Amani Ed Yakin is the seven-year-old daughter of Francoise Umuhoza who lives in Kigali. When she was four, the toddler started having several problems in her left eye, making her rub it constantly, her mother narrates. “I did not pay much attention to that, and by the time she joined the second primary grade, she was no longer able to read,” her mother adds. “It came to my attention that when she was in class, the teacher always had to lend her a notebook for her to read, as she was not able to read from the blackboard,” she says. As time went by, the situation worsened, until her mother was advised to take her to the clinic. When she got to there, she received many complaints from doctors who blamed her for the delay. “Any ophthalmologist that I met asked me why I had delayed to bring my child for treatment, which is what made the situation even worse,” she recalls. World Sight Day, observed annually on the second Thursday of October, is a global event meant to draw attention to blindness and vision impairment. On this day, many doctors raise concerns about late diagnosis, a habit of many people who start with simple eye defects that turn into dangerous ailments. Jean Damascene Kanani, the head of ophthalmological services at Kibagabaga Hospital, says that among the 700 patients they receive a month, most of them have eye defects that worsened because of the delay to get diagnosed and treated. “Most of the patients we receive here do not have dangerous optical problems. It is just because they come late for treatment and we start diagnosing them after the disease has taken another turn,” he says. This, he adds, is very dangerous because it can even result in terminal illness. “For example, glaucoma is one of the most common diseases here in Rwanda. It can be easily treated at an earlier stage, but you find people coming after sight is severely damaged,” he says. The same views are echoed by Dr Gilbert Nshimiyimana, an ophthalmologist who says that regular check-ups could facilitate better detection rates, as long as there are conventional clinical diagnostic tools. “In fact, everyone should have regular check-ups in a year, it can be once in three months, six months, etc. This helps doctors to cure the disease as early as possible because it is effective in decreasing risks of the disease’s progression. However, to many, this remains western culture,” Nshimiyimana says. A subsequent analysis of factors associated with non-diagnosis showed that glaucoma patients who had not seen an eye doctor during the previous year had six-fold increased odds of being infected than those who had seen doctors for several times. “Early detection of eye diseases is essential not only to maximise the benefits of treatment for patients, but also to minimise the economic burden of glaucoma in society,” says Olive Mukeshimana, the director general of Kibagabaga Hospital. “People have to keep in mind that the costs of treating eye diseases like glaucoma rises as the severity of disease increases, and it is relative to how advanced the disease is at the time of diagnosis,” she adds. Thus, significant potential reductions in annual healthcare burdens are possible if patients are diagnosed and treated at earlier stages of glaucoma, Mukeshimana says. The development is not only confirmed by doctors, but by patients, like Beatrice Uzamukunda who reached a point where she was obliged to stay indoors as the sun rays were a problem to her eyes. “My disease was really simple, but I neglected it and reached a level at which I was supposed to stay indoors only, but now I can even stare at the sun without any problem,” she says, adding that she has learnt that early treatment is necessary in order to ensure that the potential benefits arising from it will be implemented.
