Gender Gap In Eye Care

Gender inequality in access to health care has become a stark reality these days. According to the International Agency for the Prevention of Blindness (IAPB), out of 1.1 billion people worldwide who experience vision impairment, 609 million are women, a staggering 55 per cent, compared toA 497 million men. Women in Nepal bear a greater burden of blindness than men, but are less able to access the eye care they need.

The age-standardised bilaterally blind prevalence is 2.4 per cent in women and 2.1 per cent in men, but women have a higher risk of visual impairment, says Dr. Reeta Gurung, CEO of Tilganga Institute of Ophthalmology. Ironically, women are less inclined to visit hospitals and rather rely on community-based outreach or eye camps, which are typically limited in resources and scope”, Gurung asserts. 

Senior ophthalmologist Dr. Srijana Adhikari explains that the reasons are rooted in deep-seated social, economic, and cultural differences. Inaccessibility of transport, awareness, and affordability are immediate barriers. Women have to seek permission from male family members to seek care. Women in the majority of families are not the "family breadwinner", and as a result, their health becomes a lesser priority. "Low levels of literacy and participation in decision-making further weaken their ability to access services. Some groups only bring girls for care if marriageability is threatened, e.g., to have a squint corrected before a wedding, she says.

Women live longer than men, and with that extended life comes a higher rate of age-related eye disease like cataracts, glaucoma, macular degeneration, and diabetic retinopathy. And yet these are also some of the most preventable or treatable causes of blindness, which points to a painful truth: women are going blind not just because they are more biologically susceptible, but because their diseases are not being treated.

Following menopause, eye health becomes even more susceptible. Hormonal fluctuations can lead to dry eyes, blurry vision, and prescription changes, adding to visual discomfort and reducing quality of life. Interestingly, women also lead when it comes to care provision. In the Tilganga Institute of Ophthalmology, 25 female ophthalmologists outnumber their 8 male counterparts, while 80 per cent of the paramedical staff are females. Nationally, 65 per cent of Nepal's ophthalmologists are females, and 77 per cent in the US. 

Nepali cultural values deeply govern women's access to eye care services, and they have a tendency to impose enormous barriers. They are based upon patriarchal ideology and traditional gender perceptions that prefer men's health to women's and restrict women's autonomy in receiving care. Financial dependence on male family members leaves women without the means to pay for treatment or transportation to health facilities. Indirect care costs, such as transport, accommodation, and lost employment, are major barriers, especially in rural and remote areas where transport is scarce or costly.

With gender-sensitive policies, outreach to communities, and economic empowerment, Nepal can offer women the eye care they are entitled to, preventing unnecessary blindness and creating a more equitable society. The gender inequity in eye health is a human rights issue. It will require targeted outreach, policy change, community sensitisation, and above all, empowerment of women to demand and utilise the care that they need and deserve. Eye health is not a luxury; it is a necessity, and it must be equally accessible to all.