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Visual Impairments in the Developing World

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By Christianna Regent

When you think of health disorders plaguing the developing world, do abnormalities affecting the eye come to mind? Minor to severe eye disorders are not highlighted enough as a severe problem that can alter a person’s daily life catastrophically. In the developing world, where little healthcare is available to a majority of the population and even more rarely where eye care is seen as a priority, these cases can go overlooked. Therefore, people who suffer from eye disorders are condemned to a life of poverty.

It is a proven fact that countries in the developing world suffer more visual impairments than wealthier ones. For example, rates of blindness in wealthy countries is below 0.5% versus poor countries that exceed 1-2%. This can be due to a persistence of diseases not typically seen in richer ones such as trachoma, onchocerciasis (“river blindness”), and xerophthalmia. Trachoma is an infectious disease that causes a roughening on the top of the eyelids. River blindness is caused by an infection and is the second most common cause of blindness following trachoma. Lastly, xerophthalmia is the irregular dryness of the cornea and conjunctiva usually related to vitamin A deficiency. These three are the most prevalent in developing countries. Diseases, like corneal infections and HIV related inflammation of the retina (Cytomegalovirus retinitis) being untreated or undertreated also contribute to this percentage. As well as the fact that there simply is a lack of access to ophthalmic services for a variety of conditions. These three reasons are at the core for this major issue, which is that eye disorders continue to grow among the developing world’s population because there no solution in sight.  

Pie chart: Gloabal eye disease (percentages)

To give a more global view…

90% of eye disease is shouldered by developing countries

As of 2012, 39 million people are blind and 246 million cannot see properly worldwide

Reduced sharpness of vision (not legally blind) is 6x more common than blindness

200 million people cannot participate in the workforce due to visual impairment

Blindness and poor vision heavily impact one’s social and economic life. 90% of the blind cannot work. This means they have no means of earning a wage and sustaining a life for themselves independently. Blindness does not only effect an individual, but their family and community members as well. 75% of people who are visually impaired need help with daily tasks. The blind have to be taken care of by a sighted individual and have to live with someone who can provide for them. In the sense of the developing world, this can be extremely expensive and almost impossible to do. A caretaker requires money to be paid and if everyone has to work they cannot stay home to help. There are also negative stigmas linked to disabilities in several cultures, especially around blindness. These stigmas isolate the disabled from their homes and cause a loss in social status and authority, which was reported by 1/2 of the blind population in developing nations. Individuals who are blind also participate in productive activities less than others. The inability to engage in profitable activities combined with restrictive stigmas keeps the cycle of poverty going.

Blindness has a dramatic economic impact not only on a individual, but also their family and community. Blindness can cause poverty and poverty can cause blindness. Impoverished people are more likely to become blind due to the lack of ability to pay for healthcare, an increased vulnerability to eye infections, and limited knowledge of eye health. Although many people become handicapped because of their low income, it has been found 64% of those individuals were not impoverished beforehand. The households affected by the disability are also directly impacted. It has been shown that households not previously poverty-stricken had three times the likelihood of becoming it in less than one year. These households have an even slimmer chance of escaping poverty due to the rise of costs and minimized earnings connected to a disability. The large portion of the developing world’s population already struggles to pay for basic human needs. How can they be expected to keep up the high cost that comes along with a disability, while barely surviving without the added burden?

Living with an eye disorder is extremely difficult and I can’t imagine what it would be like living with one in a developing country. I was diagnosed at a very young age, probably only a few months old with Aniridia. Aniridia is a rare eye disorder that is characterized by the absence of one’s iris. It may cause the pupils to be misshapen, increase light sensitivity, and a reduction in the sharpness of vision. Aniridia occurs in 1 per 50,000 to 100,000 people across the world. Living in a country where receiving medical care for such life-altering disorders is nearly impossible is something that needs to be changed immediately. In further efforts to improve the developing world’s healthcare there needs to be a bigger emphasis on the visual aspect. There also needs to be more awareness surrounding this issue, considering how massive the impact is worldwide. Most organizations focus on educating the developed world on basic problems concerning malnutrition and a need for clean water which is a huge issue, but the visually impaired struggle with immense barriers that is not discussed enough for an actual change to be made. The time is now to make a radical change and stop the continuous cycle of poverty that has been created by unrecognized vision impairments.

Citations

Sommer, Alfred, et al. “Challenges of Ophthalmic Care in the Developing World.” JAMA Ophthalmology, U.S. National Library of Medicine, May 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4063878/.

“The National Eye Institute (NEI): Battling Global Blindness, Eye Disease through Research – Fogarty International Center @ NIH.” Fogarty International Center, U.S. Department of Health and Human Services, www.fic.nih.gov/News/GlobalHealthMatters/november-december-2012/Pages/eye-institute.aspx.

“Unite For Sight.” Module 12: Poverty and Blindness, www.uniteforsight.org/community-eye-health-course/module13#_ftn2.

“Uncommon Ophthalmology: A Deeper Look into the Rarest Eye Disorders.” Trial Runners, 17 Jan. 2017, trialrunners.com/uncommon-ophthalmology-deeper-look-rarest-eye-disorders/.

Achieng, Stephanie. “Africa and Asia Lead in Proportion of Blind Adults.” SciDev.Net, SciDev.Net, www.scidev.net/global/disease/news/africa-and-asia-lead-in-proportion-of-blind-adults.html.

“Studying Social Networks in Developing Worlds: Five Key Insights.” Stanford Graduate School of Business, www.gsb.stanford.edu/insights/studying-social-networks-developing-worlds-five-key-insights.

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COMMENTS: 1
  1. April 30, 2019 by Morgan.Reece

    Hi Christiana, I think you showed a lot of empathy and understanding through this project. Having a visual impairment yourself, you are able to understand the reality of someone else with a visual impairment but you also really stepped into the shoes of someone who doesn’t have access to the same level of treatment as you do and I really admire that. Great job! I wish I would’ve been able to fill out the survey but I wasn’t able to access it.

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