Lighthouse Optometrists gives sight to Kenyans in the Come and See program

Rather than tossing unwanted reading glasses in the bin, one optometrist at Ramsgate Beach is giving the lenses a new purpose.

Lighthouse Optometrists has been running its Come and See program since 2017.

The idea is to recycle old spectacles so they can be donated to people in developing countries. 

Patients and the community donated 250 pairs in about six months, and the team from the St George business took them to rural Kenya so they could be put to good use.

One of the churches in Kenya that runs free optometry clinics, prescribed the donated glasses to people of all ages.

Some patients walked for hours to get to the clinic, with glasses being a luxury beyond their reach. Many were able to see clearly for the first time.

“Lighthouse Optometrists is a family run business and community focused, aiming to make a difference not just in the local community but internationally as well,” said optometrist Mandy Iskander. 

“Since we look after many young families, the program is also a great way to teach our children the importance of recycling and giving.”

The next trip is planned for mid 2019 and the team hopes to take 1000 pairs of glasses to disadvantaged communities.

The 2 questions you should always ask your optometrist

This article is likely to save you hundreds of dollars over the course of your life. How much did you and your family spend on health this year? Do healthcare professionals view you as a patient or a customer? Or perhaps both? It is no secret that health is big business around the world and Australia is no exception. According to the 2016 census conducted by the Australian Bureau of Statistics, healthcare is Australia’s largest industry, making up 12.6% of Australia’s working population. Personal spending on health is about $28.6 billion a year. I could bore you with more statistics but let’s just agree: we all need, and therefore spend, on healthcare. And we spend big.

But did you ever stop to think how much of your health expenditure was truly necessary? How can you even determine what was necessary and what wasn’t? While we could ask Pete Evans, patients are generally dependent on the expertise and advice of trusted health professionals. Health professionals are amongst the most trusted people in society. My experience is generally that they are worthy of this trust and their advice has my best interests at heart. Sometimes, however, there are other forces at play.

This issue is obvious in pharmacies where in addition to the medication that your doctor prescribes, you may be advised to purchase a complementary product of variable utility. Some of these products are evidenced-based and helpful,  e.g. a bandage for a sprained ankle.  Others, as my biochemistry lecturer used to say, “do nothing apart from making your urine expensive”.  The field of optometry is a notorious culprit in this regard.  People often complain that every time they have an eye check, the optometrist tries to sell them glasses. So how do I know if my optometrist’s advice is concerned with my health or their bottom line? Or perhaps it is both? One  important question to ask is are they concerned with their “conversion rate”?

Many corporate optometrists are obsessed with conversion rates. It is simply the proportion of patients seen by a particular optometrist who purchases glasses on any given day. Or even more simply, how many sales (and how much money) that optometrist generated for the business. Unfortunately, it is not only a tracking mechanism, it is a KPI. Many optometrists receive sales training and even have a contractual obligation to keep their conversion rate above a certain level. I know because I’ve been there.

This raises a potential conflict of interest. Should a healthcare professional caring for a patient in need then opportunistically try and sell them something? Should a treatment that is expensive and unnecessary be prescribed? I wonder how you would feel if you were seeing a surgeon or dentist who was thinking about their conversion rate? It is something we really would not accept in any other health field and it is a mystery why optometry is exempted. The principle of caveat emptor has no place in health.

So how can you ensure that you don’t overspend on health this year? You can either go and get medical, nursing, dental, physiotherapy, podiatry, optometry and  pharmacy degrees. Or you can ask two simple questions. What would YOU do if you were in my shoes? And what is your conversion rate? Find someone who honestly answers the first question, and doesn’t have an answer for the second.

A Teary Monday Morning

It’s early Monday morning and Kim has a hectic week ahead. She wakes up and immediately realises she has a problem. Her eyes are burning, itchy and won’t stop tearing up, causing her vision to be extremely blurry. “I don’t have time for this,” she thinks to herself. Who should she see? Maybe a quick visit to the chemist? But that eye drops aisle is so overwhelming. Or perhaps she needs an eye specialist? But it can take weeks to get in and isn’t cheap. How about her GP? Maybe an optometrist can help? Or do they only sell glasses?

This scenario is all too common. What would you do? Taking a few minutes to understand what different health professionals can do for you can save you time, money, inconvenience and even your vision!  

Optometrists

An optometrist is a health care professional who cares for their patients’ vision. They are university graduates and trained to take a detailed case history (i.e. find out from the patient the exact nature of their concern), then perform a number of  examinations and tests to reach a diagnosis. The optometrist then explains the diagnosis to the patient, discusses treatment options and reach an agreement with the patient about how to proceed.

Treatment options include prescribing suitable spectacles (“prescription glasses”), sunglasses, contact lenses or eye exercises as well as lifestyle change. Some optometrists are “therapeutically endorsed” which means they have undertaken extra training and are qualified to prescribe medications to treat infections or other eye diseases. So the optometrist (who would usually see you on the same day, bulk billed by Medicare and without a long wait) would be a very reasonable first step for Kim.

General Practitioners

Kim could also see her GP for an opinion.  It may surprise many readers to know that many GPs refer people with eye problems to optometrists! Although the doctors are very knowledgeable about eye problems, they usually do not have access to the expensive and bulky equipment that an optometrist would have.

This referral pathway is a two way street: sometimes optometrists would refer a patient back  to their GP as well. Occasionally, an optometrist may detect a problem in the eyes that is suggestive of a general medical problem. For example, people with a certain pattern of bleeding at the back of their eyes may have diabetes and not know it! In these cases, the optometrist would refer the patient to their GP for blood tests.

If the optometrist is unsure about the diagnosis, or diagnoses an eye disease which requires medical or surgical treatment, the patient would then be referred to an ophthalmologist. Very occasionally, an optometrist may find evidence of a problem serious enough to warrant a visit to the Emergency Department (e.g. signs of a stroke).

Ophthalmologists

An ophthalmologist (commonly referred to as an eye doctor or eye specialist) is a doctor who specialises in the treatment of eye disease and surgery. They complete their medical degrees, work for at least two years in hospitals as junior medical officers and then complete ophthalmology training over at least four years. Many ophthalmologist then go on to develop a sub-speciality (e.g. focus on the retina; the back of the eye).

In addition to prescribing medications, ophthalmologist treat patients using lasers and also perform surgery (e.g. cataract surgery, repair of a retinal detachment). Ophthalmologists often refer their patients back to optometrists for ongoing monitoring and of course if glasses or contact lenses are required.

In order to see an ophthalmologist, a referral is required. This can come either from a doctor (GP or specialist) or from your optometrist. If you see your GP or optometrist and it is felt that an ophthalmologist visit is required, they can usually facilitate a same day appointment for you.

So what ended up happening to Kim? She made an appointment with her optometrist who diagnosed her with viral conjunctivitis. As her optometrist was therapeutically endorsed, she was prescribed eye drops and improved within 2 days. An ophthalmologist appointment was not required this time. She didn’t manage to do everything she has hoping that week but at least her eyes weren’t the reason!

Best Foods for Healthy Eyes

Eating a healthy, balanced diet is one of the most important things we can do for our general health. The benefits include improved sleep, concentration, skin health and energy. But did you know that a healthy diet also helps with maintaining eye health?

Eye conditions that you may be able to prevent with a healthy diet include:

• Cataracts
• Age-related Macular Degeneration (AMD)
• Glaucoma
• Dry eyes
• Poor night vision

Nutrients like lutein, zeaxanthin, Vitamins C and E, omega-3 fatty acids, and beta-carotene are especially important. You could go and spend hundreds on vitamins every day, or just add these yummy (and some not so yummy) foods to your diet.

1. Kale

When an optometrist hears kale, they don’t picture a vegan café or their instagram feed, they picture lutein and zeaxanthin. These vitamins help protect your eyes by filtering damaging wavelengths of light that can damage the retina. Such foods may also help to protect against AMD, the major cause of blindness in the elderly. Not a big fan of kale? Spinach, broccoli, peas, corn and eggs are good alternatives.

2. Salmon

Salmon and other oily fish are high in omega-3 fatty acids. These are “healthy” fats. Omega-3 fatty acids can contribute to visual development and the health of the back of the eye. They can also help prevent dry eyes and AMD.

3. Oranges

Oranges are high in vitamin C, an antioxidant that is critical to eye health. Vitamin C helps keep the blood vessels in your eyes healthy and can prevent, if not delay, cataracts and AMD. If you don’t like oranges, tomatoes and strawberries are good alternatives.

4. Carrots

Yes, your grandmother was right. Carrots are well-known to be good for eye health and are high in beta carotene which the body converts to Vitamin A. Vitamin A helps the eye convert light into a signal that can be transmitted to the brain, allowing people to see under conditions of low light.

Check out these recipes form the Macular Disease Foundation of Australia for some creative ideas!  https://www.mdfoundation.com.au/content/eating-eye-health-recipes

Loving Little Eyes

Five important questions:

1. Should I test my child’s eyes?  
2. When is the best time?
3. How often should I do this?
4. What are the possible outcomes from the visit?
5. What can happen if I don’t bother?

These are extremely important questions for every family, especially as we approach the beginning of a new school year.  We generally recommend an annual eye test for all children from the age of 4, especially before starting school. There are of course other situations that require earlier or more frequent assessment.

The frequency of eye problems in children is surprisingly high, and children are unlikely to notice, let alone complain. In the last decade, this number may have increased with changing lifestyle factors including less time spent outdoors and increasing levels of near vision tasks, particularly screens.¹ Many other factors are important including the child’s general health and family history of eye problems. For many vision problems, there is a narrow window of opportunity in childhood to correct things. Parents therefore need to be on high alert.

With that in mind, there are three common reasons to take your child to see the optometrist. The first is, of course, if a problem is noticed, e.g. eye-rubbing, squinting, headaches, clumsiness, or an eye turn. The second is if there is a family history of vision problems (especially a lazy eye which can be corrected if diagnosed and managed before it’s too late) or a need for glasses. And finally, for a check-up before starting school, even if there are no symptoms or significant family history.

Sometimes children (and even parents) may be reluctant to bring their child for a check-up because of fear of the unknown. What are the possible outcomes of the visit?  The most common outcomes include: reassurance, a prescription for glasses, patching (more on this in future articles), re-examination after some time, or referral to an ophthalmologist

“Back to our five questions. Should I test my child’s eyes? Yes.  When is the best time? Now.  How often should I do this? At least annually. What are the possible outcomes? Reassurance, glasses, patching, re-examination or referral.  ”

— Lighthouse Optometrists

The keen-eyed readers will notice that one of the questions (perhaps the most important one) was missed!  What can happen if I don’t bother? My child’s vision and subsequently concentration, behaviour, academic progress and even confidence can be unnecessarily hindered. Don’t let that be your child.

1. Lin Z, Vasudevan B, Jhanji V, Mao GY, Gao TY, Wang FH, Rong SS, Ciuffreda KJ, Liang YB. Near work, outdoor activity, and their association with refractive error. Optom Vis Sci 2014; 91: 376-82.

Disclaimer: Please remember that information provided by Lighthouse Optometrists in the absence of a visit must be considered as an educational service only. This information should not be relied upon as a consultation.