Kenya’s eye-care gap: Why where you live can determine how well you see
James Buore, an ophthalmic clinician at Jaramogi Oginga Odinga Teaching and Referral Hospital, conducts an eye checkup on a patient at the facility on July 14, 2026.
Getting a pair of glasses in Kenya still largely depends on where you live. Nairobi alone took 57.8 per cent of all optical visits and 62 per cent of total revenue in 2025, new claims data shows.
Yet the ten counties generating almost nine in every ten optical visits nationwide share fewer than half the country's active optical providers between them. Outside the major towns, a trip to the optician often means a trip to the city first.
A closer look at the data reveals why. The optical industry closed 2025 worth Sh3.14 billion, up from Sh2.99 billion in 2024, according to the Kenya Optical Industry Report, compiled by health-tech platform Smart with the Kenya Association of Opticians (KAO).
Visits climbed from 203,023 to 213,465. Unique patients rose from 175,380 to 186,357. But the average cost per visit barely moved, inching from Sh14,430 to Sh14,530. Kenyans, it seems, are not paying more to see an optician. More of them are showing up needing it.
Refractive errors, where the eye fails to bend light correctly onto the retina, are driving that demand. Myopia, or short-sightedness, topped the list at 20.9 per cent of visits and 19.3 per cent of spend.
It happens when the eyeball is a touch too long, or the cornea too curved, so light lands in front of the retina instead of on it, blurring anything far away while close-up vision stays clear.
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Astigmatism, where an irregular cornea or lens scatters light unevenly, was close behind at 17.3 per cent of visits and 15.8 per cent of spending.
Presbyopia, the stiffening of the eye's lens that comes with age and makes phones and books hard to focus on, accounted for 15.7 per cent of visits. It was also the priciest condition per case, thanks to the multifocal lenses it usually requires.
Degenerative myopia, a severe form of short-sightedness in which the eyeball stretches and risks permanent damage to the retina, made up a smaller 2.2 per cent. Hypermetropia, or long-sightedness, caused by a shorter eyeball or an overly flat cornea, trailed at 1.5 per cent.
When the skin and whites of the eyes look yellow, this could be an indication of jaundice, a liver disease.
Most visits are nothing dramatic, just a check-up or a new pair of glasses, and those routine cases made up 81 per cent of all visits and 82 per cent of spending. Hospital admissions are rarer, just one per cent of visits, but far costlier: they swallowed five per cent of total spending, averaging Sh91,460 a case, more than seven times the Sh12,974 cost of an ordinary visit.
The people showing up for care are overwhelmingly working age. Adults between 21 and 50 made up 68.4 per cent of all optical visits, with those aged 31 to 40 alone accounting for 28.7 per cent.
Women visited more often than men, 56 per cent against 44 per cent. Children, by contrast, were barely visible in the data: patients aged zero to 10 made up just 5.3 per cent of visits, a gap the report does not explain but which raises the question of whether children's eye problems are simply going undiagnosed.
Cost climbed with age too, from an average of Sh9,360 per visit for children aged zero to five, to Sh21,600 for patients aged 61 to 70, and Sh35,060 for those aged 71 to 80.
Beyond Nairobi, Mombasa was a distant second at 5.4 per cent of visits, with Kisumu and Kiambu tied at 4.3 per cent each. Kajiado, Nakuru, Uasin Gishu, Machakos, Nyeri and Embu rounded out the rest of the top counties.
Interestingly, most people who claim their optical benefit only do so once. Some 88.2 per cent made a single visit in 2025, while just 11.8 per cent came back for a repeat claim, spending an average of Sh16,890 for the year.
Dr Victor Opiyo, President of the Optometrists Association of Kenya, links much of this to modern lifestyle changes and rising screen exposure, particularly among children. Patients today walk in with a wide range of complaints, he says, but a handful keep coming up.
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"The most common complaints we hear are reduced distance vision, photosensitivity (in other words, photophobia and itchiness, which directs us towards allergies, among others), plus eye pain. Those are the common complaints we are getting nowadays, plus foreign body sensation in the eyes," Dr Opiyo said.
He is particularly concerned about children, who he says are increasingly showing up with reduced distance vision, something he ties to less outdoor play and more time on screens.
"We have noticed a change in pattern. Most of the time nowadays, we are finding out that most of the patients are kids, and they are coming in with reduced distance vision. And that could be because of too many e-devices; they don't play outside most of the time, and this puts them at risk," he said.
It is not a Kenyan problem alone, he added.
"Globally, the world is struggling with the levels of short-sightedness because most of the time we don't get out; we are just indoors, and we are on our devices, and that is the nature of society today. Short-sightedness has increased in terms of numbers, and even if you look at the global indices, by 2050, we are projecting that half of the world will be [short-sighted]. So, it is something that we are really, really struggling with, and we have new modalities of how to manage the levels of short-sightedness currently, unlike before," the medic said.
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He is more troubled, though, by how long patients wait before seeking help.
"The behaviour of seeking medical attention for Kenyan patients is worrying. The reason is that, most of the time, most of the patients come with eye diseases or eye problems at the end stage. We sit with sickness for a very long time; maybe sometimes we use over-the-counter eye drops, and maybe something is worsening at the back of the eye," he said.
Part of the danger, he explained, is that some of the most serious eye conditions give no warning at all. Open-angle glaucoma, often called the "silent thief of sight", can steal vision from the edges inward long before a patient notices anything is wrong.
"Remember, we also have some eye diseases like glaucoma, which is a silent thief of the eye. You won't feel any pain; you won't get any signs unless you are very, very keen. There is a type of glaucoma, which is open-angle glaucoma; most of the time it's painless. You are losing vision from the periphery, so patients normally are not aware of what is happening," he explained.
"That is why we are saying that regular eye tests are very important. And I keep telling my patients to always listen to their body. Anytime it is trying to communicate to you that something is happening, the best thing to do as Africans, as Kenyans, is always to seek medical attention," he said.
"We need to change our behaviours when it comes to seeking medical attention and always visit the nearest facility as early as possible. Because most of the time, in medical terms, some diseases that are diagnosed at an early stage are easier to manage than coming with a disease at an end stage," Dr Opiyo added.
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