Rwanda has made progress in the fight against preventable blindness and vision impairment, according to Innocent Habimana, the Eye Health, Monitoring and Evaluation Coordinator at Rwanda Biomedical Center (RBC).

Among others, the country decentralised eye care services, since 2013, allowing local health centers to provide primary eye care, he told The New Times.

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"We have trained nurses in all health centers who provide primary eye care, and serious cases are referred to hospitals where ophthalmologists manage them, including performing surgeries, when necessary,” Habimana said, explaining that the country faces several prevalent eye conditions, with allergic conjunctivitis being the most common, often linked to environmental factors such as dust. Other frequent issues include refractive errors that impair vision—treatable with corrective lenses—and cataracts, which primarily affect individuals over 50 years of age.

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Habimana stressed that untreated cataracts can lead to blindness but are effectively managed through surgery which is available nationwide.

"Another serious condition, glaucoma, can cause permanent blindness if not addressed early.”

He noted that despite the availability of treatment, public awareness about eye health remains low. Many individuals with blinding conditions do not realise they should seek help, highlighting the need for enhanced patient education.

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"Financial constraints among older populations further limit access to eye care, to combat these challenges. The Ministry of Health, through RBC, has initiated programmes like the eye health messages released in April to educate communities on basic eye care. Community health workers are also being mobilised to bridge knowledge gaps and encourage regular eye check-ups,” Habimana stated.

The National Plan of Action on Eye Health 2018-2024, a six-year initiative, aligned with the country’s broader health sector goals, to reduce preventable blindness and expand access to eye care services. Developed under the fourth Health Sector Strategic Plan (HSSP IV) and inspired by global initiatives like Vision 2020 and the WHO’s Universal Eye Health Action Plan, the programme highlights Rwanda’s commitment to achieving universal eye health.

Rwanda’s efforts resulted in notable achievements, including the availability of ophthalmologists in all provinces for the first time—a marked improvement from the past when specialists were only based in Kigali and Southern Province.

According to Dr. John Nkurikiye, the Chief Ophthalmologist and Director of Rwanda International Institute of Ophthalmology (RIIO), the country’s eye health system has advanced, with increased integration into the primary healthcare system.

"In 2011, Rwanda became one of the few countries to introduce primary eye care programmes, ensuring that every health center had a nurse trained to handle eye issues within the community –this brought basic eye care closer to the people, helping to address common issues before they escalate,” Dr. Nkurikiye said.

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Rwanda’s eye health journey began in 2004 with the introduction of a mid-level eye care training programme aimed at producing healthcare workers trained to manage eye care at district hospitals. Since then, the country has gone from just three ophthalmologists, in 2001, to eight in 2011 and now 28, with more specialists who graduated in August, he added.

"While two more specialists recently graduated, and four are in residency at RIIO, the number of specialists remains insufficient for Rwanda’s growing population of 13 million. Additionally, the recruitment and equitable distribution of Ophthalmic Clinical Officers (OCOs) presents ongoing issues.”

According to the National Plan of Action on Eye Health 2018-2024, although Rwanda has trained over 2,800 nurses in primary eye care and integrated eye health into nursing curriculums, inconsistent national coordination and the lack of guidelines for eye health services still posed obstacles. Accessibility to rehabilitation centers for those with blindness remains limited, and reliance on NGO funding has led to uneven distribution of essential eye care equipment across the country.

The government plans to introduce policy reforms, invest in infrastructure, and further expand eye care training programmes. Proposed solutions included conducting a national inventory of eye care equipment to ensure its rational distribution across healthcare facilities. Ongoing work to maintain standards for surgeries and improve access to essential medicines through the Community-Based Health Insurance (CBHI) scheme was also part of the plan.

Lately, it is planned such that, by 2029, the Ministry of Health will ensure that every district hospital has an ophthalmologist, supported by the 4x4 strategy, which aims to quadruple the number of healthcare providers, including ophthalmologists, over the next four years.

"Our goal is to ensure that every district hospital in Rwanda has an ophthalmologist by 2029, so that eye conditions such as cataracts, the leading cause of preventable blindness, are managed effectively,” Habimana stated.

However, the country continues to rely heavily on external funding to support its eye health programmes.

"External funders play a critical role in our eye health services, but we are concerned about the sustainability of these programmes should that support suddenly stop,” he added.

Habimana believes that raising community awareness, especially regarding child eye health, is essential for the early detection and prevention of vision problems. RBC will carry out extensive school screenings in October and educational campaigns on radio and TV.

Some complex eye care services are still not covered by insurance, placing a financial burden on patients requiring advanced care.

As the six-year national plan of action on eye health nears end, policymakers are focused on ensuring sustainable funding for eye care services and addressing disparities in access to quality care. The country’s efforts are reinforced by its adherence to international frameworks such as the UN Convention on the Rights of Persons with Disabilities, ratified in 2008, which promotes the rights of individuals with disabilities, including those affected by vision impairment. Rwanda’s progress in this area positions the country as a model for healthcare equity and accessibility.

The global issue of preventable sight loss is also being addressed by the World Health Organization (WHO) through initiatives like SPECS 2030, which aims to improve access to corrective lenses and tackle refractive errors—the leading cause of vision impairment worldwide.

During the course of the national eye health week, from September 23-29, Rwanda joins global efforts to raise awareness about the importance of regular eye tests and early detection of conditions like glaucoma and diabetes. The campaign encourages individuals to adopt eye-friendly habits, including reducing screen time and wearing sunglasses outdoors.

"Globally, 2.2 billion people suffer from vision impairment, with at least one billion cases being preventable or unaddressed. The main causes are refractive errors and cataracts. Despite this, only 36% of those with refractive error and 17% with cataracts receive proper treatment.

Vision impairment carries a huge financial burden, costing an estimated $411 billion annually in lost productivity. While vision loss affects all ages, it predominantly affects those over 50,” the World Health Organization states.