(Inspirational Message delivered by Rep. Edcel C. Lagman at the Fred Hollows Foundation Optometrists’ Forum at the Holiday Inn, Makati on 14 October 2023)
With more than two million people in the Philippines alone having to live with visual impairment, preventable blindness is a growing global phenomenon that is made all the more tragic because it is a loss that could have been avoided. It robs individuals of their ability to see and experience the world around them, affecting their independence and self-determination, quality of life, and overall well-being.
Blindness not only impacts individuals but also their families and communities. It can lead to increased dependency, loss of livelihood, and social isolation. The emotional, mental, and financial toll of blindness can and will be immense, causing frustration, despair, and damage to self-esteem, not to mention loss of livelihood and economic opportunities.
What makes preventable blindness even more terrible is that many of the causes, such as cataracts, refractive errors, and glaucoma, can be detected and treated early on. With timely intervention, vision loss can often be prevented or minimized. However, due to various factors such as lack of access to eye care services, financial constraints, or limited awareness, many individuals do not receive the care they need in a timely and appropriate manner. It is also compounded by the lack of social commitment of some optometrists and some ophthalmologists to whom referrals are made.
This global problem is felt more keenly in low- and middle-income countries like the Philippines where eye health and vision care rank low in the hierarchy of basic services. Moreover, for many poor Filipinos, there is no question as to which is more important between a visit to an optometrist to address vision problems and putting food on the table.
Blindness likewise perpetuates a cycle of poverty and inequality, as individuals with visual impairments face significant barriers in education, employment, and social participation.
Ultimately, preventable blindness is heartbreaking because it represents the loss of a fundamental human sense and the potential for a full and enriching life. It reminds us of the importance of proactive measures, teamwork, and advocacy to ensure that everyone has the opportunity to enjoy the beauty of sight.
This is why we are deeply indebted to the Fred Hollows Foundation and its hardworking and dedicated officers and members led by Dr. Maria Victoria Rondaris for their outstanding and competent work in areas such as establishing local vision screening centers and teaching basic eye care; partnering with local government units and working within existing public health structures in launching well-equipped eye clinics manned by well-trained personnel; conducting health education, training, coaching, and mentoring sessions for community health workers, teachers, and nurses; and raising awareness that eye health need not be expensive even as it is vital to overall health and wellbeing.
Your work is both admirable and indispensable precisely because addressing preventable blindness and promoting eye health requires a multi-faceted approach, which includes consciousness raising, information drives, improving access to eye care services, and strengthening healthcare systems.
By prioritizing prevention, early detection, and treatment, we can significantly reduce the burden of blindness and help individuals lead fulfilling lives and ultimately contribute to their communities and eventually, to nation building.
It is clear that optometrists are our first line of defense against blindness and ocular morbidity. You are the frontliners in the war against vision problems. We cannot, therefore, turn a blind eye to the indispensability of the services you provide.
It was for these reasons that almost 30 years ago in 1995, I authored and successfully defended a bill that aimed to address the country’s vision care needs by strengthening and further professionalizing the practice of optometry in the Philippines.
Before it became a statute, the “Revised Optometry Law of 1995” or Republic Act No. 8050 underwent contentious debates and deliberations inside and outside the Halls of the Congress.
Almost all of the laws I have authored are controversial. They are controversial because they are innovative and pace-setting. Hence, they were important as they were in fact enacted as laws.
While I was a freshman legislator, I authored the Comprehensive Agrarian Reform Law. Much later, I authored the Reproductive Health Law and the triumvirate human rights legislation like the “Anti-Torture Act”, “Anti-Enforced Disappearance Act”, the law on the Recognition and Compensation of human rights violations victims during the Marcos Sr. martial law, in addition to the repeal of the death penalty.
The Revised Optometry Law (RA 8050) was in the mold of these controversial measures. Most of these laws were challenged before the Supreme Court which declared them constitutional.
Similarly, RA 8050 reached the Supreme Court because it dismantled the corporate practice of optometry and the High Court refused to declare it unconstitutional in the case of Board of Optometry vs. Acebedo Optical Company, Inc.
Optometrists provide one of the most important and basic of healthcare services and RA 8050 aims to modernize and maximize cutting edge services on vision care, particularly in the countryside and among low-income groups.
Among the salient features of the law are:
- It allows optometrists to use diagnostic pharmaceutical agents or DPAs in their detection of eye problems. Being at the forefront of the eyecare system, optometrists should be equipped with the best tools for eye examination to enable them to render eyecare services efficaciously and these tools include the use of DPAs, which, optometrists were not allowed to use prior to this law;
- It mandates a six-year course, as opposed to the then four-year course, leading to a degree of Doctor in Optometry to give our future optometrists more extensive and intensive training;
- It upgrades the quality of optometric education through the technical panel on optometric education; and
- It prohibits the corporate and other forms of indirect practice of optometry. This is a vital provision since it protects the profession from the onslaught of commercialism which was shown to have serious and deleterious effects on the quality of eyecare services. It should be noted that before the passage of RA 8050, corporations could merely hire licensed optometrists, thereby making it possible for a consistent board flunker to simply organize a corporation and employ duly licensed optometrists to work for him.
RA 8050 gave renewed interest in optometry, placed it in the public eye, and firmly set it in its rightful place as an essential branch of primary health care in the country.
It serves as the backbone of the optometry profession in the Philippines.
RA 8050 continues to be significant three decades after its enactment because the burden of blindness and visual afflictions continue to weigh down our health system.
According to data from the Department of Health (2017), out of the over two million Filipinos with visual impairment, 332,150 suffer from total vision loss, 33% of this number are blind because of cataracts, 25% due to error of refraction, 14% because of glaucoma, and the rest are due to other eye conditions such as retinopathy and maculopathy.
However, despite these alarming statistics and the importance of optometry in preventing vision loss, promoting visual health, and improving the quality of life of patients, ocular health is still often overlooked and undervalued.
This is where organizations like the Fred Hollows Foundation plays a crucial role in advocating for the profession of optometry as it continues to partner with LGUs and national optometric associations in its education campaigns and training seminars. Moreover, it also engages with policymakers and other stakeholders and collaborates with other medical professional organizations to promote the interests of optometry and optometrists.
But the Fred Hollows Foundation is doing something over and beyond education, training, and collaboration. Through its grassroots work and local projects, it is opening the eyes of our optometrists that their profession is also a vocation.
A big part of being an effective optometrist is giving back to the community. Your years of training and expertise allows you to make a positive impact on the lives of others, especially those who may be less fortunate or in need of support. Remember that your passion for your work will grow and your trade will flourish by showing compassion for others.
Philanthropic work helps build a strong sense of connection and belonging. When you actively participate in community service or volunteer work, you not only form connections with individuals who share similar values and goals but also develop bonds with the community you serve.
Altruism and lending a helping hand provide numerous opportunities for personal growth and development. Through volunteering or engaging in civic initiatives, we often develop new skills, gain valuable knowledge and experiences, and ultimately broaden our perspectives. This can enhance creativity; problem-solving abilities; and make us more balanced, more well-rounded human beings.
Giving back to our communities can bring a deep sense of fulfillment and happiness. It helps remind us of our shared humanity and the importance of coming together to make the world a better place.
To ensure that community service will truly be ingrained in the practice of optometry and to further strengthen the profession, I will file a bill amending RA 8050 to include:
- Incorporating the subject of “Community Optometry” that focuses public health methodologies, community medicine, and working in grassroots settings in the curriculum of optometry schools and colleges;
- Granting full scholarships to deserving students who want to take up optometry considering that the latest data from the Philippine Statistics Authority reveals that for every 10,000 Filipinos, there is only 0.4 or grossly less than one optometrist;
- Encouraging optometrists to provide at least forty-eight (48) hours annually of optometric services, ranging from providing information and education to rendering medical services, free of charge to indigent and low-income patients. The 48 hours annual pro bono services shall be included as a prerequisite in the accreditation under the PhilHealth; and
- Urging associations of optometrists or individual optometrists to enter into a Memorandum of Agreement with the Regional Directors of Centers for Health Development (CHDs) of the Department of Health for them to avail of payment for services rendered pursuant to the DOH medical assistance to indigent and financially-incapacitated patients.
Blindness prevention is a critical aspect of your role as optometrists. You have the power not only to identify, but more importantly, to address, eye conditions at their earliest stages. Regular eye examinations, early detection of ocular diseases, and appropriate intervention can prevent irreversible vision loss. It is good to always keep in mind that your knowledge, training, and skills are instrumental in preserving and protecting the precious gift of sight.
But again, allow me to underscore that public service, as with all other healthcare occupations, lies at the core of the optometry profession. Serving the needs of your community is a privilege you cannot afford to pass up and it should be underlined that providing accessible and affordable eye care services to all, regardless of their economic status, is vital to public health.
Espousing the spirit of Republic Act 8050 also requires continuous learning and professional growth. Stay updated with the latest advancements in optometry; participate in conferences and seminars like these; and share your knowledge with fellow professionals. Collaboration and knowledge-sharing are essential to elevating the field of optometry and ensuring that the best possible care is provided to your patients.
Allow me to commend everyone here today, especially the Foundation’s new members in six new provinces, including my home province of Albay, for your dedication and commitment to the field of optometry. You are the gatekeepers of good vision and your work impacts people's everyday lives.
In conclusion, the importance of the “Revised Optometry Law of 1995” cannot be overstated. It solidifies your role as key players in blindness prevention and champions of public service.
Embrace this law with pride and passion. Remember, you are not just optometrists. You are healers, educators, and advocates for vision.
Keep shining your light because there is very clearly more to optometry than meets the eye. Together, let's create a world where everyone can experience the beauty and wonder of sight.