Reducing Visual Disability Through Affordable, High Quality Vision Care

I just returned from a short trip to El Salvador. The purpose was to follow up on a mission to provide cataract surgery to a group of people in the impoverished Rio Lempa Region south of San Salvador.

I met with the leadership of FUDEM (Women’s Foundation for health and vision), which was started in 1989 by Claudia Quiñónez and David Krasnow, OD of VOSH California. Thirty years ago, the women organizers of FUDEM did a small study and found that poor vision was a common and preventable disability that adversely affected women in poor neighborhoods and regions of the country. By helping women to see they would be helping women to prevent visual disability. At that time El Salvador was still in the throes of a brutal civil war. Because of the political instability, the idea was to create a non-profit, non-governmental organization to provide affordable eye and vision care, especially to the most vulnerable in society.

Now, 30 years later, FUDEM Eye Clinics are going strong. They charge fair and affordable prices for eye exams, spectacles, eye drops, treatments, and surgeries. An eye exam is $7 and single vision glasses are as low as $20, $30 for bifocals. For those who cannot pay, they provide discounts or simply give the service for free. They have eight brick and mortar clinics and do missions to schools and community centers. FUDEM Eye Clinics have been a resounding success and VOSH was a key part of their formation. Greg Pearl, OD, past president of VOSH/International, plans a trip almost every year to help out with their outreach missions. He was just there with another optometrist two weeks ago.

FUDEM Clinic Optical Shop


Every 3rd of December the world observes International Day of People with Disabilities. VOSH/International focuses on preventing blindness and visual impairment among those most in need and is proud to contribute with our expertise on low vision, collaborate with ophthalmologists referring patients who require cataract surgery and support the work of local initiatives such as FUDEM.

In addition to FUDEM, in El Salvador another promising institution is The University of San Salvador (UASS) School of Optometry. I met with director Paul Rivera, who is a physicist, and faculty member and licensed optometrist Liliana de Murcia, who studied at the Autonomous University of Aguascalientes in Mexico. They have a 5 year optometry degree program and have five to seven students per year. Many of the graduates end up working at FUDEM eye clinics.

Dr. J. Daniel Twelker, President of VOSH/International, donates a Heine Diagnostic Kit to UASS Optometry (Donated by Heine Optotechnik)

This visit was very productive and an eye opener to the situation of optometry in El Salvador. I hope that in the near future we will be welcoming UASS Optometry as a new SVOSH chapter. We hope to provide advice, equipment, and perhaps some funding for outreach clinics to elementary and high schools. This would be a great opportunity to send a VOSH/International Ambassador to improve knowledge and skills to practicing optometrists and optometry students.

El Salvador has a new government just elected seven months ago that recognizes the importance of primary eye health care. They are eager to reduce visual disability in El Salvador. The time is ripe to continue to build partnerships and ongoing friendships with our optometric colleagues in El Salvador.

For more information:
Greg Pearl, OD ( ) does one trip to El Salvador every year. Contact him if you would like to help out with a mission, especially if you are an optometrist or optometry student.

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 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