President’s Insights – December 2020

Each December 3rd , the United Nations observes the International Day of Persons with Disabilities. The UN estimates that more than one billion people live with some form of disability, 80% in developing countries. Persons with disabilities, have generally poorer health, lower education achievements, fewer economic opportunities and higher rates of poverty than people without disabilities. The World Report on Vision (WHO, 2019) highlights that more than 1 billion people worldwide are living with vision impairment that could have been prevented or has yet to be addressed for conditions like short and far sightedness, glaucoma and cataract. The report, found that ageing populations, changing lifestyles and limited access to eye care, particularly in low- and middle-income countries, are among the main drivers of the rising numbers of people living with vision impairment.

That is why this date is an excellent opportunity to highlight the challenges that people with disabilities face and the role that optometry can have in improving their lives. I have a fair amount of experience with this because one day a week I work at Children’s Clinics in Tucson, Arizona. Children’s Clinics is a comprehensive outpatient clinic for children with disabilities. Many of my patients have conditions such as Down Syndrome, autism, hearing impairment, intellectual disability, Spina bifida, genetic disorders, and/or visual/ophthalmic conditions.

One major lesson we have learned from COVID-19 is the importance of reaching out, meeting, communicating, and learning through technological means such as online conferencing, e-mail, and messaging applications. When we are quarantined in our homes, or staying home to stay safe, we can reach out to our families, communities and others around the world. VOSH/International has adapted quickly to expand our technological capabilities to meet, conference, teach, and discuss. We have held several online conferences and working groups/committees are meeting more frequently than ever. And when at home on our computers or other devices, clear and comfortable vision becomes extremely important.

A person with a disability, in some ways similar to an individual quarantined at home, might face a lifetime of challenge in mobility, for example, or hearing, thereby making their sense of vision even more important for them. As optometrists and volunteers working to improve ophthalmic health and vision, we can greatly enhance and improve the lives of people with disabilities. For example, a person with a mobility disorder or health condition that limits time away from home, who also has moderate to high astigmatism, might find it difficult to read a book or use their computer. By providing spectacles for astigmatism, their world could be opened up to intellectual pursuits, education leading to certifications and degrees, interesting hobbies, and productive work. We can see inspiration in the life of Stephen Hawking, the theoretical physicist and author, who became Director of Research for the Centre for Theoretical Cosmology at the University of Cambridge, UK.

At every step we must endeavor to open up the lives of people with all types of disabilities, to enhance every capability, to improve their chances of a healthy, active, and productive life. This is especially important in lives of people with visual disabilities. The area of low vision assesses what visual capabilities exist in acuity, tracking, visual field, and mobility and then improves those capabilities using optical means, such as lenses and prisms, or vision enhancing technology.

This is important, not only as a matter of helping people with disabilities, but for each and every one of us. Many people with disabilities have a unique perspective on the world. Their insights and intelligence could lead to technological advances or breakthroughs in understanding of our place in the world as human beings on a finite planet.

VOSH/International has built a network of optometrists, educators, researchers, physicians, nurses, and volunteers dedicated to bringing vision to those who could not otherwise obtain such eye and vision care. We provide spectacles, eye drops, and other treatments to people in need, including people with disabilities. Our Past-President, Dr. Tracy Matchinski, is an expert in low vision and has educated optometrists, other health workers, volunteers, and students on how improve the lives of persons with disabilities. We recently enjoyed Dr Matchinski’s lecture on low vision technologies and Dr Sandra Block’s lecture on evaluating the vision of patients with intellectual disabilities at our recent Annual Meeting as a clear sign of VOSH/International commitment to strengthen our knowledge to serve all communities in need.

As 2020 comes to a close, I wish everyone a safe and festive holiday season, a Happy New Year, with hopes of a bright future in 2021.

J. Daniel Twelker, OD, PhD, FAAO, FVI
President, VOSH/International

For more information:

Flatten inaccessibility-Impact of Covid19 on blind and low vision adults report produced by the American Foundation for the Blind (AFB). Downloadable here

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Updated COVID-19 and VOSH Humanitarian Clinics Advice

VOSH/International recently consulted its US and International Chapters about the feasibility and timing to restart our humanitarian clinics. While the vaccination process continues with different levels of success depending on availability and acceptance, it is evident that vaccine inequity and the availability and reliability of data in several countries are issues we need to consider.

Even if already vaccinated and boosted, our chapters are still concerned about the wellbeing of our volunteers and patients.  Some chapters, are organizing clinics locally where they are better able to comply with the existing safety requirements and respective state/country regulations.

The COVID-19 pandemic and its variants are being experienced quite differently depending on state, region, country, vaccine availability, vaccine acceptance, and the spread of SARS-COV-2 variants. Most VOSH chapters are not holding clinics or traveling internationally in 2021 or 2022.

If a VOSH Chapter choses to hold a clinic or travel internationally, we highly recommend that the chapter performs due diligence to comply fully with the requirements established by the visited country, ensures all VOSH volunteers are aware of and follow strict safety guidelines and all existing protocols and regulations of the country, and keeps the principle of “do no harm” embedded in all its decision making. As always, the wellbeing and safety for VOSH volunteers and our patients is of utmost importance and central to any decision-making process. We have published our updated clinic guidelines with best practices to be observed in this new context. VOSH chapters in specific countries are using protocols that need to be considered as well. You can download VOSH/International clinic guidelines here.

*VOSH/International is formed by autonomous US and international chapters that are fully and only responsible for their activities, fundraising and decision-making.  VOSH/International can only provide recommendations based on our best knowledge and information at the time.

Also please keep checking the following sites with official and most recent updates:

World Health Organization:


US Government Travel Advise:

Thank you for your hard work and dedication to improving vision and eye health throughout the world.

Michael Ciszek, OD, dipl ABO, FVI

President, VOSH/International

December 2021