In the Pacific region, where island nations are dispersed across vast ocean distances and health resources are often constrained, a quiet but transformative health profession is making a measurable difference: optometry. As the first line of defence against visual impairment, optometrists play an indispensable role in protecting and improving sight for communities that have historically lacked access to comprehensive eye care.
Across Fiji, Samoa, Vanuatu, Papua New Guinea, Tonga and other Pacific Island countries, the consequences of uncorrected vision problems extend far beyond blurred sight. Poor vision affects education, economic productivity, safety, and quality of life. In many rural and remote communities, undiagnosed refractive errors, childhood vision disorders, and preventable eye diseases persist simply because no trained professional is on hand to detect them early.
Optometrists as a backbone of Eye health care
Optometrists are primary eye care providers trained to examine, diagnose, manage and treat visual problems and eye disease. Their role goes far beyond prescribing spectacles. During routine eye examinations, optometrist can detect and can identifying early signs of serious conditions like glaucoma, diabetic retinopathy, cataracts and macular problems long before a person notices symptoms. In a region where specialists are few and distances are great, the role of optometrists is both clinical and preventative.
Optometry is a broad and evolving profession which is recognised across the globe by their specialisation in eye care field. These specialisations allow optometrists to deliver targeted care, manage complex condition, and support prevention of vision loss across different stage of life. Primary eye care and general optometry, paediatric optometry, contact lens practice, low vision rehabilitation, ocular disease and medical optometry, public health and community optometry, geriatric optometry, vision therapy and binocular vision, occupational and environmental optometry, academic and research and teaching roles are the specialisations, where optometrists expand the reach and impact of eye care services throughout the world.
Many cases of vision loss that we encountered in our clinic are preventable or treatable. When an optometrist screens a child at school or a farmer in a remote village, we can catch vision issues early, provide correction, and refer for further care if necessary. This stops problems before they become irreversible.
School vision screening programs, for example, have emerged as a cornerstone of early detection across the Pacific. Uncorrected refractive errors are one of the leading causes of visual impairment in children. Left undiagnosed, they can hinder learning, reduce classroom participation, and affect academic achievement. By bringing optometrists into schools, nations are ensuring children have the clear vision they need to thrive.
Tackling the burden of non-communicable disease and eye health
Pacific Island countries are significantly facing the higher rates of diabetes and hypertension in the world, and the eye complications associated with both i.e. diabetes — particularly diabetic retinopathy and hypertension — hypertensive retinopathy — are a growing public health concern. According to the latest 2024 data from IDF (International Diabetes Federation) Diabetes Atlas, the global age -standardised prevalence among adults aged 20-79 is 11.1 per cent, while specific Pacific nations like Samoa (25.4%), Nauru (21.8%), and Fiji (16.6%) far exceed this scenario. Similarly, according to the WHF (World Heart Federation) data, Fiji hypertension rate climbed from about 20% in the 1980s to 37-41% in the year 2011. Thus, diabetic retinopathy and hypertensive retinopathy can lead to vision loss if not detected and treated early. Optometrists are critical in screening diabetic patients and detecting retinal changes before symptoms even appear.
In Fiji, where diabetes prevalence is high, estimates suggest about 2.6% of adults are blind and cataract, uncorrected refractive error, and diabetic retinopathy together accounts for 80% of vision impairment and blindness. (Source: Pacific Eye Institute article published in Fiji village news)
Thus, reducing the eye health burden globally and in the Pacific requires a strong focus on prevention, early detection and accessible primary eye care. For the Pacific, strengthening optometry services, integrating eye care into primary health system, introducing special eye care services and improving referral pathways are critical priorities.
Regular eye exams by optometrists are crucial in areas where diabetes is prevalent. Regular examinations frequently reveal early indications of retinopathy or other issues, and prompt treatment can save vision. Because diabetic eye disease often shows no early symptoms, regular screenings — ideally annually — are recommended for individuals with diabetes. Optometrists can also educate patients about the connection between systemic health and eye health, reinforcing the importance of blood sugar control for preserving vision.
Overcoming access challenges
One of the most persistent challenges for eye care in the Pacific is geographic access. Many islands are remote, transportation infrastructure is limited, and specialist services are often concentrated in urban centres. This makes it difficult for rural populations to receive routine eye exams or follow-up care.
To address this, several Pacific Island governments and non-governmental partners have implemented outreach eye care programs. Optometrists travel to outer islands with portable equipment, offering screenings, eyeglasses, and referrals. These mobile services bring care directly to communities that would otherwise go without.
In some areas, optometry is being integrated into broader primary health care initiatives. Nurses and community health workers receive basic training via optometrists to identify visual complaints and refer patients to optometry and ophthalmology services, creating a more seamless connection between general health care and eye health.
Workforce development and sustainability
Despite the clear need for optometry services, workforce shortages remain significant across the Pacific. Many countries rely on visiting practitioners or sending students abroad for training. While these approaches provide temporary relief, they do not build sustainable local capacity.
Recognising this, initiatives to establish or expand optometry training programs within the region are gaining momentum. Local training ensures that eye care professionals are equipped with cultural competence and an understanding of the unique challenges facing Pacific communities.
An optometrist with local training is an advocate for eye health in their community in addition to being a medical professional. They understand not just the clinical needs, but also the social and logistical barriers that people face in accessing care.
Public awareness and preventive action
Vision impairment is often conceptualised as a clinical issue, but in the Pacific, it is increasingly understood as a public health priority. Uncorrected refractive errors, glaucoma, cataracts, and diabetic eye disease contribute to disability, reduce economic participation, and diminish quality of life. Preventive eye care — led by optometrists — addresses these challenges upstream.
Public awareness campaigns are central to this shift. Through radio, social media, community events, and school initiatives, optometrists and health authorities are educating the public about the importance of regular eye examinations. These campaigns emphasise that many eye conditions are asymptomatic in early stages, making routine checks essential.
At the policy level, several Pacific governments are integrating eye health into national health plans. This includes allocating resources for optometry services, investing in equipment, and strengthening referral systems to ensure continuity of care.
A vision for the future
The Pacific region faces a complex set of eye health challenges, but the growing presence and recognition of optometrists offer a path toward preventive, accessible, and effective eye care. By catching problems before they cause irreversible damage, optometrists help individuals maintain quality of life, children succeed in school, and working adults remain productive.
Preventing blindness is not solely a matter of clinical intervention; it requires public awareness, health system integration, accessible services, and workforce development. In the Pacific, optometrists stand at the intersection of these efforts, translating clinical expertise into measurable community impact.
As nations continue to invest in eye health, the role of optometry will only become more vital. Through collaboration, education, and sustained commitment, the Pacific can move closer to a future where preventable vision loss is no longer a barrier to opportunity or wellbeing.
DR BIKAS GYAWAL is consultant optometrist and public health expert.
