6 November 2017

Rwanda: Cataracts - A Major Cause of Blindness Among Elderly People

opinion

Onesphore Ruvunabahizi from Kacyiru in Gasabo District had a normal sight until five months ago when he realised his left eye was no longer seeing as it used to.

"One day I was reading the Bible and I saw sort of cloud in my left eye. I closed the right one and the other was in partial darkness," says Ruvunabahizi.

He decided to go to Kacyiru Health Centre for screening then received some drugs, but nothing changed. When he visited Kibagabaga District Hospital for further tests, he was told he was suffering from cataract disease.

Luckily, recently he underwent an eye operation for cataract disease, and he can see again.

A big number of visually impaired elderly people are victims of cataracts.

Ophthalmologists say 4 among 5 visually impaired persons would be cured and avoid blindness if they sought medical care on time.

What is cataract disease?

Pacifique Uwamahoro, an ophthalmic clinic officer working with Vision for a Nation, says cataract disease often affects old people, above 50 years of age.

He says it's a clouding of the lens in the eye which leads to a decrease in vision.

"Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in difficulty when driving, reading, or recognising faces. If not treated on time it may result in blindness or visual impairment," he says.

Uwamahoro explains that as a person gets old, their body weakens which leads to many diseases, including cataracts.

Statistics from Ministry of Health show that 1 per cent of the Rwandan population aged 50 and above become blind.

Uwamahoro says young people may suffer from this eye disease because of diabetes or high blood pressure.

"Sometimes, a child may be born with cataract from its mother or diseases like diabetes.

"The problem with cataracts and other many eye diseases is that they don't ache until you become blind or visually impaired," he says.

Egide Gisagara, an ophthalmologist at Rwamagana District Hospital and a representative of Rwanda Ophthalmology Society, says cataracts can also be caused by eye injury, noting that people with risky jobs should wear protective gear to keep their eyes safe.

"Farmers, welders and technicians are among people who may encounter many risks in their job; so they have to be very protective of their eyes to avoid possible injuries which could result into cataracts," he says.

Some drugs, especially steroids, can cause this eye disease, Gisagara adds.

"When a part of the eye called the cornea is injured, it mostly results into permanent blindness. It's mostly caused by some traditional drugs," he says.

How to avoid cataracts

Dr Aimée Muhimpundu, the head of non-communicable diseases department at Rwanda Biomedical Centre, says Rwandans should adopt the culture of going for regular eye checkups to avoid cataracts and other eye diseases.

She says many people are not aware they have eye problems until they get blind or visually impaired.

"We have to care about our eyes every day and go for screening regularly, instead of going there after danger has occurred," she says.

Muhimpundu says the Ministry of Health, together with partners like Vision for a Nation and Fred Hollows, has put more effort in decentralising ophthalmic facilities across the country to help Rwandans to access eye care easily.

Gisagara says people should only use drugs recommended by certified medics or professional health practitioners in order to keep away from medication that could affect eyes.

Muhimpundu says 83 per cent of cases would be preventable if people had regular checkups and treatment on time.

Uwamahoro adds that eating healthy is another way to sustain healthy eyes. "Fruits, vegetables, milk and other foods rich in vitamin A are very good for eyes."

How to test sight ability

Generally, when a person doesn't see well objects that are either nearby or far away, it is an indication that their sight has issues.

Gisagara says a person is considered visually healthy when they are capable of reading letters within average size, with one closed eye from 60 metres away and 6 metres close (6/60).

However, if someone can't read letters in 3 metres then they are turning blind.

Fifty-six per cent of blindness among people aged 50 and above is from cataracts, while over 90 per cent of patients with cataracts are old people. Patients with cataracts can regain their sight if operated on early.

In 2016, 700,000 Rwandans received ophthalmic services in different public health centres and hospitals across the country.

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