Spectacles galore

By George Laghu and Rogers Musoke

Mary Kiden, 28, is a vendor on Kyagwe Road in Kampala. Apart from roasted groundnuts, newspapers and old books, she has added spectacles to her stock.

“I sell these spectacles at sh7,000 each and they are the hottest items these days,” she says before a middle-aged man disrupts our conversation to try on a pair.

After a bargain, they settle for sh5,000 and the gentleman pays. He immediately wears the spectacles and walks away looking satisfied.

“I sell up to 15 pairs of spectacles in a day, mostly to students and middle-aged persons,” Kiden says before our conversation is disrupted again — this time by a young lady.

In less than 10 minutes, she seals another deal.

“The clients usually select one and we negotiate the price,” she says as she hands over one pair.

“Can you read this?” she asks, pointing at words in small fonts on the newspaper.

After testing three different pairs, I select one. “It fits you smartly too,” she responds, handing over a mirror to see myself.

“That one costs sh10,000 but I can reduce,” she pleads.

At St. Balikuddembe Market (Owino), youngster carrying a piece of paper torn from a newspaper accosted me with similar spectacles.

Not far away, another one holding a box of matches harangued me further.

“If you can read these things on the box of matches with any of these glasses, then it is the one for you.”

By all standards, both of them do not know a thing about eye defects. A school girl tested a couple of eye glasses, and ended up buying a pair at sh5,000.

“I knew I had eye defects,” she argues.

“I cannot read something written on the blackboard when I sit far away. One time,

I borrowed a classmate’s glasses and they were perfect.

The consultation fee of sh30,000 and the prices of spectacles in eye clinics are prohibitive. This is affordable,” she says.

Ophthalmologists warn

While there is no law prohibiting anyone from selling spectacles in Uganda, experts warn that it is wrong to buy spectacles from unqualified people.

Dr. Grace Ssali, the chairperson Association of Ophtamologists of Uganda (AOU), says spectacles are meant to correct eye defects.

Their misuse can lead to blindness.

Uganda “Spectacles can only be prescribed by an ophthalmologist or oculist, a specialised physician of the eye or an optometrist – a specialised dealer of glasses,” says Ssali, who is a consultant ophtamologist at Mulago Hospital.

Ssali said all eye services at Mulago Hospital are free.

Ssali clarifies that opticians are non-medical persons who deal in fixing the prescribed lenses on the frames.

It is, therefore wrong, she says, for anyone to go to an optician or freelance spectacle seller for any problem of the eyes connected to spectacles.

“All users of spectacles ought to undergo a visual acuity test before wearing any glasses,” she says.

Ssali regretted that neither the National Medical Services (NMS) nor the National Drug Authority (NDA) have the powers to regulate the sale of spectacles.

“It is time our MPs came up with stringent measures to regulate the sale of spectacles or else many eyes are at risk,” she says.

“There are many churches, NGOs and charitable bodies that dump second-hand eye glasses into the country. We have contacted some of these organisations and many have heeded to our calls.

There is need for urgent legislation on the sale and distribution of spectacles,” stresses Ssali.

Sources at both the NMS and NDA agree that they do not have an oversight role on spectacles.

“We can only play a role when spectacles are classified as drugs,” said an NDA official.

Shortage of eye specialists

According to Ssali, Uganda has only 40 trained and registered ophthalmologists for a population of 36 million.

The recommended World Health Organisation (WHO) standard is one ophthalmologist for every 250,000 people.

Dr. Ssali said wearing unprescribed spectacles leads to headache, tiredness, stress and increased pressure on the eyes, which can cause permanent poor vision and eventual blindness.

Correcting defects

Of all diseases of the eye, only colour blindness cannot be cured and cannot get worse as it is caused by abnormalities in the retina’s cones to receive and remit signals of colour to the brain. Other common curable sicknesses include:

Shortsightedness/myopia

It is characterised by blurred distant vision though near visions remain sharp. It is treated by use of concave glasses.

Longsightedness

It is also known as hyperopia is where one gets blurred near vision and clear far vision.

It is corrected by convex lenses. Presbyopia is when a person between the ages of 40 and 50 loses sight of objects that are near and need glasses to read or see things that are near. This is because the lenses of the eyes begin to harden and lose the ability to thicken. This can be corrected by a single or bifocal lens given after a specialized examination.

Astigmatism

It is the result of misshapen cornea which results in light rays which do not converge at the same point giving blurred vision both near and far.

Contact glasses with cylindrical components which have greater bending power can correct astigmatism.

Strabismus

It is a defect in which both eyes are not used together as one eye is deviated. When one eye is deviated towards the nose, it is called “cross eye” when an eye deviates to the side it is called “well-eye”.

Strabismus eyes see different parts of a scene, thus each eye sends different signals to the brain, causing double vision.

The brain ignores the weaker message from the deviated eye. It can be treated by glasses, eye drops, surgery or wearing a patch on one eye.

Unless treated early, the deviated eye maybe reduced to a “lazy eye” or strabismus amblyopia.

Regular eye checks the solution

Ssali recommends that an eye examination be done shortly after birth, every after a few years till the age of 40 after which eye tests must be done annually.

The cost of spectacles

A survey in selected eye clinics in Kampala indicates that lenses and frames are priced separately. The frames cost anywhere between sh60,000 and sh200,000 while lenses may set you back by as much as sh600,000 for bi-focal progressive ones.

The survey done on eye care centre along Kampala Road showed that contact lenses are sold strictly on prescription and the cost depends on the power and type with the cheapest going for sh300,000.