Cambodia, with a population of nearly 14 million, is one of the poorest countries in the world. Approximately 85% of the population lives in rural areas. The prevalence of blindness in Cambodia is estimated to be 1.2% which translates to nearly 168,000 people. The main causes of blindness and vision impairment are refractive error, cataracts, trachoma and glaucoma. Most of these are avoidable or preventable.

There is an existing network of 19 Eye Units based in its provinces. These units are staffed by ophthalmologists, Basic Eye Doctors, Basic Eye Nurses and ophthalmic nurses. Many of these units receive additional support from international non-governmental organizations (INGO) but there are limited health care facilities in Cambodia.

Currently, ICEE is collaborating with other NGO’s and the National Program for Eye Health of Cambodia to develop the National Refraction Training Centre to train local eye care personnel to address vision impairment due to refractive error. Part of this process is building local capacity – training eye care staff to, not only provide eye care services but, act as educators themselves – limiting the need for the continued presence of organisations like ICEE.

According to World Health Organization (WHO), Asia-Pacific has the greatest need in terms of vision impairment and blindness. Since 2003, Gerd Schlenther, International Centre for Eyecare Education (ICEE) Programs Manager for Australia and the Asia-Pacific, has watched the region as it begins to address the problem.

According to Gerd, “Our training models are all about developing sustainable systems that are culturally appropriate and will last beyond ICEE involvement in that country.”

The region, that also includes countries such as Timor Leste, Vanuatu and Papua New Guinea, ICEE optometrists and educators have been involved in providing and developing eye care for a number of years. Through collaboration with local communities and ministries of health, ICEE has begun to establish eye care services.

In 2004, ICEE conducted a situational analysis of the refractive error services in Cambodia with the Christian Blind Mission International and Disability Action Council of Cambodia. Together with the Cambodian Optometrists Association (COA) and the National Program for Eye Health, ICEE developed the current, Ministry of Health approved, three month refraction training curriculum and conducted a ‘Train the Trainers’ program for the refraction trainers at the COA.

Gerd explained that the means of addressing the refractive error problem is, “Training people that are able to dispense glasses – that’s what ICEE is all about”.

The approach sounds simple enough, but achieving the goal of providing access to basic eye care to all people is a complex task that involves substantial resources deployed through a range of programs and activities, requiring the support of governments and communities and managed by a lot of dedicated, competent people.