Eyes forward to better eye health

The Philippines is a signatory to the United Nations Resolution on Vision (#2030InSight). The UN resolution was signed last July 23, days before we, at the National Committee for Sight Preservation (NCSP), celebrated Sight Saving Month. For us who have been working on eye health for the last two decades, this was a watershed moment that can positively impact 1.1 billion people globally and about four million Filipinos who have undiagnosed eye problems.

The resolution makes eye health part of and integral to the achievement of the UN’s Sustainable Development Goals. For patients, this also means full access to eye care services through their country’s public health care system.

Before Bayanihan #2030InSight, the NCSP, along with the Department of Health (DOH), civil society, and private sector partners, worked within the VISION 2020 framework, focusing on the people’s “right to sight.” It outlined the same ambitious goal of eliminating avoidable blindness through cost-effective disease control, human resource development, and technology adaptation. The World Health Organization and the International Agency for the Prevention of Blindness laid the foundation for VISION 2020 in 1999.

The VISION 2020 framework paved the way for the DOH to develop an administrative order (AO) for the implementation of the National Prevention of Blindness Program (PBP). The DOH PBP AO resulted in good outcome cataract surgeries, provincial and regional hospitals getting equipped with appropriate technology for surgeries, distribution of eyeglasses, the establishment of refraction centers, and timely intervention for children with visual disabilities. One of our biggest wins was the full coverage of cataract surgeries by PhilHealth.

In the policy arena, the Philippines did particularly well by establishing all the mechanisms and the funding necessary for the delivery of eye care services.

But things don’t always roll out smoothly on the ground. Eye doctors like myself are mostly practicing in urban centers. For us to successfully conduct missions in geographically isolated areas, we have to hurdle logistical and financial challenges. First, we need to reach patients, the patients then need to undergo preoperative exams, and finally, we need them to come to the nearest public health facility where the operation is feasible.

There have been significant improvements in medical techniques and technologies over the last three decades, but the challenges in service delivery still remain. I witnessed and experienced the evolution of the ophthalmology practice in my 37 years of active service. Technological advancements in surgical and diagnostic equipment made surgeries and diagnoses faster and simpler. A cataract surgery, for example, used to take 1-2 hours, and the patients were confined to the hospital for about 3-5 days. Now, the surgery takes less than 30 minutes, and outpatients would only need a day to recover. Laser refractive surgery also made people spectacle-free with excellent outcomes.

A combination of effective policy and technology should have closed the gap. But after years of on-ground work, there is a crucial thing missing: effective advocacy.

To start the process of fixing one pair of eyes after another, the doctors must be available to the patients, and the patients must actively come to us. If patients defer their consultations and surgeries, the backlog of eye services increases and the patients are prone to loss of vision and, consequently, have poor quality of life.

For this reason, we have intensified the communication work with partners like the Fred Hollows Foundation, Physicians for Peace, Vitreo-Retina Society of the Philippines, Philippine Society of Public Health and Occupational Optometry, EYE hEAR Foundation, and other eye health stakeholders as well as Novartis Philippines in pushing for quality information on how to actively care for the eyes.

We launched a campaign called “Maging MATAlino” last August in a bid to teach effective eye care habits, to aid parents in conducting vision screening at home, and to lead patients to facilities where they can access clinical care. All these actions are meant to start and shorten the patient’s journey from the time symptoms appear to the first contact with a health care provider, to treatment and recovery.

NCSP partner organizations had to pivot and make changes from the usual practice to continue vision screening even with the temporary closure of screening sites due to community quarantine restrictions. The COVID-19 pandemic may have delayed our plans, but as a practicing ophthalmologist and public health professional who has labored for the cause since the early 2000s, I say this is not the time to slow down.

In celebration of World Sight Day this October, we encourage everyone to start a habit of actively taking care of their eyes. After all, better eye health is a “bayanihan” effort among doctors, public health workers, development partners, and, most of all, patients.

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Dr. Noel Chua is chair of the National Committee for Sight Preservation.