Focus on eye-care

By Theresia Tjihenuna
March 2013
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Caring for one’s own vision is perhaps one of the most important aspects of the human functions that a lot of people take for granted until something goes terribly wrong with one or both their eyes.

In some instances, an eye condition can cause potential blindness if not detected and treated in good time.

Given Namibia’s dry climate, experts strongly advice that people wear sun glasses to prevent eye damage through ultraviolet (UV) rays. Any eye doctor will tell you to go for regular eye screenings to detect potentially blinding conditions. Ordinary citizens, especially those in the rural areas, hardly ever get eye examinations until something goes terribly wrong.

A State-ophthalmologist at the Windhoek Central Hospital in the eye-care department, Dr Sven Andreas Obholzer, believes eye care is a primary health right that every Namibian should be able to afford.

“A decrease in vision can affect the quality of life, ability to learn, work and properly communicate, not to mention the affected person’s self-confidence,” he explains.

He says most State patients with no or little income cannot afford the [much-needed] prescribed eye glasses as they are expected to purchase them from their own pockets. Government does not subsidise for prescribed eye glasses.

“We are trying to push for Government to subsidise public patients who are in need of eye glasses. The reality is, they cannot be completely free of charge but at least they should be accessible to those who could otherwise not afford them,” Dr Obholzer says.

For those already wearing prescribed eye glasses, Dr Obholzer says the general belief that eye glass lenses and frames should be changed every few years is a myth: “Unless in children’s cases where their vision constantly changes, eye glass lenses can last up to five years or more while in perfect condition.”

Dr Obholzer who joined the public hospital last year after graduating from Stellenbosch University in Cape Town, performs eye surgery every Thursday. Most of his patients are children with congenital eye problems and adult patients with glaucoma, eye-allergies, inflammatory diseases and infections, he reveals.

“Most of these conditions are treatable with eye-drops. Surgery should always be the last option if and when patients do not respond to eye drops,” he explains, adding, of all the eye conditions diagnosed in patients, cataract is the most common one. Cataracts is a condition in which the eye lenses become clouded, making it the leading cause of blindness.

“It is a given that most people, at some point in their lives, will suffer from cataracts as their vision gradually decreases with age,” he says.

Most of the operations he performs are on cataract patients: “This is one of the most common surgeries in the ophthalmology field and generally the safest and most successful one in the medical field.”

He advises the general public to neither stall frequent visits to eye specialists nor wait till they are stranded with eye conditions.

According to Dr Obholzer, most HIV-positive patients usually have an eye condition called ‘squamous cell carcinoma’, which is a form of cancerous growth on the surface of the eye, often associated with a decreased immunity.

“This condition is very uncommon in healthy people but is mostly found in young patients who are HIV-positive,” he explains.

Another common phenomenon that he comes across, especially after weekends, is eye trauma caused by violence, alcohol and assaults; “When there is damage to the eye as a result of violence, we usually attempt to surgically repair the eye but often, the damage is already done and surgery may not completely improve it.”

To aspiring eye specialists, efficiency in the profession is key, Dr Obholzer emphasises.

“Although one can learn the surgical part of the profession with time, the passion has to exist - besides a good background in medicine and specialised understanding of the human eye,” he advises, adding that currently, none of the local educational institutions offer post-graduate programmes in eye care. Namibian students have to go to South Africa for ophthalmology training.

Another concern facing the public eye care department in Namibia, Dr Obholzer says, is the uneven geographical distribution of public ophthalmologists.

“There is a need for public ophthalmologists in the public health sector, especially in the northern regions where most of the country’s population is concentrated. Most ophthalmologists have private practices,” he says.

One of the eye specialists who has dedicated her skills for the good of the public is one Dr Helena Ndume. She has been working closely with Dr Obholzer in performing some of the life-changing eye-surgeries in the country’s most remote areas. “We travel around the country once a month as a team of experts to perform free eye-surgeries. We have been bringing experts on board from as far as the United States of America and other countries,” Dr Obholzer says.

The initiative was started by Dr Ndume in 1999. During such outreach programmes, more than 350 patients usually recover their sights after treatment.

“Transforming someone’s eyesight is the greatest reward I get from my job. Seeing them smile when they regain their eyesight after living in blindness for a long time is heartwarming,” Dr Obholzer marvels in conclusion. PF