To draw attention to blindness and vision impairment worldwide, every second Thursday of October, the World Health Organisation (WHO) celebrates World Sight Day.

Themed, ‘Love your eyes at work’,this year’s celebration clearly draws focus on eyecare in workplace. This is because people spend much of their time at workplace than their homes. The international body believes it isimperative to pay close attention to eyesight and vision, to keep the work environment safe and protect the eyes from possible hazards that could impair vision.

The organisationduring the 2023 celebrations, launched ‘WHOeyes’, a free app for the general public to check how well they could see things close up and at a distance and learn how they can protect their eyes.

The app checks visual acuity, a measure of how well the eye could distinguish shapes and details at a given distance. This is the most common assessment of visual function. It is a simple, non-invasive measure, which is critical to determine if someone has vision impairment or not.
Understanding that engaging the public is pivotal to advance the demand for eye care services, WHOeyes targets the entire population aged over eight years. WHOeyes does not replace the need for regular eye checks by an eye care professional; its primary objective is to encourage people to seek out eye care.

WHO Director for Noncommunicable Diseases, Dr. Bente Mikkelsen, said the app could help people quickly and easily identify potential vision issues that merit further checking by a qualified professional.

“We decided to share this simple eye test and quick tips for eye care on an app, as people use their phones daily, and many people are unaware that they have a vision problem until it is too late.”

Mikkelsen said vision loss could affect people of all ages. Globally, at least 2.2 billion people have a near or distance vision impairment. At least, 1 billion of these cases could have been prevented or can be easily addressed with spectacles or cataract surgery.

In addition, vision impairment poses an enormous global financial burden, with an estimated 411 billion lost in workplace productivity owing to poor vision.

However, eye health experts have warned that the leading causes of blindness globally are refractive errors, cataract, diabetic retinopathy, glaucoma and age-related macular degeneration.

The experts noted that early detection, regular eye examinations, proper management of underlying medical conditions for instance, diabetes, and timely treatment are crucial in preventing or minimising vision loss and blindness caused by these conditions.

According to Chairman, Nigerian Optometrics Association, Lagos State chapter, Dr. Gloria Okoekhian, the prevalence of blindness among adults in Nigeria is 4.2 per cent for people under 40 years, 6.5 per cent for people under 50 years, it is lower than in Pakistan with 5.1 per cent for people under 40 years; 7 per cent for people under 50 years, 25 higher than in Bangladesh with 2.3 per cent for people under 40 years; 3.9 per cent under 50 years, 26 and similar to that in India with 5.34 per cent aged less than 50 years.

She said that having good vision is essential to workers’ effectiveness and maximum productivity at work; hence, both the employer and employee are encouraged to prioritise eyecare for effective delivery of tasks and optimal performance.

Okoekhian noted that a critical look at this theme “love your eyes at work” throws up a lot of questions: What are the leading causes of blindness? What are the causes of eye related problems at the workplace? How do we prevent eye injuries at the workplace? Who is at risk to these eye injuries? What are the responsibilities of the employers and employees towards a safe work environment?
 
Okoekhian disclosed that fortunately, almost all eye injuries at the workplace could be prevented with the right strategies and policies in place.

Both the employers and employees have responsibilities to ensure these are well stated and implemented, accordingly. She called on workers to carry out proper risk-assessment of the workplace and put precautionary measures in place that will help to eliminate potential eye hazards from the workplace.

She advised on the need to maintain workplace equipment and ensure the safety devices are in proper and good working conditions.
“Replace toxic chemical substances and high-risk equipment with safer alternatives,” she warned.
 
On how to prevent workplace hazards, she noted thatthey include, use of exhaust hoods or extractor fans to manage dust or fumes in the work site. Ensure all workplace equipment operators follow the manufacturer user instructions and safety guidelines. Ensure adequate ventilation and humidification for dusty environments.

Okoekhian said for the worker, the simple tips that would help maintain eye-safety in the workplace include, always wear safety goggle and other protective eyewear that is needed for the job they are assigned to like welding, grinding metal, handling chemicals, among others.
Okoekhian explained that good eyesight and vision are invaluable to a worker’s quality of life and level of productivity at work, and as such both the employees and employers must ensure the work environment guarantees safety of the eyes at work.

She explained that these causes are all related to the internal structure of the eye and disease conditions not related to the workplace even though they can be found among workers. Whereas eye related problems in the workplace are majorly caused by the hazards of the work environment.

She said: “These hazards could either cause eye related injuries or predispose the worker to syndromes that can cause great discomfort to the workers and reduce their work performance. Work-related eye problems can come in various forms of injuries from jobs like construction work, engineering, factory work that involve chemicals, exposure to bright ultraviolet light like welding and prolonged exposure to the digital screen at the office.”

She noted: “Observe the 20-20-20 rule while working, by taking a break from the computer screen every 20 minutes. Visit the eye clinic for regular comprehensive eye examinations at least once a year.”

She urged employers to prioritise eye safety in the workplace by placing eye safety posters around the workplace with inscriptions such as, “Wear Eye Protection” sign in the areas of the workplace where they are needed. “They can also include information and tips about eye safety in the company’s newsletter or have it posted at strategic locations in the workplace.

She added, “to show love to your eyes at work is to show one’s desire and commitment to performance and productivity”.
A public health specialist/physician and Executive Director, STAND Consulting Abuja, Nigeria, Dr. Otubo Victor Ogemdi, said blindness couldalso result from various eye conditions and diseases, and it is important to note that some causes are reversible or preventable if detected and treated early, while others may be irreversible.

He said that cataracts cause clouding of the lens in the eye, leading to blurry or dim vision. It is a common cause of blindness, especially in older adults.

He noted that glaucoma involves increased pressure within the eye, damaging the optic nerve. If left untreated, it can cause gradual vision loss and eventually lead to blindness.

“Age-related macular degeneration (AMD) affects the central part of the retina (macula), resulting in a loss of central vision. It is a leading cause of vision loss in older individuals,” he revealed. He stated that diabetes could damage the blood vessels in the retina, causing vision problems and potentially leading to blindness if not managed properly.

Retinal detachment occurs when the retina pulls away from the underlying supportive tissues, causing a sudden loss of vision in the affected eye.
However, he said optic nerve disorders is a condition affecting the optic nerve, such as optic neuritis, optic nerve atrophy, or ischemic optic neuropathy, can lead to vision loss or blindness.

Ogemdi disclosed that refractive errors that could lead to blindness include, uncorrected refractive errors like myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia can cause significant vision impairment if not corrected with glasses, contact lenses, or surgery.

He said: “Eye infections is another cause of blindness, which include severe forms of conjunctivitis, keratitis, or endophthalmitis, can cause vision loss if not promptly and adequately treated.

“Injuries and trauma, these are severe injuries, including chemical exposure, dusts and radiation injuries to the eyes can result in blindness or significant vision impairment, depending on the extent of damage.”He said blindness is hereditary or genetic, as certain genetic or hereditary conditions, like retinitis pigmentosa and congenital cataracts, can cause blindness from birth or early in life. “Retinopathy of prematurity (ROP) is a condition affecting premature infants and can cause vision impairment or blindness due to abnormal blood vessel development in the retina.

He said excess exposure to screens, particularly, digital screens like those on computers, smartphones, tablets and televisions, is associated with a range of vision-related issues, but it is not typically linked to permanent blindness.

However, he explained that prolonged and excessive screen exposure can cause a condition known as digital eyestrain or computer vision syndrome, with symptoms such as eye discomfort, blurred vision, headaches, neck and shoulder pain. Difficulty in focusing eye on objects, amongst others, this has become very prevalent in our workplaces.

“It is important for both employers and employees to understand the economic significance of vision impairment and blindness. Blindness undermines the productivity of organisations and the earning capacity of individual workers,” Ogemdi said.

He said personal responsibility is very important, as employees must take responsibility for themselves above anything else. “I always call myself back whenever I begin to put so much undue pressure on myself. I have found out over time that there may not be time for everything but there will always be enough time for what really matters,” he revealed.

On how to prevent eye infections, he said people should position their computer screen at eye level, maintain good posture, and sit at an appropriate distance from the screen to reduce strain on your eyes, neck, and back.
Use of blue light filters on your screens or wear blue light-blocking glasses to reduce potential eyestrain caused by prolonged screen exposure.

“Remind yourself to blink regularly to keep your eyes moist and prevent dryness. Give your eyes a break by stepping away from the screen periodically, engaging in activities that do not require screen use. Adjust display settings to ensure that your screen’s brightness, contrast, and font size are set for comfortable viewing”.

“Acquire Personal Protective Equipment (PPEs), whatever work you do, buy PPEs that help you stay safe. In fact, as medical doctor I have my personal stethoscope and a few other work tools that hospitals often provide. I go on to acquire what suites me, and it is personal,” the medical doctor said.

Ogemdi explained that government is the mother of society. Government can also be the murderer of society. A good mother should simply take care of her children, and this is what the Nigerian government owes its citizen.

Consultant Ophthalmologist, at Lagos, State University Teaching Hospital (LASUTH) Ikeja, Lagos Dr. Ibukunoluwa Adeogun, said eyes are invaluable and very delicate organs of the body. No other part of the body can play the unique role that our eyes do. He said blindness is a condition with far reaching psychological and socioeconomic implications for both the individual and community.

Adeogun said primary prevention of blindness is directed at avoiding the events or onset of disorders that may lead to vision loss. “In practical terms, primary prevention of blindness is a journey that commences at conception all through adulthood. An individual’s eye health is determined by his/her mother’s health at conception, adoption of proper diet and comprehensive antenatal care in the course of the pregnancy.”

He said other important factors include, delivery in a standard environment; and after the baby is born, strict compliance with the national immunisation schedule particularly rubella and measles vaccines as well as vitamin A.

“Critically, children and adults must be aware of sight-threatening behaviour and encouraged to avoid them,”Adeogun reiterated.He noted that secondary prevention is focused on presenting early when one develops any eye problem so that treatment can be promptly instituted so as to avoid irreversible complications. “We must note that certain eye conditions like glaucoma can only be controlled and not cured. Tertiary prevention simply refers to rehabilitation after irreversible blindness has developed.”

He said the theme “Love your eyes at Work” seeks to help people understand the importance of protecting their vision in the workplace and to motivate employers and business owners to prioritise their workers’ eye health. He said employers should develop up-to-date policies on eye health and safety and this should be clearly communicated to employees.

Specifically, organisations should conduct regular eye health and safety training for employee in all appropriate languages.
“Provide and encourage their employees to undergo regular eye screening.

Provide their staff with ergonomic workstations with proper lighting to prevent eyestrain. To ensure that work processes and procedures are regularly reviewed for potential risk of causing eye injury.

He said organisation should equip all employees with appropriate eye protection free of charge. Provide regular training of employees on the proper use and maintenance of eye protection gadgets.

“Encourage employees to report all actual eye injuries as well as near misses. Draw up a written protocol and train employees on emergency response to eye injuries detailing, where the first aid supplies are located as well as proper use of materials if an injury occurs.

While advising that work-screens are 50 to 66cm away from the eyes, Adeogun, however, added that they should be equipped with in-built glare filters.He said there is need to ensure workrooms are well lit make use of blue light, glasses when working with their screens.

Adeogunalso said government is the principal custodian of the health of its people. As such, eye health promotion would involve increasing awareness on eye health and safety across all categories of the populace.

He equally raised the need for government to “formulating policies and enacting laws that would make certain that employers comply with all the aforementioned responsibilities. Incorporate primary eye care into primary health care. Provide adequate funding through comprehensive health insurance that will enable citizens to access optimal eye care at all levels of health care. Provide an attractive and enabling environment that would militate against the brain drain epidemic that plagues the health sector,” said Adeogun.