Allanah Bakker with a patient in Mexico
By Ashleigh McMillan
Allanah Bakker found it confronting but rewarding to help patients with uncommon presentations during her busy clinical placement in regional Mexico.
As a fifth-year QUT student, Alannah spent 10 days in November 2016 examining eyes in Tecalitlán, a town in western Mexico with a population of 13,000. She travelled with Volunteer Optometric Services to Humanity International.
The screenings were conducted on the ground floor of an old shopping mall where the top level had been recently renovated into dorm rooms where volunteers stayed.
‘Pretty much everyone and anyone showed up. We had children from the local school on the first day but also examined a lady who was over 100 years old,’ Allanah said. ‘People had travelled from quite a distance to come and see us, including from Guadalajara which was two hours away.’
Allanah saw unusual presentations which she hadn’t encountered on her previous placements, such as toxoplasmosis, juvenile macular degeneration, asteroid hyalosis and a phthisical eye.
‘It was quite confronting but at the same time it was rewarding, because they were so thankful that we were there and helping them. They were the most grateful people I have ever met, and they didn’t seem upset or to be dwelling on their poor vision.
‘It just opens your eyes about so many different things and what the scope of optometry can be. It’s not just checking refraction; it’s really about changing people’s lives and helping them see. In Australia you’re not really confronted with that, but these people have never had an eye test and they may never have one again.’
In the clinic
Allanah was among a group of volunteers who rotated through different stations, carrying out visual acuity tests, full eye examinations and tonometry.
‘In triage, we checked the back of their eye with the direct ophthalmoscope, in order to measure their health. If they did need an eye test and were over 35, we measured the pressure of their eye.
‘There were four of us in a room doing full eye examinations, or as much as we could do with the limited equipment. That included checking their vision, trial frame refractions or retinoscopy, then checking health of the back of the eye and the front with the slitlamp.
‘We then referred them to an ophthalmologist if they had a condition, or sent them up to get glasses, or both,’ she said. ‘Some of us were also placed on dispensing, so we would rifle through hundreds of donated glasses which were all organised by scripts, and we had to find the closest one and give it to them, which was complicated.’
To improve her Spanish in preparation for the trip, Allanah used the language app Duolingo.
‘We were really lucky that one of the optometrists there was from Montreal and could speak French, English and Spanish. He wrote up a cheat sheet for us, and the group sat down together and practised at night, but mostly you just had to pick it up as you went,’ she said.
‘Learning how to do refraction while not being able to talk to someone, because you don’t know the language, was definitely challenging.
‘I am now much better at retinoscopy and my efficiency has improved, just because I had to get through so many people when I had so much to do. It was one of the best experiences I’ve ever had and I 100 per cent recommend overseas placements to other students.’