A few years ago, I decided to accompany a friend to his tailor. As we walked along the narrow and winding path to his workshop, something caught my attention. It was a middle aged woman who was trying to remove tiny particles of sand, dirt and remnants of rice husk from the large bowl of uncooked rice. From the way she was squeezing her eyes, I knew she had difficulty seeing clearly.

As we moved further along, from the distance, I could see an elderly man about 80 years old reading a newspaper held at arm’s length. His arms looked as if they were too short for the distance at which he held the paper.

He looked up just as we reached the front of his house and our eyes met.  It was Pa Jomo, the oldest member of the United for Vision Club. He shouted, “Dokita, so you dey come this way too? You see wetin I dey suffer. Na only large prints of newspapers I fit read. I don forget my Bible long time. Make you give me an appointment to see you next week.” “Na here you dey live?” I asked in Pidgin English, and continued, “Make una come next Wednesday. I dey around now,” I added.

 Pa Jomo had blown my cover! One of the reasons for accompanying my friend to his tailor was to play the detective. His tailor who was about two houses away was reported to be working as an itinerant eye surgeon.

He had performed many couching with disastrous consequences. A few of the patients had ended up in my clinic. An interview with him would provide us with some insight into his personality and how we could work together to prevent further loss of eyes.

This initial visit was for me to get acquainted with him and gain his confidence. If he knew I was an eye doctor he would not cooperate. I prayed he hadn’t overheard Pa Jomo’s outburst.

The tailor’s house was two houses away. His workshop was in the back of the house. Surrounded by five apprentices, he seemed engulfed in an activity. Without looking up, he asked the young man nearest to him “Is it inside or outside?”

Curious to know what it was, I stooped over the head of one of the apprentices to see what was going. He was trying to thread a needle.

The needle was held at arms length in his left hand and the thread in his right. It was obvious he had tried several times without success.

He gave up. “Dele would you thread this needle for me?” he commanded his assistant as he handed both the needle and thread to him.

Then the unusual happened. The tailor looked up in my direction. Both of us recognised each other instantly! Bashiru, the tailor was one of my patients. All the precautions were unnecessary. His cover, not mine, had been blown and I knew my interaction with him would be much easier than I had anticipated.

“Bashiru, why don’t you use your reading glasses to thread the needle? I asked him. “I don’t wear them in public because people would think my eyes are weak,” Bashiru replied avoiding my eyes. I looked at him and I knew he was insincere.

But I couldn’t help thinking how common the problem of presbyopia was. “What is presbyopia?” my friend asked. “Are you a mind reader?” I asked my friend. “You blurted it out. You were talking to yourself!” he answered.  

 “Presbyopia is a health condition where the eye exhibits a progressively diminished ability to focus on near objects with age. It commences about the age of 40 years and gets progressively worse with advance in age. It is not a disease but an ageing process. The first symptoms most people notice are difficulty reading fine print, particularly in low light conditions, eyestrain when reading for long periods, blur at near or momentarily blurred vision when transitioning between viewing distances.

The middle-aged woman, Pa Jomo and Bashiru exhibited symptoms of presbyopia. It is important to note that there other potentially blinding conditions such as glaucoma that may present like or co-exist with presbyopia.

The only solution for presbyopia at the moment is a pair of appropriate glasses. A full eye examination is imperative to exclude these blinding conditions before obtaining glasses.

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