Somalia is losing sight of a major public health crisis: the country lacks trained optometrists and eye care professionals, leaving millions vulnerable to preventable blindness. A new analysis of nearly 2,900 patients in Mogadishu reveals that most eye conditions could be caught and treated early if the nation had a structured optometry workforce. Researchers are now proposing a three-part plan to build this critical infrastructure and expand access to vision care across the country. What Eye Problems Are Most Common in Somalia? When researchers reviewed eye care data from 2,890 patients examined between January and October 2025 at Dr. Sumait Hospital in Mogadishu, they discovered a striking pattern of preventable and treatable conditions. The most common diagnosis was conjunctivitis, affecting 1,231 patients, or 42.6% of those examined. Cataracts came in second, affecting 644 patients, or 22.3%. Refractive errors combined with computer vision syndrome affected 410 patients, or 14.2%. Beyond these primary conditions, researchers also identified serious comorbidities that require ongoing monitoring. Among the patients examined, 176 people, or 6.1%, had elevated eye pressure suggesting glaucoma risk. Additionally, 116 patients, or 4.0%, had diabetes, 98 patients, or 3.4%, had hypertension, and 14 patients, or 0.5%, had diabetic retinopathy, a serious eye complication of diabetes. Why Does Somalia Lack Eye Care Professionals? Somalia faces unique geographic and systemic challenges that have prevented the development of a trained optometry workforce. The country spans approximately 637,657 square kilometers with a population of about 19 million people spread across dispersed communities. Eye care services remain concentrated in major urban centers like Mogadishu, while rural, remote, and internally displaced populations face significant barriers to accessing timely screening, refraction services, and referral-based care. This geographic isolation means that patients with refractive errors, glaucoma, or diabetic eye disease often present late for treatment, after vision damage has already occurred. Without trained optometrists and optical technicians available locally, the country has become dependent on outreach programs and mission-based services that cannot reach everyone. Globally, low-income countries report fewer than one optometrist per million people, and Somalia's situation reflects this broader workforce gap. How Can Somalia Build a Stronger Eye Care System? Researchers propose a comprehensive three-component implementation framework designed to strengthen eye care delivery across Somalia: - Workforce Training: Establish formal optometry and optical technician education programs to create a pipeline of trained professionals who can provide primary eye care services and manage common conditions like refractive errors and early-stage cataracts. - Decentralized Service Delivery: Develop community and hospital-based eye care programs outside major urban centers, with clear referral pathways so patients with complex conditions can access specialist care when needed. - Sustainable Multi-Sector Partnerships: Build long-term collaborations between government health agencies, universities, international organizations, and private sector partners to ensure consistent funding and support for eye care services. This approach aligns with recommendations from the World Health Organization's World Report on Vision and the Integrated People-Centred Eye Care framework, which emphasizes building national capacity through optometry training. What Treatment Options Are Currently Available? Among the 2,890 patients examined in the Mogadishu study, treatment varied based on diagnosis and severity. Medical therapy, such as eye drops for infection or inflammation, was the most common intervention, used for 1,789 patients, or 61.9%. Prescription spectacles were provided to 595 patients, or 20.6%, addressing refractive errors that blur vision. Surgical procedures, primarily cataract surgery, were performed on 457 patients, or 15.8%. Finally, 64 patients, or 2.2%, were referred to specialists for conditions requiring advanced care. The high proportion of patients requiring spectacles underscores a critical gap: without trained optometrists to perform refraction assessments and dispense glasses, many Somalis with correctable vision problems remain untreated. This is particularly significant because refractive errors are among the most common causes of vision loss globally and are entirely preventable with proper correction. Why Should Somalia Prioritize Optometry Training Now? The data from Mogadishu demonstrates that a substantial proportion of patients could benefit from optometric and optical interventions. Uncorrected refractive error and cataract remain major causes of vision loss worldwide, and both are manageable through primary eye care when professionals are available. Building an optometry workforce is not just about improving individual vision; it is about preventing avoidable blindness at a population level. When patients can access early screening and treatment in their own communities, they avoid the progression to irreversible vision loss. This reduces the burden on specialist services, improves quality of life, and supports economic productivity. For a country like Somalia, where health infrastructure is already strained, investing in optometry training offers a cost-effective way to address one of the most neglected public health challenges. The framework proposed by researchers at Dr. Sumait Hospital and SIMAD University provides a practical roadmap for other low-resource settings facing similar challenges. By combining workforce development, decentralized service delivery, and sustainable partnerships, Somalia can begin to close the gap between the eye care services people need and the services currently available.
