The ability to see is often taken for granted in Australia with free eye tests and optometrists easily accessible, yet for millions in Bangladesh, preventable blindness and vision impairment remain a profound barrier to education, work, and a fulfilling life.
This Christmas, Symbiosis is raising critical funds to support our Eye Health Projects. We chatted with Leah McClintock , a dedicated optometrist who helped establish this vital work, to understand the scale of the challenge—from the leading causes of sight loss to the profound impact of simple school screenings.
As an optometrist, what was the personal or professional moment that first inspired you to become involved in setting up the Eye Health Projects with Symbiosis in Bangladesh?
When my husband Jeff and I moved to Bangladesh in 2004, I spent the first few years just tagging along with the GP’s as they did medical clinics in the rural project offices. I did eye testing in an adjacent room and got to know the common eye problems rural people were experiencing, and the barriers they (especially women) were facing to accessing treatment.
The need for primary eye and prescription glasses was huge. While it was very satisfying work to meet this need, I knew I would only be in Bangladesh for a few years and I kept wondering how we could sustainably offer primary eye care within Symbiosis.
Then a Bangladesh colleague made me aware of a course being offered at one of the local Universities ‘Masters of Public Health Ophthalmology’ which was all about designing, implementing and evaluating eye care projects in the context of developing countries- everything I need to know in fact. So I spent a year studying and thinking about how primary eye care could work in the Symbiosis context.
Then we started SPECS (Symbiosis Primary Eye Care Service) and it’s been a bit of a run-away-train ever since, expanding in scope and locations beyond what I ever had in mind!
Could you describe the greatest challenges to sight in Bangladesh, and what unique or essential role the Symbiosis Eye Health Projects play in overcoming it?
Of all the blindness and low vision in Bangladesh, one third is identified as avoidable, one third is treatable and one third unavoidable. So the two thirds that is avoidable or treatable is the area we can make a difference and the strong relationships and trust that Symbiosis has forged in the communities they work in is the reason Symbiosis can play an essential role in addressing this challenge.
Let me explain how:
- Avoidable blindness: this is commonly due to injuries, inappropriate use of eye medications or herbal remedies and not getting timely treatment for things that need early attention. Education is the key to avoiding blindness from these things. Symbiosis educates children, teachers, community members, and local leaders about avoiding injuries, appropriate use of medications and what symptoms need urgent attention. They also facilitate speedy referral for patients with injuries or infections that need urgent specialist care.
- Treatable blindness/low vision: by far the 2 main causes are cataract and refractive error (need for glasses) and Symbiosis is identifying and referring patients for cataract surgery constantly in all the vision centres as well as facilitating cataract eye camps for patients who cannot afford surgery. Similarly in all the vision centres, every day our optometrists are addressing poor vision due to refractive error by prescribing appropriate glasses.
Education, referrals and treatment recommendations are much more effective when they come from people trusted in the community and this is where Symbiosis real strength lies.
This was identified as a strength by one of our previous partners Operation Eyesight when they first visited the SPECS project and could see the strong community connection that Symbiosis had. Although they were a bit scathing of our record keeping and general level of organisation, the strong community connection outweighed this and made them want to partner with Symbiosis!
Why is reaching children through school-based screening so critical to the long-term success of the Eye Health Projects?
Addressing children’s vision issues is particularly important for 2 reasons. The first is that for children under the age of 10, their brains are developing ‘visual pathways’ for processing vision. If their vision is very blurred during this time, these pathways don’t develop properly, and even if you give them the perfect glasses to correct their eyes later, they still will not see properly because these visual pathways didn’t develop during the critical time.
For a child, poor vision negatively impacts their education and job opportunities as they get older. So it’s super-important that children get the glasses they need while they are young.
The other reason it’s so important to have school screening and catch eye problems early is that children have a whole lifetime of potential sight in front of them. So when a child goes blind from something avoidable, they might then have 70 ‘blind years’ in front of them, whereas for an older person it may only be 20 blind years.
Children with significant refractive error struggle at school and often eventually drop out, they are unfit for any visually demanding job as they get older.
However, with timely correction they can complete school, and may go on to further studies and will be capable of various visually demanding jobs.
The first trajectory inevitably leads to more entrenched poverty, the second trajectory gives hope and opportunity to move out of poverty. This is why Symbiosis recognises eye care, and especially eye care for children as an essential part of their work.
We are grateful to Leah for how her vision has impacted and grown the Symbiosis Eye Health Projects.
Your support for our Christmas appeal enables our hardworking staff to continue providing good quality, affordable eye care in poor, rural communities and schools.
Together, we can break the cycle of poverty driven by poor sight.
As little as $10 provides an eye examination & subsidised spectacles for a school child, empowering them to pursue education and secure their future.
$175 enables our team to run a screening clinic for an entire school of students, plus teacher training so they can identify problems early.