Preventable blindness remains a major public health challenge in Africa

An ophthalmology specialist says avoidable blindness remains one of Africa’s biggest eye health challenges, with cataracts, glaucoma, diabetic eye disease and uncorrected refractive errors continuing to affect millions of people on the continent.

Dr Mpopi Lenake, a highly respected ophthalmologist (eye specialist), said while many of these conditions are treatable, patients often present too late because of limited access to specialists, long travel distances, and overstretched health systems.

She said the issue is not only increased disease burden but also unequal access to timely care.

Her comments come as South Africa hosts the African Ophthalmology Council Congress, where eye specialists from around the continent gather to share research, strengthen surgical training and discuss solutions to Africa’s eye health challenges.

The congress started on Friday and ends on Sunday at the Cape Town International Convention Centre, under the theme “Ophthalmology from Cape to Cairo”.

Lenake believes that hosting the congress is a significant milestone, as it positions South Africa as a leader in advancing eye health on the continent.

It provides an opportunity for African specialists to share research, strengthen surgical training and develop solutions that address the unique challenges.

She has a special interest in oculoplastic surgery, focusing on the medical and surgical treatment of conditions affecting the eyelids, tear ducts, and orbit (eye socket) in adults and children

Preventable blindness remains a major public health challenge in Africa, with millions of people living with vision loss that could have been prevented or treated through timely intervention, she said.

Beyond affecting eyesight, blindness impacts education, employment, independence and economic productivity.

“Preventing avoidable blindness is therefore a health care priority and a development priority.”

Lenake said cataracts remain the leading cause of avoidable blindness, followed by uncorrected refractive error.

“Glaucoma and diabetic retinopathy are particularly concerning because they often progress silently before symptoms develop. Regular eye examinations are critical because early detection significantly improves outcomes.”

According to Lenake, the biggest barriers include shortages of ophthalmologists, long waiting times, unequal distribution of specialists, travel costs and limited awareness of eye disease.

Many patients seek help only after significant vision loss has occurred.

“Strengthening referral pathways and improving access to community-based screening are essential.”

Lenake warned that people should not ignore symptoms which include “any sudden loss of vision, severe eye pain, flashes of light, a sudden increase in floaters, a painful red eye or double vision, which requires urgent assessment”.

“However, it’s equally important to remember that diseases such as glaucoma and diabetic retinopathy may have no symptoms at all, making routine eye examinations essential.”

She said some of the most rewarding cases involve reconstructing eyelids after tumour removal or severe trauma.

“Restoring a patient’s ability to protect their eye, preserve vision and regain confidence is incredibly fulfilling. Oculoplastic surgery allows us to improve function and quality of life in a very tangible way.”

Lenake said advances in reconstructive eye surgery have led to more precise, patient-centred treatment.

“Modern reconstructive techniques are far more precise and tailored to individual patients. Better imaging, refined surgical methods and multidisciplinary care have improved functional and cosmetic outcomes while reducing complications and recovery time. Today, success is measured not only by healing but also by restoring comfort, vision and confidence.”

She believes South Africa is making progress in producing enough ophthalmologists, but not enough to meet growing demand.

Lenake said the challenge is not only increasing the number of ophthalmologists but also ensuring they are supported, retained and distributed around the country.

“Sustainable investment in training, public sector posts and regional services will be essential if we are to improve equitable access to specialist eye care.”

She added that emerging technologies such as AI can transform eye care in Africa.

“Artificial intelligence has enormous potential to improve screening for diseases such as diabetic retinopathy and glaucoma, allowing patients to be identified earlier and referred appropriately,” she said.

Combined with telemedicine and portable imaging devices, these technologies could dramatically expand access to specialist care, particularly in rural communities.

However, she warned that technology must complement — not replace — clinical expertise.

Lenake holds an MBChB from Stellenbosch University, as well as FCOphth (SA) and MMed Ophth (UCT) qualifications.

In 2015, she completed advanced subspecialist training in oculoplastic surgery at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia, further strengthening her expertise in this highly specialised field.

She has been recognised for her academic excellence throughout her career and was awarded the prestigious Justin Van Selm Medal, presented to outstanding candidates in the fellowship examination of the College of Ophthalmologists of South Africa, and also passed her MMed degree with distinction from the University of Cape Town.

Her clinical work spans a broad range of ophthalmic and oculoplastic conditions, including disorders of the eyelids, the tear drainage system, orbital disease, and skin cancers affecting the eye region.

A recognised leader in her field, Lenake is the former president of the South African Society of Oculoplastic Surgeons, a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery, and a founding member of Women in Ophthalmology South Africa.

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