Building the Optometry Workforce in Somalia: A Strategic Approach to Preventing Avoidable Blindness and Expanding Access to Vision Care

Purpose: Somalia faces a substantial burden of avoidable eye disease, while access to primary eye-care services remains uneven and optometry training capacity is limited. This rapid communication reports the pattern of ocular conditions and service needs identified in a large service-based eye-care dataset from Mogadishu and outlines a practical implementation framework for strengthening the optometry workforce in Somalia. Methods: This study was conducted as a retrospective review of routine service data from 2,890 patients evaluated during community- and hospital-based eye-care programs at Dr. Sumait Hospital, SIMAD University, Mogadishu, Somalia, between January and October 2025. Patients underwent routine eye assessments according to program protocols, including torchlight examination, visual-acuity testing, refraction assessment, intraocular-pressure measurement, and dilated fundus examination where indicated. Diagnoses and treatment/referral decisions were recorded and analyzed descriptively using frequencies and percentages. Results: Among 2,890 examined patients, the most common ocular condition was conjunctivitis (n=1,231; 42.6%), followed by cataract (n=644; 22.3%) and refractive error plus computer vision syndrome (n=410; 14.2%). Other ocular conditions accounted for the remaining cases (n=605; 20.9%). Comorbid conditions included glaucoma with IOP > 21 mmHg (n=176; 6.1%), diabetes (n=116; 4.0%), hypertension (n=98; 3.4%), and diabetic retinopathy (n=14; 0.5%). Treatment modalities consisted of medical therapy (n=1,789; 61.9%), prescription spectacles (n=595; 20.6%), surgical procedures (n=457; 15.8%), and referrals (n=64; 2.2%). Conclusion: The findings indicate a high burden of preventable and treatable eye conditions and support the need for a structured optometry workforce in Somalia. We propose a three-component implementation framework: (1) workforce training (optometry and optical-technician education), (2) decentralized service delivery with referral pathways, and (3) sustainable multi-sector partnerships to expand access to vision care and strengthen long-term eye-care service delivery. Keywords: Somalia, optometry workforce, primary eye care, avoidable blindness, refractive error, cataract, referral pathways, low-resource settings