Between textbooks, whiteboards and videos in class, most of the information that’s presented to kids at school is visual. So what does that mean for a child who can’t see clearly?
In countries where eye health care is difficult to access, a simple eye condition like myopia (nearsightedness) can cause a student to fall behind and even drop out of school, which in turn could affect the child’s income for the rest of his or her life.
Ensuring that Quality Education is available to all children is one of the 17 Sustainable Development Goals set by the United Nations’ 2030 Agenda. We’re working towards this goal by ensuring that more children get the eye health care they need to thrive at school and take charge of their education.
The link between vision loss and school enrollment and performance
According to a survey by the World Bank, children with visual impairments in sub-Saharan Africa are five percentage points less likely to ever be enrolled in school or to complete primary school. They are six percentage points less likely to be literate.1
The links between academic performance and visual impairment can be harder to draw given the complexity of the issue, but one survey from francophone countries in Africa found that primary school students – who self-reported difficulties with their vision – performed worse on standardized tests in math and reading in all but one of the 10 participating countries.2 Similarly, a Stanford study of 20,000 fourth and fifth graders in rural China found that eyeglasses boosted the standardized test scores by 18 per cent over six months.3
Even studies from higher income countries, where children have better access to eye health care, show that students with poor vision tend to read more slowly than their peers and are more likely to report that they don’t like reading.4 Visual fatigue is a likely culprit for both, and the resulting headaches and tiredness that these kids experience are also thought to play a role in behavioral issues at school.
The magnitude of the problem
Roughly 22.16 million children ages 14 and under have Moderate to Severe Vision Impairment (MSVI) and 44.6 million have mild vision impairment, according to a panel of global health professionals called the Vision Loss Expert Group.5
Only 20-50 per cent of the children who need prescription eyeglasses worldwide actually own a pair.6 Often, this is due to a lack of access to eye health care. In rural, remote or underserved communities, especially in low- and middle-income countries, many kids don’t get regular eye exams or have access to prescription eyeglasses and other treatment. This could be due to financial constraints, lack of education about the importance of eye health, or simply because there aren’t any optometry clinics nearby.
Across lower-income communities, schools may also lack electricity or lighting, making it even more difficult for a student with vision impairment to read information written on a blackboard. Lack of adequate lighting at home can also cause difficulties in completing homework. For a secondary student who is already falling behind in class, not being able to finish homework in a timely manner could end their school career, and cause them to drop out early.
The struggle students face
Isaac Baffoe, who manages our school eye health programs in Ghana, says one student’s story really stuck with him. The girl reported that her eyesight started to fade when she was about 12 years old, and by age 15 she had severe vision impairment. For years, she relied on a classmate to read the blackboard out loud to her during class. Isaac often wonders what would have happened to her if her friend hadn’t been so helpful, or even more importantly, if our school eye health program hadn’t reached her school and she hadn’t gotten prescription eyeglasses.
Our field staff hear a lot about the difficulties that students face before they get eyeglasses. One student in Ethiopia reported that she and her friend were frequently scolded when the friend read the blackboard notes aloud to her. Others reported that their grades dropped sharply, or that they lost interest in their studies. Many children say that they asked their parents to take them to the eye doctor, but due to tight finances or difficulty in reaching a clinic, they weren’t able to get the eye care they needed.
The good news is that, with your ongoing support, we are changing all of this – one school and one child at a time.
Delivering eye care in the classroom
Part of our goal at Operation Eyesight is to reach every single member of a community with eye health care, ensuring that nobody gets left behind. Increasingly, we’re screening school-aged children for eye issues right in the classroom.
In 2023 alone, our school eye health programs helped us screen more than 240,000 students in Bangladesh, Ethiopia, Ghana, India, Kenya, Nepal and Zambia.
In Kenya, we’ve partnered with the United States Agency for International Development’s (USAID’s) Child Blindness Program and Peek Vision to deliver an innovative program where teachers are trained to do the initial eye health screenings using a simple smartphone app. This allows us to screen more students overall, while still providing referrals to those children identified with eye problems to get a complete eye exam with a healthcare professional.
In Ghana, we train community health nurses to help deliver our school eye health programs, also in partnership with USAID and with funding from the Church of Jesus Christ of Latter-day Saints and Latter-day Saints Charities. In addition to conducting school eye health screenings, the nurses provide the students with eye health education sessions, where they learn how to prevent eye injuries and infections and learn about various conditions, like refractive errors (the need for eyeglasses). By making sure children have basic eye health information and know where to go for subsidized eye care, whole families are made aware of the services that are available to them.
Isaac, who has been on hand during several of these school screening events, says the children are always very eager to get involved. “The children show lots of interest. They want to participate,” he explains. “During all the screenings we’ve attended to audit, the children are very cooperative, they really want to know what is going on.”
He adds that it’s not just the students who are happy with getting a pair of eyeglasses.
“It’s not only a relief to the children, but also to the teachers,” he says, “because it also made their work difficult to spend extra time with these children who were struggling with their studies prior to receiving eyeglasses.”
More girls in school thanks to clean water closer to home
In November 2020, the borehole in the Zambian village of Kangwa broke down. The COVID-19 pandemic was in full swing, and the need for clean water was more urgent than ever. For Natasha, a teenager who was in high school at the time, the breakdown had devastating consequences. As the family member tasked with fetching water, Natasha now had to walk several kilometres each day to complete the chore, meaning she could no longer attend school. She wasn’t alone – other teenage girls in her community were in the same situation.
When our team in Zambia found out about the broken borehole, they sprang into action and quickly got it fixed. They were well equipped to do so, because we have been working with communities to repair and drill boreholes for many years to curb the spread of trachoma.
Trachoma is a bacterial eye infection that’s common in areas with water shortages and crowded living conditions. The bacteria spreads easily through contact with eye discharge from infected people on hands and clothing, and also through direct transmission by flies. If left untreated, it can cause severe pain, vision loss and even blindness. In fact, it is the leading infectious cause of blindness worldwide.
When we work with communities in areas of Zambia, Ethiopia and Kenya where trachoma is endemic, we ensure that water and sanitation issues are part of our intervention. In communities like Kangwa, this means training local volunteer teams to help maintain and repair broken boreholes, and training community WASH (Water, Sanitation and Hygiene) teams to educate their neighbours about preventing trachoma transmission in the home.
In order to ensure that girls have equal access to quality education, clean water and sanitation facilities must be part of the solution. (Watch this video to learn more about the ripple effects of clean water.)
Myopia on the rise
Myopia (nearsightedness) rates are on the rise all over the world. In 2020, the global prevalence was 30 per cent. It’s estimated to rise to 50 per cent by 2050.7
In China, where the rise in myopia in children is being described as an epidemic, the government has rolled out a nation-wide strategy to curb the growth, which includes school-based eye screenings, public health education campaigns, a reduction in homework and an increase in time spent outdoors.8
As suggested by China’s strategies, many of the factors contributing to the rise of myopia are likely due to modern lifestyles: more time spent indoors, doing near-work like homework, and more time spent parked in front of digital devices.
But there may be more at play in the phenomenon, including environmental risks like increasing urbanization and changing diets. As low- to middle-income countries become more urbanized and educational pressures mount, children everywhere are at increased risk of developing the refractive error. In parts of Africa and Asia where families already face difficulties accessing eye health care, the gap between eye health services and those in need of treatment will continue to grow.
Our commitment to eliminating avoidable vision loss in children
As part of our 2024-2028 Global Strategy, we are committed to providing eye health care and clean water to more children so that they can take full advantage of any educational opportunities they are presented with. This means integrating WASH projects with school eye health projects and rolling out more school eye health programs across our countries of work.
We have already seen much success with our school eye health programs in countries like Kenya and Ghana, where we’re working with the local ministries of health and education. Now, it’s time to scale our efforts to more schools, more districts and more countries. With your ongoing support, we can expand our reach and improve the quality of life for more kids around the world.
Donate today and help us restore sight and prevent blindness for more children. The Gift of Sight is the gift of education and the gift of opportunity. Thank you for your support!
- https://documents1.worldbank.org/curated/en/964201621218582928/pdf/The-Price-of-Exclusion-Disability-and-Education-Looking-Ahead-Visual-Impairment-and-School-Eye-Health-Programs.pdf ↩︎
- https://www.unicef.org/congo/media/561/file/PASEC%202014.pdf ↩︎
- https://fse.fsi.stanford.edu/news/eyeglasses_boost_test_scores_in_rural_china_20140311 ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641537/ ↩︎
- https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30488-5/fulltext ↩︎
- https://www.iapb.org/wp-content/uploads/2022/02/2016-Situational-Analysis-Full-Report_LR-1.pdf
↩︎ - https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(23)00155-4/fulltext ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10912377/ ↩︎
