Strengths, challenges and opportunities of implementing primary eye care in Nigeria

Abstract

### Summary box An estimated 253 million people are blind or visually impaired worldwide, 90% of whom live in low-income and middle-income countries (LMICs).1 In Nigeria, a LMIC, approximately 4.25 million adults are blind or visually impaired with over 80% of the blindness from avoidable causes.2 Cataract is the most common cause of blindness in Nigeria and is readily treatable by surgery. Refractive errors, which can readily be treated by spectacles, are the most common cause of visual impairment. However, the Nigerian national blindness survey showed that almost half of all eyes that had a procedure for cataract had been couched (a traditional procedure for clearing the visual axis as a treatment for cataract3), with poor visual outcomes and <5% of those with refractive errors had spectacles.4 5 Lack of accessible eye care services and lack of awareness of where to seek services are some of the reasons why patients remain visually impaired or seek unorthodox treatment, even though outcomes are poor.6 Other eye conditions which cause ocular morbidity for which access to eye care is needed include presbyopia (age-related decline in near vision), allergic/infective conjunctivitis and other conditions which may cause distress and warrant treatment at the primary …