Optometry – more than improving vision

The Fred Hollows Foundation’s Fiji outreach program provides a sustainable way to support the community by training postgraduate students who will go back to their respective home towns and will usually be the sole eye care provider in the region. Affordable and accessible eye care is not yet universally available in the Pacific Islands, and the program aims to bridge the gap in a viable way.

Incorporating regular volunteer work into my career has always been one of my long-term goals. My philosophy is to offer understanding, respect, empowerment and support in a sustainable way to those in need. The Fiji Pacific Eye Institute (PEI) outreach program was uniquely structured to align with these values. It allowed me to share my knowledge and pass on skills that the students will be able to use as a long-term way of providing much-needed eye care to the local community. The knowledge that our work will create a positive ripple effect long after we leave is extremely rewarding.

Throughout my career, I have been fortunate enough to work with the latest equipment available. My recent outreach experience took me out of my comfort zone and taught me to trust my skills and instincts. I relied heavily on my ophthalmoscopy, retinoscopy and manual vertometry skills. As a result, I have a new-found appreciation for the importance of these skills, particularly as I aim to continue volunteering with outreach programs in the future.

In normal practice, there are a variety of tests we can use to assess visual fields, however, during the outreach, confrontation testing was used to screen each patient. In one particular case, this test helped pick up a bi-temporal field loss on an asymptomatic teenage girl. This event totally changed my perspective on the value of this form of testing.

The price of prescription glasses in Suva is generally unaffordable for many locals, and one of the main benefits of the PEI is that free eye tests and affordable spectacles ($15 per pair) are provided for all patients, some of whom make long journeys across Fiji to attend.

Even though the spectacles available at the PEI are relatively cheap, some still struggle to afford them. It is under these special circumstances that Specsavers supplies tailor-made spectacles free of charge. It is an absolute privilege to work for a company that generously donates to those who need it the most. Witnessing these cases first-hand was a truly gratifying experience.

All patients at the PEI who have previously been diagnosed with high blood pressure or diabetes have their blood pressure and glucose levels tested before entering the room. I was surprised to see a staggering number of malignant hypertension cases, and blood glucose levels that were unable to be read as they exceeded the maximum range of the blood glucose monitor. This information was imperative for correct triaging of the patient, and in some cases, could have saved the patient’s life.

The main cause of low vision in the patients I saw was due to refractive error, cataracts and diabetes. Some people live with this for five to eight years before seeking attention, and for many, cataracts are not treated until aided vision is 6/60 or less due to long waiting lists.

My outreach experience made me realise that the optometry profession is more than just improving the patient’s vision. Eye sight affects the patient’s independence, education, ability to make a living, and psychological state; these are all important facets of life that our profession directly impacts.

My passion for optometry has been revitalised by this experience. One inspiring local student summed it up very eloquently:

“Sight is your connection to the outside world. It brings the outside world into your soul. When you are feeling down inside, you can look at a flower in bloom and this lifts up your soul. What else is more important?”

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