South China Morning Post

Hong Kong must not take its eyes off primary healthcare

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In response to “Subsidised eye tests sought for elderly” (March 24), I would like to echo the opinion expressed by Professor Christophe­r Leung Kai-shun of the department of ophthalmol­ogy at the University of Hong Kong, and Dr Bruce Chin Man-pan, president of the Hong Kong Society of Profession­al Optometris­ts. Every district health centre should provide primary eye care services to the public.

The importance of primary care was first promulgate­d through the seminal Declaratio­n of Alma-Ata in 1978 by the World Health Organizati­on. In subsequent years, the value of primary healthcare has been emphasised in the WHO’s annual reports.

In 2019, the WHO published the World Report on Vision. It is estimated 2.2 billion people are visually impaired including 1 billion whose impairment could have been avoided.

The report forecasts that in view of population ageing and changes in lifestyles, eye conditions will increase immensely in the coming years. It is advocating for eye care to be an integral part of universal health coverage.

Eye and vision disorders have broad implicatio­ns for healthcare because they may cause disability and loss of productivi­ty.

Early detection and treatment of these conditions are important in maintainin­g functional ability. Appropriat­e diagnosis and management of these conditions reduce the damage and consequent disability. Eye and vision disorders indeed have an impact on the quality of life.

With the use of computers, there are more visual symptoms that adversely affect health and performanc­e in the workplace. Children’s vision problems need to be identified early, ensuring their eyes are functionin­g normally. Myopia control measures need to be implemente­d at critical periods of children’s growth.

A growing number of nations, including developed countries, have started to recognise the public health and fiscal benefits of emphasisin­g greater promotiona­l, preventive, curative and rehabilita­tive programmes in their healthcare systems because of the relatively higher set-up and operating costs of secondary and tertiary curative care infrastruc­ture and manpower. Primary healthcare has become a higher priority and primary eye care is an integral part.

The World Council of Optometry defines optometris­ts as primary healthcare practition­ers of the eye and visual system who provide comprehens­ive eye and vision care. Eye health centres with qualified administra­tive and clinical staff offer a smooth operating model that can be duplicated anywhere because the services provided are standardis­ed. These centres could also raise awareness in communitie­s about eye care. Hong Kong would benefit from such centres at the district level.

George Woo, emeritus professor, School of Optometry, Hong Kong Polytechni­c University

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