Health and Wellness

I am informed that:

The Western Cape Department of Health and Wellness provides access to basic vision screening and, where clinically indicated, referral for optometry assessment and spectacles through the public health service platform.

It should be noted that there is a distinction between Snellen screening and a formal optometry assessment. Snellen screening is a basic visual acuity screening test that uses a chart with letters, numbers, or symbols of different sizes to assess how clearly a person can see at a distance. It is used to identify possible vision problems and determine whether a patient should be referred for a formal optometry assessment.

Snellen screening is performed at all primary healthcare facilities, both fixed and satellite, by registered nurses. Formal eye testing refers to the assessment conducted by an optometrist using specialised eye-testing equipment or machines.

The information below is based on inputs received from Rural Health Services and Metro Health Services. Kindly note that Rural Health Services and Metro Health Services use different reporting systems. For this reason, some Metro information is not yet fully consolidated in a uniform provincial format.

(a) Based on the information received, access to the pathway for reading or seeing glasses is available through PHC facilities where patients are screened and, where indicated, referred or booked for optometry assessment.

In Rural Health Services, 64 clinics and 10 community day centres reported on spectacles required during 2025/26, giving a total of 74 clinics and community day centres in RHS reporting on this element. RHS further indicated that satellite clinics, a mobile service, Grabouw Community Health Centre, some district hospitals, and one specialised TB hospital also contribute to the reporting on spectacles required.

In Metro Health Services, access is provided through the relevant sub-structure arrangements, including fixed facilities and service-provider sessions. However, due to localised data systems in parts of Metro, the Metro facility total should be regarded as requiring further consolidation before a final provincial facility total is confirmed.

(b) Based on the information received, 66 Rural Health Services facilities are able to conduct formal eye testing on site.

Metro Health Services also provides on-site optometry access at several facilities across its sub-structures. However, as mentioned a final consolidated Metro total is not available in a uniform format at this stage.

(c) The number of residents recorded as having applied for, or been screened for, reading or seeing glasses through public health facilities was as follows:

These figures are based on the available RHS and Metro inputs received. As noted above, some Metro information is not yet fully consolidated.

(d) The number of residents recorded as having received glasses was as follows:

(e) The total cost incurred for the provision of glasses, based on the information provided, was as follows:

(f)(i) Turnaround times vary between service areas, depending on the scheduling of optometry sessions, the service model used, and the availability of spectacles once ordered.

In general, the turnaround time is between two weeks and one month, or by the patient’s next scheduled appointment or service-provider visit. In areas where optometry sessions are less frequent, patients are given a return date for collection aligned to the next available session.

(f)(ii) The main factors that may affect turnaround times include:

• the timing and frequency of scheduled optometry sessions;
• service-provider availability;
• budget availability within the relevant service area;
• demand for appointments;
• patients not collecting spectacles on the scheduled date; and
• difficulty contacting patients where contact details have changed.

(g) Measures implemented to manage turnaround times and support access include:

• screening at PHC level to identify patients who require referral for formal optometry assessment;
• scheduled appointment systems for optometry services;
• prioritisation of clinically urgent and priority clients;
• use of external service providers in some areas;
• referral pathways through school health services for learners; and
• referral of some children to partner services where free services are available in certain towns.

Priority clients may include patients with significant visual impairment, patients with one effective eye, children, school learners, students, and working residents who require spectacles to support daily functioning or economic participation.

(h) The current process followed by residents is as follows:

A resident reports to the local clinic or nearest public health facility, where they are screened by staff. Where indicated, the resident is referred or booked for a formal eye test.

If the eye test confirms that spectacles are required, the patient is placed on the relevant spectacles pathway and given a return date for collection.

Referrals may also be made through the School Health Professional Nurse. In some districts, the service is provided through a contracted service provider. Rural Health Services also uses the relevant standard operating procedure for refraction and ophthalmic health services in the applicable districts.