors for our programs. It speaks to the strength of our approach – by taking the time to build relationships in the community, patients with success stories become empowered to spread the word about the importance of getting treated for blindness and vision loss.

To create the biggest impact, we start at the community level. By training and empowering local health workers, we can help create lasting connections that bring eye care directly to people’s doorsteps. These trusted workers are the heart of our model – identifying problems early, guiding patients through treatment and spreading awareness that can transform entire villages.

With your support, we can train more health workers, open more vision centres and ensure that no one is left behind. Donate today to help us build a future where avoidable vision loss is eliminated for good.

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When Fassikaw was in first grade, he began to have trouble seeing objects far away. Reading books and the blackboard became difficult. Sitting in the middle or back of the classroom, he often had to borrow his classmates’ exercise books to copy notes. 

At home, reading took him a long time. His eyes often watered, and his grades began to drop. More than his grades, his parents worried about his worsening vision and the way it was affecting his mood and sleep. Fassikaw even spoke about leaving school. 

Around this time, his family learned about our School Eye Health Program run in partnership with Partners in Education Ethiopia. The program offers free diagnosis and eyeglasses to students in need. 

After hearing this, his family went to the hospital and Fassikaw’s eyes were checked. At the hospital, tests revealed that Fassikaw’s vision required strong corrective lenses: +15.00 for his left eye and +16.00 for his right. Thanks to our partners and generous donors, he received the eyeglasses at no cost. 

Today, Fassikaw can read easily from anywhere in the classroom. At home, he reads without headaches or watery eyes. His grades have improved, and his class ranking has risen from 27^th to 21^st, with steady progress. 

His father says their son is now happy and confident, and the family can sleep without worry. “With God’s help, we hope you will never have to worry about anything,” he says with gratitude. 

Did you know?
Bringing eye health care to students is an investment in their education and their future. Globally, 450 million children have an eye condition that requires treatment; of these, 448 million have refractive errors that only require eye exams and eyeglasses (Source: IAPB Vision Atlas – Child Eye Health). The cost of eyeglasses in our countries of work is approximately C$20. 

By providing eyeglasses through school-based eye health programs, we can transform the lives of children like Fassikaw, helping them see clearly, succeed in school and embrace a brighter future. Give the Gift of Sight today.  

Our Work in Ethiopia 
Since beginning our work in Ethiopia in 2018, we’ve made significant strides toward preventing avoidable vision loss. In 2024, our programs reached more than 33,424 people through eye health screenings, treatment, training and community outreach. From surveying over 14,000 residents in Debre Work to training frontline workers and teachers, screening students and providing eyeglasses, we are building lasting capacity for quality eye care. Read more about our work in Ethiopia in our 2024 Annual Report. Download it here. 

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His story is a common one. Global estimates suggest that people with moderate to severe vision impairment are about 30 per cent less likely to be employed than those with good eyesight.¹ For lack of a pair of eyeglasses, for want of a simple cataract surgery, millions of people are unable to work. It can keep entire families stuck in the cycle of poverty.

Abraham’s story has a happy ending. After meeting a community health volunteer during a door-to-door eye health screening, he was diagnosed with bilateral cataracts and got sight-restoring surgery on both of his eyes at one of our partner hospitals. He started taking in shoes for repair once again.

But many people won’t get back to work like Abraham did. And that’s because basic eye care isn’t available or accessible to them. According to estimates, about 2.2 billion people worldwide have vision impairment, and in roughly half of those cases, the vision loss could have been prevented or hasn’t yet been treated.²

Lack of access to eye health care

For many people across the globe, the neighbourhood optometry clinic simply doesn’t exist. While people in Western Europe enjoy a ratio of one optometrist to every 3,877 people, countries in central sub-Saharan Africa reported a ratio of one to every 1,198,141 people, according to a 2023 study.³ Even when there is an eye care provider in a nearby city, the barriers to reaching them can be insurmountable for some people living in remote and rural areas. Many can’t afford the bus or train fare, let alone the fees for diagnosis and treatment. And for women and children, travelling alone can be dangerous, so they often need to wait for someone – usually the family breadwinner – to take time off work to escort them. For those with seriously impaired vision or other disabilities, travel might be nearly impossible.

Every day, the community health workers who do eye screenings on our behalf meet people who have previously tried to solve their vision issues without success. Many patients had visited the nearest healthcare provider, often a local dispensary, and were sent home with eyedrops or told their vision couldn’t be treated. Some had bounced around from clinic to clinic, others had resigned themselves to living out their days in blindness. That is why we are working hard to provide eye health care services at the community level.

By connecting people with our partner vision centres and hospitals, helping cover fees and offering safe transportation to the hospital, we can help restore vision to people who may never have gotten treatment otherwise. It’s just one of the ways we are working towards the United Nations Sustainable Development Goal number one: No Poverty. By addressing some of the root causes of poverty, like poor eyesight, we can help people stay employed and stay in school.

How eyeglasses can improve income

The global productivity loss attributed to impaired vision is estimated at US $411 billion annually.⁴ And those effects can be seen on the individual level as well.

A recent study looking at workers with presbyopia between the ages of 35-65 in Bangladesh found that those who had reading glasses made 33 per cent more than those who did not.⁵ The study, published in PLOS ONE, tracked the incomes of more than 10,000 participants who work in near-vision intensive occupations – like tailors, mechanics and carpenters – over eight months. Half of the participants received reading glasses right away, while the control group only got a pair after the eight months of data collection. The eyeglasses themselves cost only about US$3-4 per pair but had the potential to transform the lives of the workers.

Another study of tea pickers with presbyopia in India found similar results in 2018.⁶ In that case, the three-month study found that a pair of reading glasses increased productivity for the plantation workers – who are paid by the kilogram of leaves picked – by about 22 per cent, and 32 per cent for those over the age of 50.

As these studies show, addressing vision loss can increase productivity and provide greater economic opportunities for individuals.

The chicken or the egg

Like many other health issues, it can be difficult to untangle the relationship between low incomes and eye health problems. Poor vision can lead to poverty because people often lose or quit their jobs when they’re no longer capable of doing them effectively or safely.

Take Junmoni in India, for example. The mother of two dreamed of sending her daughter to college with her earnings making handwoven fabrics on her loom. But when her vision became blurry, she had to stop weaving. Money got so tight that she was on the brink of selling her handloom. Fortunately she met a community health worker who told her she just needed to visit the local vision centre to get a pair of eyeglasses. Junmoni now wears her prescription eyeglasses while working at her handloom, her dreams for her daughter back on track.

But just as vision loss can lead to poverty, the opposite may also be true.

An infectious eye disease, called trachoma, continues to cause vision loss and blindness in dozens of countries around the world. It is widespread in some rural areas, and also in regions where there are high rates of poverty. The bacteria spreads through personal contact, via hands, clothes and bedding, and by flies that have been in contact with discharge from an infected person. It is most common in areas where people don’t have access to clean water or have to travel long distances for water.

If left untreated, trachoma causes the eyelashes to turn inward and scratch the cornea, leading to severe pain, vision loss and even blindness.

The spread of trachoma can be managed when people have access to clean water, allowing for more frequent hand and face washing, and the cleaning of clothing and bedding. Antibiotics can also help prevent and treat trachoma in areas where it is endemic.

We work with partners and communities in Ethiopia, Kenya and Zambia to prevent the spread of trachoma by helping establish water boreholes and latrines and administering antibiotics.

Ninety per cent of vision loss is preventable or treatable, but people living in underserved communities are more likely to go blind. In fact, 90 per cent of people with vision loss live in low- and middle-income countries, which is why we’re working in these areas.

Reaching the unreached

Lack of education is another factor that keeps vision loss in lockstep with poverty. Some people don’t seek eye health care simply because they believe their condition is untreatable. Many older patients believe that vision loss, even blindness, is just an inevitable part of aging. In some communities there may be additional fear or distrust of medical authorities based on previous experiences, myths or other cultural stigmas.

By reaching people in their homes and communities through door-to-door eye screenings and eye camps, we can offer basic eye health education and choice to those who might never get treatment otherwise. And in cases where a patient might be hesitant to get surgery, our community-based approach enables health workers to continue counselling patients over weeks and months, reassuring them, explaining the benefits of a procedure and often convincing them to get treatment in the end.

Another way we work to prevent the devastating effects of vision loss is by making sure the youngest people in our project areas learn about eye health. By offering eye screenings and education in schools, organizations like ours can reach thousands of families through their children, who go home brimming with excitement over the vision test they took at school, and what they learned about eye health. By providing children with referrals to the nearest vision centre or partner hospital, the whole family is made aware of the services that are available to them.

Effects on the whole family

The effects of a cataract surgery often ripple down through the beneficiary’s entire family. We hear of many young women who have given up jobs or dropped out of school to care for a senior family member who has gone blind. Once the family member has had their vision restored through cataract surgery, they often regain their independence, freeing up their caregiver to devote that time to work, school or other economic opportunities.

And parents who have had their vision problems corrected, like Junmoni, are better placed to keep their children in school longer, and even send them off to advanced education, potentially lifting future generations out of poverty.

Finally, children with vision problems who get corrective eyeglasses or treatment fare better at school. In fact, prescription eyeglasses have been shown to have a greater impact on academic achievement than other health interventions, like nutrition and deworming programs.⁷ This is why we are currently expanding our school eye health programs, so we can help more children thrive in school so they can get the best possible start on their working lives.

The road ahead

While many organizations like ours are collaborating with partners, governments and funders to address vision loss and blindness, aging populations and population growth mean that the problem will increase if we don’t act quickly. Some estimates say that by 2050, half of the global population will have myopia.⁸

You can help us continue our mission to prevent blindness and restore sight by following us on our social media accounts, signing up for our newsletter and sharing what you’ve learned with friends and family. Join our global community today.

1. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00132-2/fulltext ↩︎
2.  https://iris.who.int/bitstream/handle/10665/328717/9789241516570-eng.pdf ↩︎
3. https://www.researchgate.net/publication/375055096_Global_mapping_of_optometry_workforce ↩︎
4. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30488-5/fulltext ↩︎
5. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0296115 ↩︎
6. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30329-2/fulltext ↩︎
7. https://educationcommission.org/updates/providing-eyeglasses-school-age-children-high-impact-investment-education/ ↩︎
8. https://www.essilorseechange.com/wp-content/uploads/2020/02/Eliminating-Poor-Vision-in-a-Generation-Report.pdf ↩︎

The post The role of eye care in preventing poverty appeared first on Operation Eyesight.

Our worldwide team of locally-recruited health workers and volunteers gives us ‘insider knowledge’ of a community’s needs and helps us deliver care that is sustainable to those who need it most.

Tapobrat Bhuyan, our Program Manager in India, says an entire community or village benefits from the presence of our health workers, because they help identify those who need eye care and encourage health-seeking behaviour through education and referral to other health resources in the area.

The position of community health worker is also a unique job opportunity, especially for women. 

Tapobrat recalls an instance where he was interviewing a prospective health worker in 2013. When prompted as to why she wanted the job, the woman began to cry. 

“She told me she was working in a small school, making little money. She could not afford her children’s education. However, her excellent writing skills earned her a spot on our team, where she remains to this day,” explains Tapobrat.

“The stipend she receives helped to pay for her children’s education, and one of her daughters is now a teacher.”

Once trained, community health workers survey their local community door to door, identifying eye health conditions and referring community members for care. They also collect comprehensive data on the prevalence of eye conditions so that progress can be tracked.  

Tapobrat has worked closely with community health workers across India. He says they play a key role in connecting communities with eye health care, through referral to locally-established vision centres, which we open in convenient locations based on the needs of the community.

“Community health workers are the key link between communities and the vision centre. Often, individuals are unaware of their treatment options, or fear that it will be unaffordable,” Tapobrat says.

“However, our network of community health workers helps to create demand for these services by raising awareness about their availability.” 

Staying locally informed 

Given their connection to their own communities, Tapobrat says, community health workers can help identify and dismantle local barriers that many face in accessing eye health services.  

“They provide not just screening, but also education sessions that aim to give community members more knowledge about eye health and other topics such as maternal and child health,” Tapobrat says. “These sessions empower community members to seek health care services when needed.”

Tapobrat says our approach has also led us to consult communities in the development of educational materials, including a recent project aimed at debunking feminine eye health myths.

Working with community members and a local illustrator and writer, he and our India team are creating educational materials that reflect the community’s collective identity and address local myths about eye health. Tapobrat notes that this was the first opportunity for community members to participate in this type of workshop, and it was met with success.  

“Rather than just focusing on disease, we are telling stories, which draws more interest and helps create deeper engagement. We are able to connect on a more personal level when people see themselves reflected in the materials they are shown,” he says.

Delivering eye care that is sustainable 
 
Door-to-door surveys are only one step in ensuring a community has access to eye care. Community health workers also follow up with those who were referred to the vision centre but have not yet gone, often counselling those who are hesitant to receive treatment.  

“We are constantly learning and growing, especially regarding the importance of language. For example, often people only know the word ‘operation’ when referring to treatments for conditions like cataracts, rather than terms like ‘surgery,’” explains Tapobrat.  

“We have learned from this and now encourage a multi-faceted explanation of treatment processes,” he adds.

Part of a global team

In Ghana, community health nurses recruited to our team are provided professional education at nursing colleges. After training, they are frequently deployed to rural areas.

“Local vision projects are usually announced at a community durbar, which is a gathering often held to discuss development projects,” explains Emmanuel Kwasi Kumah, our Country Director in Ghana. “Local leaders, healthcare workers and other community members are invited to attend and provide insight.”

Emmanuel is passionate about engaging the community and addressing local needs. He notes that our community health nurses also use other local platforms to promote eye health and engage community members. 

“Given the background and training of our community health nurses, they often use techniques such as focus groups at child welfare clinics to engage mothers in discussion, provide education and learn from community members,” Emmanuel explains. 

After they receive training in primary eye care, the community health nurses begin the process of surveying the area, also utilizing a door-to-door approach to ensure they reach everyone.

Emmanuel explains that they refer those with eye conditions to district hospitals, where they are further screened by ophthalmic nurses and optometrists.  

After this initial survey, community health nurses continue to observe the community’s progress and follow up on their referrals. They also help to ensure proper post-treatment care plans are followed.  

With this knowledge and feedback, community health nurses can help to dismantle local misconceptions about eye health and further increase the uptake of eye care services at the district hospitals.   

“Community members become stakeholders in the process of eliminating avoidable blindness. Together, we help create sustainable and long-lasting change,” Emmanuel adds.   

While local barriers may vary across the regions and countries we work in, the community remains at the heart of our approach.  

From India to Ghana, and beyond, we are committed to addressing local needs and learning from those we work alongside.   

Learn more about our approach.  

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