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According to the WHO about 831 million people are visually impaired worldwide, 45 million of them are blind. Most people with visual impairment are older, and females are more at risk at every age, in every part of the world. Uncorrected Refractive Error accounts for over half of all visual impairment. About 87% of the worlds visually impaired live in developing countries. The Mozambique Eyecare Programme (MEP) is a cross institutional collaboration between governments, higher education institutions, non-governmental organisations and corporations. The aims of this Programme are to collaborate to provide a sustainable solution to the problem of avoidable blindness in developing nations, by addressing the significant barrier of local human resource capacity development, through optometric education, research capacity strengthening and the enhancement of specialist knowledge for future collaborations. The MEP is an example of how cross institutional collaborations work effectively and efficiently to address uncorrected refractive error as a leading cause of global blindness and vision impairment. Dissemination of lessons learned will inform collaboration with the government and relevant organisations to integrate outcomes into the development of a National Eyecare Plan in Mozambique and other countries.

The dire need for eye care services and a dearth of human resources (HR) in sub-Saharan Africa motivated the setting up of new optometry programmes. However, to make a meaningful impact, geographical, gender, economic and educational disparities must additionally be addressed. A qualitative study utilizing purposive sampling to select academic leadership and students from optometry programmes in sub-Saharan Africa was conducted. Individual and focus group interviews produced data that were coded and analysed using a deductive thematic analysis approach. The themes that emerged as contributing to disparities in access through recruitment and selection were institutional barriers (student intake numbers, programme marketing, minimum entry requirements, absence of pre-medical programme) and socio-economic barriers (finance, poor secondary school education, lack of knowledge of optometry, geographic location of institutions, gender). To address equity, institutions should engage with communities, market via community radio stations, offer pre-medical and bridging programmes, partner with governments and private funders to offer loans and bursaries and affirm females and rural applicants in recruitment and selection. In conclusion, universities must be socially accountable in all facets of education including recruitment and selection.

Background: This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. Methods: A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practice in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. Results: One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95 per cent CI 1.3–8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ2 [1] = 13.52, p < 0.001). Multiple linear regression showed that optometrists with less experience, charging lower fees, and working in large multiples or franchised practices have the shortest appointment times. Conclusion: The strong link found between postgraduate education and the confidence of optometrists in detecting glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest. The responses also indicate a lack of funding for the level of diagnostic testing required for accurate glaucoma diagnosis. Recent increases in the state's eye examination fees look likely to address the identified time and financial barriers to glaucoma detection in Ireland. Future work should look to analyse the effects of increased funding on optometric case finding for glaucoma.

Background: This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. Methods: A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. Results: One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95% CI 1.3–8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ2 [1] = 13.52, p < 0.001). Multiple linear regression showed that optometrists with less experience, charging lower fees, and working in large multiples or franchised practices have the shortest appointment times. Conclusion: The strong link found between postgraduate education and the confidence of optometrists in detecting glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest.

Introduction/Purpose: There are almost twelve million children (years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3] In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself with broader child health and education strategies. The considerations discussed are relevant to organisations and institutions involved in the provision of primary child eye care through school screening. Methods: A review of published articles and white papers around current international trends in child eye health was performed. The Mozambique national, provincial and district educational and health systems were examined through the 2007 census and other published statistics. Interviews were conducted with representatives of the provincial health and education systems and an external bilateral aid representative. Local potential stakeholders in the child eye health programme were identified and interviewed; these included primary school principals, teachers and representatives from NGOs working locally and nationally. Results: Considerations will be discussed under the following headings: Social; Educational; Community; Health. A School Health policy exists in Mozambique but the implementation of the policy is not consistent in each province. The main considerations in Nampula are the lack of resources in education and health and the extreme poverty in which most children live. Potential areas for positive integration of child eye health were identified in several government run school and community health and education schemes. Conclusion: Highlighting potential barriers and opportunities to programme design ensures that it is sustainable and appropriate to the local setting. Familiarity and engagement with stakeholders in existing child health and educational systems in Nampula, as outlined in this presentation, will inform in the design of a child eye health programme and has the potential enlighten child eye health programme design in other countries. References: 1. UNICEF - Mozambique - Statistics. 2012 16/11/2012]; Available from: http://www.unicef.org/infobycountry/mozambique_statistics.html. 2. Baltussen, R. and A. Smith, Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ, 2012. 344: p. e615. 3. Gilbert, C., IAPB Briefing Paper: Integrating eye health into school health programmes, 2011, International Centre for Eye Health, London School of Hygiene and Tropical Medicine.

Introduction/Purpose: There are almost twelve million children (years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3] In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself with broader child health and education strategies. The considerations discussed are relevant to organisations and institutions involved in the provision of primary child eye care through school screening. Methods: A review of published articles and white papers around current international trends in child eye health was performed. The Mozambique national, provincial and district educational and health systems were examined through the 2007 census and other published statistics. Interviews were conducted with representatives of the provincial health and education systems and an external bilateral aid representative. Local potential stakeholders in the child eye health programme were identified and interviewed; these included primary school principals, teachers and representatives from NGOs working locally and nationally. Results: Considerations will be discussed under the following headings: Social; Educational; Community; Health. A School Health policy exists in Mozambique but the implementation of the policy is not consistent in each province. The main considerations in Nampula are the lack of resources in education and health and the extreme poverty in which most children live. Potential areas for positive integration of child eye health were identified in several government run school and community health and education schemes. Conclusion: Highlighting potential barriers and opportunities to programme design ensures that it is sustainable and appropriate to the local setting. Familiarity and engagement with stakeholders in existing child health and educational systems in Nampula, as outlined in this presentation, will inform in the design of a child eye health programme and has the potential enlighten child eye health programme design in other countries. References: 1. UNICEF - Mozambique - Statistics. 2012 16/11/2012]; Available from: http://www.unicef.org/infobycountry/mozambique_statistics.html. 2. Baltussen, R. and A. Smith, Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ, 2012. 344: p. e615. 3. Gilbert, C., IAPB Briefing Paper: Integrating eye health into school health programmes, 2011, International Centre for Eye Health, London School of Hygiene and Tropical Medicine.

Background - The Mozambique Eyecare Programme is funded by Irish Aid and designed to address the need for optometric education in Lusophone Africa. It is a multi-partner collaboration between Universidade Lúrio, Mozambique, Technological University Dublin, Ireland, University of Ulster, Northern Ireland, and The International Centre for Eyecare Education (ICEE) an international Non Government Organisation. A key output from the programme is the development of an optometry school based at Universidade Lúrio, the first of its kind in Mozambique. The aim is to address unmet eye care needs through human resource development. All students enrolled at Universidade Lúrio, including the optometry students, are required to participate in the One Student One Family programme. This initiative aims to improve the public health of disadvantaged communities in Nampula province through information dissemination and increased interaction between health science students and the general public. It also provides the students with the opportunity to interact with the community and apply their theoretical knowledge in the local context. This experience will enhance their patient care and as it is a community informed project, it ensures the wider eyecare programme follows a pro-poor approach. Aim - This paper aims to analyse the lessons learnt from the programme so far. Methods - Surveys and key informant interviews with optometry students, individuals within communities, teaching faculty and partners involved with the Mozambique Eyecare Project will form the basis of the analysis. Results - The results are expected to indicate both the successes and failures of the One Student One Family programme. The results will contribute to the development of a framework to improve the programme in order to achieve the desired outcome of improved community eye health. Conclusion - The Mozambique Eyecare Project is developing human resources in Lusophone Africa through a partnership linking higher education institutions in Europe and Africa. The One Student One Family programme addresses a current deficit in eyecare knowledge within the local community by transferring knowledge from optometry students to the general public. In conclusion, innovative models of education and interaction between students and the community is necessary to address the eye care needs of the country, the region and the continent.

Introduction Uncorrected refractive error is the leading cause of visual impairment worldwide and leads to an impaired quality of life. This study was designed to determine the prevalence of uncorrected refractive error and presbyopia, to assess spectacle coverage, and to evaluate visual health-related quality of life among persons aged 15–50 years old in Nampula, Mozambique. Methods Participants were assessed using a validated rapid assessment of refractive error protocol, comprised of a demographic questionnaire, a standardized ophthalmic assessment to determine refractive status and spectacle coverage, and a modified vision-related quality of life questionnaire to assess the impact of uncorrected refractive error on participants' visual health status. Results Among the 3,453 respondents, visual impairment prevalence was 3.5% (95%, CI 2.7%–4.2%), with 65.8% of those visually impaired being 35 years of age and older. Uncorrected refractive error prevalence was 2.6% (95%, CI 2.1–3.2%), and was the primary cause of visual impairment among 64.5% of cases. The spectacle coverage for uncorrected refractive error was 0%. Presbyopia prevalence was higher, at 25.8% (95%, CI 12.0–30.5%), with only 2.2% spectacle coverage. Respondents with visual impairment demonstrated statistically significantly lower quality of life scores compared to those without visual problems ( p < 0.01). Implications for practitioners The uncorrected refractive error problem and a distinct lack of spectacle coverage for refractive error and presbyopia indicate an urgent need for the development and delivery of a comprehensive refractive error service in the Nampula region of Mozambique.