Avoidable blindness and vision impairment are significant global health issues. The World Health Organisation (WHO) estimates that at least 1 billion people worldwide suffer from preventable or treatable vision problems. Around 11 million people in South Africa live with some degree of vision loss, including 370,000 classified as blind. Optometrists are crucial in preventing avoidable blindness caused by uncorrected refractive errors and cataracts. However, South Africa’s optometry services are marked by severe disparities. Of the 4,200 registered optometrists, only 6.7% work in the public sector, leaving rural and poor communities with minimal access to essential eye care. This urban-rural divide is exacerbated by inconsistent government approaches to eye health across provinces. Despite significant state investment in optometrist training, most graduates enter the private sector, further widening the gap in public access to eye care. Calls for a dedicated directorate for eye health services and better integration of optometrists into the public healthcare system have gone unanswered. National Health Insurance (NHI) could provide a solution through public-private partnerships. However, the timeline for NHI implementation is lengthy, and immediate action is needed to prevent further avoidable vision loss. The Health Department must urgently address these systemic imbalances to prevent more South Africans from losing sight due to preventable conditions.
- Majid and Sparks are Global Atlantic fellows for Health Equity in South Africa and advocates on the National Eye Health Advocacy Project.