Dr Ozy Okonokhua, is the National President of the Nigerian Optometric Association (NOA). In this interview with our Health Editor, HASSAN ZAGGI, he explained how blindness and other eye related illnesses are on the rise in Nigeria due to the lack conducive environment for optometrists to operate in public hospitals. Excerpts.
What is the dividing line between an optician and an optometrist?
The optometrist is a health care professional who is licence by the Optometrist and Dispensing Optician Registration Board of Nigeria to practice optometrist having undergone six years programme in a University with a one year internship programme following, after they go for youth service.
In Nigeria, besides the medical doctor, the optometrist is the next person who can do direct consultation with the patient. The other health care professionals wait for prescriptions from either the medical doctor or from the optometrist. When I say a medical doctor, I generalize it to mean all the specialist areas in medicine.
Unlike the optician who is a technician by training. His job is to take prescription from the optometrist and fit into spectacles or frames.
There is a group of people that normally go to places of worship and outreaches to give people glasses, who are they?
A lot of these persons are not professionals, these are just business men and women who are cashing in on the need of Nigerians and the gap created by poor distribution of healthcare professionals.
For instance, you can hardly find them coming into city centres like Abuja to carry out such screenings, but where there is a shortage of manpower, they cash in on that and deceive most Nigerians that they are providing eye services. Often times the prescription that they give are not correct.
Yes, there are some professionals who are engage in it but if it is not done with the intent of helping the people, then it has become another business venture all together. This is because an outreach is to reach out to a community that has need.
So the professional is expected to go there, meet with these people, provide them their need and where they cannot provide their need they refer such people to a recognized center. But most of these people just come, sell glasses, sell drugs and then they walk away.
Some churches, in a bit to help the congregation, fall prey to these people because they are not speaking with the right professionals, they have not interface with the people who actually know and can identify a quack from a real professional.
So, we normally encourage people, please whenever you want to render such services to the community which is a laudable project, reach out to the professionals groups like ours and find out whether such group of people are actually competent to carry out such services.
Optometrist practice in Nigeria, how far, so far?
Optometrist practice in Nigeria has come a long way. Even though people still mistake us for opticians from the days where it was purely optical services, now optometrist practice have gone very deep, it has a very wide scope of practice now.
We are now beginning to venture into some specialties which hitherto we have not been doing and expanding our institution based training. Our academia is also growing and even in the clinical aspect, the optometrist practice has expanded tremendously.
However, our challenge basically is with the public practice. In the private sector, I can say we are doing well.
However, in terms of public practice, government has not seen the important role that optometry has played in eye care services.
Unfortunately, a lot of my colleagues in public practice do not have the liberty to the fullest of their scope because of government bureaucracy and intra-professional rivalry.
The optometrist is cage in the public practice, where in the private practice, the optometrist explores fully the scope of his knowledge and is very wide.
I can assure you that if optometry is given the rightful place it deserves in private and public practice, blindness that is occurring in this country currently will be abated.
Talking about professional rivalry, can you explain further?
In the eye care industry, the stratum include the optician, the ophthalmic nurse, optometrist and the ophthalmologist. These are the four recognized eye care professionals we have currently in this country.
Top at the cadre is the ophthalmologist. They have permeated the public sector to the extent that very senior ranking person, most times in the public practice is the ophthalmologist.
Now the optometrist is supposed to come next in terms of ranking. Now, for one reason or the other, the optometrist is not allowed to express himself professionally speaking as he or she should in the public practice and this is affecting the profession negatively.
In the eye care profession, it is also expected that if you come in, you don’t jump to go and see the consultant. You start with the general practitioner or with the primary eye care provider who is the optometrist.
The optometrist is meant to screen you, determine whether you have a problem and what type of problem. Is it the problem that can be solved here and now? or is it a case that you need to see a specialist or a consultant? That is the practice that is supposed to be, but that is not how it is done in the public practice.
In the public practice, you just come and the consultant insists on seeing you first and then when he is done, he refers you simply to the optometrist to go and get glasses. The optometrist is not the refractionist. The optometrist is a competent eye care provider who is trained in the art detection and treatment of wide range of eye infections and is able to provide remedy using a lot of procedures including drugs and other forms of therapy.
But in the public sector, this is not what is allowed to play out. They have reduced the optometrist to a refractionist. Patients are suffering. How does this play out? You come with problem to the hospital, because we have one consultant, most times and you may have five optometrists and one ophthalmologist and he (the ophthalmologist) wants to see all the patients. So, there is a backlog. Patients are lining up to see the ophthalmologist.
So, the gate into the eye care industry is narrowed. So patients piled up, they give them appointments for next month. In some hospitals, you have patients who have been booked for August or September (remember we are in May). If this patient has a blinding condition, you expect him to wait till August because he wants to see a specialist and then you have at the back house, optometrist waiting the see patients, but you don’t want them to see patients, why- professional rivalry.