•Dr Priscilia Imade
INTRODUCTION
We are continuing our discussion on avoidable blindness today by looking at the common causes of avoidable blindness in Nigeria.
As a recap, avoidable blindness refers to visual impairment that could be either prevented or treated through timely and appropriate interventions. In Nigeria, like many other low- and middle-income countries, blindness remains a significant public health challenge.
Despite medical advancements and available treatments, millions of Nigerians still suffer from vision loss that could have been prevented or reversed. This situation is often driven by a combination of socioeconomic, cultural and systemic factors.

CAUSES OF AVOIDABLE BLINDNESS
1. Cataract: This remains the leading cause of avoidable blindness in Nigeria. It is characterised by the clouding of the eye’s natural lens, leading to progressive vision loss. Though cataracts can be treated effectively with surgery, many Nigerians especially those in rural or underserved areas lack access to quality surgical services. Cost, fear, myths and poor awareness often prevent patients from seeking timely treatment.
2. Glaucoma: Glaucoma, often referred to as the “silent thief of sight,” is another major cause of irreversible blindness in Nigeria. It typically presents without symptoms until significant vision loss has occurred.
Due to inadequate public awareness, lack of routine eye checkups and limited availability of diagnostic equipment, many Nigerians are diagnosed late when damage is already advanced and irreversible. With early detection, glaucoma can be managed effectively to preserve vision.
3. Uncorrected Refractive Errors: Millions of Nigerians live with uncorrected refractive errors such as myopia, hyperopia and astigmatism, which could be easily corrected with prescription glasses. Unfortunately, the cost of spectacles, limited access to optometrists and lack of eye health education contribute to the persistence of this avoidable cause of visual impairment, particularly among school children and low-income earners.
4. Diabetic Retinopathy: As diabetes prevalence rises in Nigeria, so does the risk of diabetic retinopathy, a condition where uncontrolled blood sugar damages the retina.
Many diabetic patients do not undergo regular eye examination and by the time vision problems arise, the damage is often advanced. Public awareness campaigns and routine screening programmes are critical in preventing vision loss from this condition.
5. Trachoma and Other Infections: Trachoma, an infectious eye disease caused by Chlamydia trachomatis, remains endemic in some northern parts of Nigeria due to poor hygiene and limited water supply.
Other infections, such as onchocerciasis (river blindness), which is transmitted by blackflies, also contribute to avoidable blindness in certain regions. While significant progress has been made through mass drug administration, these conditions still pose a threat in vulnerable populations.
6. Eye Injuries and Occupational Hazards: Eye injuries from road traffic accidents, domestic incidents and hazardous occupations — like welding and agriculture also contribute to preventable blindness.
Many of these injuries could be avoided through the use of protective eyewear and safety training, yet the adoption of such practices remains low in Nigeria due to poor enforcement and limited awareness.
7. Harmful Traditional Practices: Cultural beliefs and harmful traditional practices, such as the use of herbal eye medications or cow urine concoctions, often result in chemical injuries and infections that lead to permanent blindness. These practices persist due to mistrust in modern medicine, low literacy levels, and lack of public health education.
8. Poor Access to Quality Eye Care Services: The general lack of accessible and affordable eye care services across Nigeria plays a significant role in avoidable blindness. Rural and underserved communities often lack trained eye health professionals, diagnostic tool and surgical facilities. Even in urban centers, the cost of eye care can be prohibitive for low-income patients, leading to delays in seeking treatment.
CONCLUSION
Avoidable blindness in Nigeria is a multifaceted problem rooted in both medical and social determinants. Addressing it requires a coordinated effort involving the government, healthcare professionals, non-governmental organisations and the general public.
Public health education, policy reform, infrastructure development and community outreach programmes are essential to tackle the leading causes of avoidable blindness.
*Dr Priscilia Imade is CEO, Modern Eye Clinic, Lagos. E-mail: moderneyecliniclagos@gmail.com
Another edition of the column returns on Monday in The Frontier.


