President’s Insights October 2020

This October we mark the 30th anniversary of International Day of Older Persons. There are many reasons to highlight the lives of older persons, and when it comes to vision and ocular health, it becomes even more important. As eye care providers and volunteers, we know that older people are especially affected by age-related changes. Of course, the most obvious place to start is presbyopia. The World Health Organization World Report on Vision reported that 1.8 billion people worldwide are affected by presbyopia, 826 million of which have limited access to optical correction. We know that a pair of spectacles that costs less than $1 could change the lives of hundreds of millions of older people to help make their lives more fulfilling and independent by being able to read, pursue a hobby, or work as it is the case in many low income countries or if they so desire in better income settings.

Everyone, if they live long enough, will experience at least one ophthalmic condition in their lifetime. One of the most common is cataracts, which are highly associated with advancing age. At least 65 million people are visually impaired due to unaddressed cataracts, which as we know could be addressed with a highly successful cataract surgery that takes about 5 minutes, using the Manual Small Incision Cataract Surgery (MSICS) technique, and costs about $15 according to a 2003 British Journal of Ophthalmology article.

Glaucoma is prevalent in older persons affecting about 5% of the population over 40 years of age in Africa (4.8%), the Caribbean (4.5%), and the Latino population of Los Angeles (4.74%) according to the LALES Study. Age-related macular degeneration, in a study by Wong, et al in Lancet (2014) showed a global prevalence of 11.6% in people aged 60-69, 19.5% in those aged 70-79, and 27.1% in people aged 80-84.

VOSH/International has programs designed to increase the quantity and quality of optometrists worldwide to detect and address refractive error and eye disease, whenever possible. We have increased the experience and education of US-trained optometry students by actively including students on VOSH Chapter clinics and establishing Student-VOSH (SVOSH) chapters. Optometry students can see more patients in a one-week clinic than they might see all year in their university or college clinic. International SVOSH chapters in Kenya, Uganda, Mexico, El Salvador, and Haiti have been formed in the last couple of years to increase their educational opportunities and to access much needed equipment and supplies.

Additionally, the Decade of Healthy Ageing (2020-2030) offers opportunities to VOSH/International and its chapters to raise awareness about the importance of eye health and vision care for everyone regardless of age so people can fulfill their potential in dignity and equality.

It is important to remember that older people inherently have accumulated a lifetime of knowledge and wisdom. They deserve our utmost respect. The key is to unlock their potential through optimizing health and vision. It is very important to increase interaction between older people and the younger generations so they can learn from each other. Sometimes the energetic and fresh perspective of youth is what is needed, while at other times the steady experience of an older person provides the insight for a solution to a challenge.

Finally, let us remember that older people are taking the brunt of the illness and losses of the COVID-19 pandemic. It is of utmost importance to protect our elders by promoting the use of face masks, frequent hand washing, and by selecting the safest environment for an in-person visit if or when that is possible. We must always remember the principle and intention to do no harm.

For more information on Older Persons Day, ideas on how to help, and other organizations and resources, please see these sources of information.

https://www.un.org/en/observances/older-persons-day

https://www.macular.org

https://www.who.int/publications/i/item/world-report-on-vision

Ageing and health: https://www.who.int/en/news-room/fact-sheets/detail/ageing-and-health

https://www.givingsight.org

https://www.helpage.org HelpAge International is a global network focused on creating a fairer world for older people so they can live safe, healthy and dignified lives.

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

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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, 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 is 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.

Thus, VOSH/International is slightly moderating its overall guidance against clinics and travel issued in late March 2020 and renewed in January 2021. This will be reviewed and communicated on a quarterly basis.

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 Organisation: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: https://www.cdc.gov/coronavirus/2019-ncov/travelers/when-to-delay-travel.html

US Government Travel Advise: https://travel.state.gov/content/travel/en/traveladvisories/COVID-19-Country-Specific-Information.html

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

John Daniel Twelker, OD, PhD, FAAO, FVI

President, VOSH/International

July 2021