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Bay of Plenty optometrist Bridget Field with Nancy, one of the post-grad students she helped train.

A Mount Maunganui optometrist helps tackle Fiji's growing eye care problem

Stepping out of her normal day job, Bay of Plenty optometrist Bridget Field, swapped the Mount for Suva after she was given the opportunity to help contribute to an initiative designed to deliver a long-term, sustainable solution to the region’s eye health problems.

While Fiji is known for its picturesque beaches and resorts, I experienced a different side of Fiji. I saw a Fiji where hospitals were few and far between; where people who did not have much still blessed me with gifts and ensured I would never go hungry; where housing involved no more than four tin walls; and where a man would travel three days by boat from a remote island just for a medical check-up.

As part of an outreach programme I recently undertook with The Fred Hollows Foundation NZ and Specsavers, I spent one week at the Foundation’s Pacific Eye Institute in Suva. My role was to supervise, train and mentor local postgraduate students who were on a one-year scholarship funded by The Foundation, on the fundamentals of eye care, so they could take this knowledge back to their communities. 

Diabetic eye disease, or diabetic retinopathy, is a significant and growing cause of blindness and vision impairment, particularly in the Pacific Islands, where there is a high rate of diabetes and lack of access to care.  More than 40 per cent of adults aged 40 years and over in Fiji have diabetes, meaning demand for services is huge.  

One of the students whose training I supported was a woman called Nancy, from Vanuatu. Nancy was a single mother and had to leave her three-year-old son back home as she was living in Suva for the year-long course. Each morning, she would get up at 4:30am to attend the eye clinic for training and study. She told me how passionate she was about learning as much as she could, so that she could take this knowledge back to her village and help her community. Her story was only one of many that I heard while at the clinic, and each and every one of them was just as inspiring.

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I was also fortunate enough to spend two days at the end of the trip visiting villages to perform eye screenings with the team that runs the Foundation’s Mobile Eye Clinic. I had no idea what to expect in terms of the people we would meet and how we would perform the screening. The days involved conducting a basic eye screening and giving ready-made glasses in either a plus or minus prescription. I was amazed as I came across people who had never had an eye exam and were walking around with 6/60 vision. With a simple pair of ready-made glasses, we were able to improve their sight to a visual acuity of 6/6, which was extremely rewarding.

As I looked around at the students in training and the people benefiting from this basic eye screening programme, I felt proud to be a part of it. I was grateful to have been given the opportunity to study optometry and I wanted to give back to the community; I went to Fiji to help, I left Fiji having gained a lot more in return.

The outreach, facilitated by The Fred Hollows Foundation NZ and Specsavers, is the result of a local partnership between The Fred Hollows Foundation NZ, The Ministry of Health & Medical Services and Fiji National University. 

The students are trained specifically to provide eye care to their local Pacific Island communities and gain a solid academic basis for their practice with considerable supervised practical experience. Once the year of training is over, they return home and are often the single source of professional eye care in their community.

A recent review of records from the Pacific Eye Institute Diabetic Eye Clinic in Suva describes alarming prevalence rates of diabetic retinopathy (DR) in patients; higher than rates reported in other developed and developing settings.

Research shows that more than half of new patients in 2010 had some degree of DR, a quarter had sight-threatening DR in at least one eye, and 10 percent had advanced sight-threatening DR in at least one eye. 133 of the 988 patients with sight-threatening retinopathy had vision worse than 6/60 — clinically blind. This means that they could see at six metres what someone with standard vision could see from 60 metres away. These patients are unlikely to regain vision, even with surgical intervention. The findings of this study emphasise the importance of early referral, close follow-up and improved glycaemic control to reduce the likelihood of sight loss from diabetes.

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