Glasses for everyone? A bill in Andalusia opens the debate on visual poverty

The first thing Salma does as soon as she wakes up is go get her glasses.

She is two years old and this fall the ophthalmologist, after detecting strabismus, verified that she also had farsightedness and astigmatism –3.5 and 4 diopters in each eye.

Wearing them, as his mother, Pepa Fajardo, says, has changed his life: “He walks very well and before he fell a lot, he keeps looking at everything because he can see it clearly…” A change that for his family is practically unattainable.

Her glasses cost 288 euros, including 36 euros for insurance, which represents 82% of Fajardo's salary.

That salary is the only one that goes into her house, where two adults and four children live (her husband is unemployed), and which they complement with the 850 euros they receive thanks to the Minimum Living Income.

After weeks of trying to find a way to pay for them, they managed to afford them thanks to a financing plan offered by the company where Fajardo is employed.

That optical products are not a luxury item and that they are accessible free of charge to all minors and to the elderly depending on their income is the initiative that has begun to be processed in the Andalusian Parliament through a proposal law promoted by Adelante Andalucía that, by virtue of the articles of the Statute of Autonomy, would have a state character.

An initiative in which the Minister of Health, Mónica García, has been interested, who announced last week that throughout this term she intends for glasses and contact lenses to be incorporated into the National Health System to guarantee that users They don't have to pay for them out of their pocket.

The norm aims for visual health to be a universal right and that access to glasses and contact lenses, which are essential items, does not depend on the economic capacity of families.

“From the National College of Opticians-Optometrists we are trying to promote in all the autonomous communities and in the National Health System a national visual health plan that integrates visual health as one of the essential elements.

The cultural and intellectual development of a child and then the work of people depends on them being visually effective and learning through that sense," explains Eduardo Morán, president of the National College of Opticians, who agrees that allocate budget items to guarantee visual health.

61% of Spaniards use glasses or contact lenses, according to the 2022 European Health Survey published by the INE.

A percentage that, in the case of the poorest communities such as Andalusia - with the lowest GDP per capita in Spain and the one with the least use of glasses in the entire State - is reduced to seven points, showing that the socioeconomic factor influences when it comes to putting on glasses and having check-ups, as denounced by the left-wing Andalusian formation.

In the case of minors, and according to the calculations made by the Visión y Vida organization in its

2021

report

years―, 31% have some unresolved visual health problem.

Percentages that also worsen depending on the degree of poverty in the territory, which led this entity to coin the term “visual poverty.”

In the case of child poverty, the average in Spain is 8.56%, but in Extremadura it rises to 11.52% (the highest) and in Andalusia (the third) it reaches 10.53%.

“Poverty rates do not stop growing and it is increasingly difficult for families to make ends meet, especially when unforeseen expenses arise, such as glasses.

For many it is a luxury item, not because they do not see it as necessary, but because they have to prioritize between putting a plate of food on the table or glasses, and then that has an impact on school performance," says Ana Sánchez, head of Advocacy. in Andalusia from Save the Children. “One in three cases of school failure are associated with poor vision,” explains Elisenda Ibáñez, optician and coordinator of Visión y Vida.

“Some families cannot consider buying glasses or changing lenses if their visual problems have increased because they do not have money.

As a society we should give them an answer,” she adds.

Fajardo, who is about to end his contract at his company, is paying in installments for his daughter's glasses, after verifying that there was no aid for having a large family that would allow him to pay for them.

She lives with the anguish that, since she is so small, the girl could break them or lose them.

That she wears glasses and a patch—that is financed by Social Security—is vital so that the diopters do not increase.

“The insurance only guarantees me 30%, I would have to pay the rest and it would be starting all over again,” she emphasizes.

Her glasses are special because of Salma's pronounced lack of vision and because they must be very flexible so that she can manipulate them more easily.

Her vision problems require constant review and Fajardo also fears that her prescription will increase and with it the expense involved in changing lenses.

“If the law passed, she could still have spare glasses in case something happens to them, because if that happens, she is left with nothing,” he says.

Adelante Andalucía's proposal contemplates small changes in Law 16/2003 on Cohesion and Quality of the National Health System Fajardo, 32, could also personally benefit if the rule went ahead.

He wears glasses, but because of his job in a delicatessen, he needs contact lenses.

The investment does not seem that high.

The Andalusian training estimates it at about 710 million euros: about 260 million for minors and about 450 for adults at risk of poverty.

“The cost is perfectly acceptable if we take into account that Spain will receive 500 million euros from European child guarantee funds,” says Ibáñez.

The importance of prevention

Pepa Fajardo shows the special glasses that her daughter needs and the cost of which requires a great financial effort.PEPO HERRERA

Free glasses are only part of the solution to guarantee adequate and quality visual health.

This is where the national plan that Morán alluded to comes into play and which undergoes periodic reviews.

“Visual health should not depend on a pediatrician, there must be guidelines in Social Security and just as there is a vaccination program, visual check-ups should also be scheduled.

One should be mandatory before entering Primary school, which is when children are going to start reading, drawing...,” says Ibáñez.

When Fajardo began to notice that her daughter was squinting, she went to her pediatrician, who didn't see anything in particular.

She consulted a second woman who did refer her to the ophthalmologist and it was two months later, when they gave her the appointment — “because they processed it as urgent, because otherwise it would have taken four or five months,” she says — when they detected her farsightedness and astigmatism. .

“The sooner these problems are addressed, the sooner they are addressed,” says the president of the Official College of Opticians and Optometrists of Andalusia, Blanca Fernández.

Agreements with the Valencia City Council and the Community of Madrid

Cristina Vazquez |

Valencia

The Adelante Andalucía initiative is a pioneer in Spain because it guarantees the universal right to enjoy optical products, without depending on subsidies linked to the interests of whoever governs.

At the national level, only the mutual societies of public officials and members of the Army offer aid for the acquisition of optical products.

At the local level, the Valencia City Council and the community's opticians association signed an agreement in 2021 to finance part of the cost of glasses and contact lenses based on income.

“We value the implementation of the agreement very positively, since it ensures that people with greater access difficulties have the opportunity to receive high-quality visual and hearing care,” the school indicates.

In 2023, a total of 902 grants were awarded for an amount of more than 250,000 euros, reports

Cristina Vázquez

.

In Madrid, the Community and the National College of Opticians are also about to sign another agreement of 50 million that will guarantee basic coverage for all children under 14 years of age who cannot afford glasses.

"We did a study that establishes that the prevalence of myopia appears between the ages of six and eight and that it develops until the age of 14 or 16, so it is essential to stop it as soon as possible and prevent any child in Madrid from being left without their optical correction,” explains its dean, Emilio Morán.

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