By Angela Fa
Fifth year optometry student, QUT
I spent five days in remote Western Australia in early 2017, visiting seven Indigenous communities: Warburton, Jameson, Wanarn, Blackstone, Wingellina, Warakurna and Kiwirrkurra.
I was motivated to undertake a placement of this kind as I knew it would be an incredible opportunity to give back, broaden my cultural awareness and to be a part of providing eye health care to those who cannot access it easily.
As one of two optometry students on this trip, my roles included carrying out preliminary eye examinations and taking each patient’s case history, vision assessment, retinoscopy and refraction, tonometry, stereoacuity in children, and administering dilating eye-drops if necessary.
The patients would then see optometrist David Bradley, who would conduct the eye health checks, provide therapeutic advice or medication, and dispense glasses if necessary.
Blindness or poor vision due to injury, infection or scarring was not uncommon among our older patients. These issues would often have been long-standing, due to the problem occurring at a young age without the ability to seek proper medical care.
We encountered many other conditions we expected to encounter, due to the environment and patient demographic. Trachoma is a common problem in these remote areas due to the large number of flies and many patients presented with complaints of sore, watery eyes.
In suspected cases of trachoma, the management would be to prescribe a single dose of systemic 1g azithromycin along with patient education on proper hygiene to prevent disease transmission.
Diabetes is also highly prevalent among the Indigenous population, with cases of diabetic retinopathy and central macular scarring common.
After the trip I found there was a big improvement in my retinoscopy skills and trial-frame refraction, and I have become more efficient in them. These skills are particularly helpful back home when seeing children and elderly patients for whom a phoropter refraction is not possible.
These placements really help you to think on your feet and make quick decisions when assistance or supervision is not readily available.
One of my biggest interests in optometry is ocular disease management and therapeutics.
On this WA placement and on another I undertook in Mexico, I was able to witness a wide range of ocular pathology that is rare to come across in urban areas, especially since easy access to medical attention would not allow certain diseases, like diabetes, to progress so far.
The placements have been very eye-opening, and I’m most grateful for the opportunities to gain valuable clinical experience that will be helpful in my career.