As 2024 draws to a close, we’d like to congratulate the four Community Eye Health PhD students who have successfully confirmed their candidature and moved into the next phase of their doctoral studies. During an intensive oral examination, our students demonstrated their developing skills as researchers by fielding questions from other academics, meeting the first official milestone in their doctoral degree.  Their confidence reflects the growing capacity of our Community Eye Health research team as we head into the second quarter of the century.

First up was Nimisha Chabba, who plans to develop better methods to measure access to diabetes eye care services. Her work is internationally relevant, and her findings may change the World Health Organization’s reporting guidelines for diabetic eye care.

For Nimisha, a PhD in the Community Eye Health team flows naturally from her previous experiences in public health with the Fred Hollows Foundation. Her attention to detail and hard-working attitude were evident as she described the detailed protocol she has developed to summarise access to diabetes services in all countries of the world.   

“I’m glad to move past my provisional year so that I can focus on the next challenges,” says Nimisha.

Newly confirmed PhD candidates Claire O’Shea and Deborah Ewuru are also working to improve diabetes healthcare services, albeit closer to home, as part of our population-based health survey that will begin imminently within 2025.

Claire is the Lead Podiatrist at Waikato District Health Board, and she brings a refreshing new perspective to our research team which has, until now, been predominantly focused on eye care. To date, Claire has focused on identifying evidence for service integration—where sensory care services for vision, hearing, foot health, or diabetes are offered alongside each other. 

Compared to her clinical work, Claire describes her doctoral studies as “a new kind of challenge”, and it’s one that she’s rising to meet.

“It’s great to work with other more senior researchers,” says Claire, “because you realise we’re all facing similar challenges.”

Claire looks forward to 2025, where she will survey optometrists, audiologists, and podiatrists to work out how we can provide integrated services that are more accessible for patients.  

Deborah’s PhD project runs alongside Claire’s, but with a focus on vision and eye care services. Deborah brings her experiences as an Optometrist in Nigeria, where she operates her own eye care clinic for people with limited access to eye care. Since moving to New Zealand over a year ago, she has focused on increasing her knowledge of epidemiology that underlies her work. In the coming months, she will play a key role in conducting vision assessments in the community within our population-based survey in four regions of New Zealand. 

“I learned a lot from preparing for my provisional year review,” says Deborah, “and I feel more ready for what comes next.”

Most recently, we congratulate Renata Watene on her PhD candidature. Renata is an Optometrist with a passion for promoting eye heath for Māori and Indigenous Peoples. On returning to University from her clinical work, she describes an incredible year of learning opportunities as she gets up to speed with her colleagues.

“Giving my confirmation talk gave me an immense sense of achievement to look back at what was completed during my first year,” says Renata, “and it gave me a clearer sense of direction for my work.”

With the first major milestone complete, we wish all our doctoral students well as they move into the next phases of their doctoral pathway.

Why did you decide to do a Masters?

I wanted to deepen my understanding of research and public health.  I saw it as a chance to develop research skills that could help improve patient outcomes, influence healthcare policy, and address gaps in service, especially in underserved areas like South Auckland.

Can you tell us about your Masters project topic?

My Master’s thesis focused on the non-attendance at Diabetes Eye Services in South Auckland and the impact of COVID-19. Specifically, I wanted to understand the factors that led to patients missing their scheduled eye exams for diabetic retinopathy screening and diabetic eye assessments within a tertiary ophthalmology setting over a two-year period including during the Covid 19 pandemic.

My research showed that age, ethnicity, and socioeconomic status were associated with non-attendance at diabetic retinopathy screening services, and that Covid restrictions during this time presented additional barriers for diabetic patients.

I chose this topic because diabetic retinopathy is a leading cause of blindness in people with diabetes, and South Auckland has a higher proportion of people from ethnic groups at greater risk of both diabetes and related eye complications. 

What were the highlights of doing your Masters?

One of the biggest highlights of doing my Master’s was the opportunity to conduct research that could potentially make a real difference in patient attendance and hence patient care and outcomes.

Another highlight was the satisfaction of analysing data and uncovering patterns that could inform practical interventions. The process of collecting data, interpreting it, and then seeing the findings contribute to a deeper understanding of the problem was intellectually fulfilling.

I also appreciated the chance to develop stronger research, writing, statistical analysis, and critical thinking skills.

How has the experience you gained during your Masters contributed to your work?

The experience I gained during my Master’s has greatly influenced my work. The research process honed my ability to critically assess healthcare problems and solutions, which has been of great help in my clinical role at Counties Manukau. I now feel more confident in understanding and evaluating the health disparities that exist within different patient populations. This has helped me better communicate with my patients, especially in communities with high rates of diabetes, where education about eye care and screening is crucial. Additionally, the data analysis skills I developed during my research has helped in a recent clinic audit.

What advice would you give other optometrists thinking about doing a Masters?

My advice would be to approach the decision with clear goals in mind. The Master’s journey can be intense, and it’s important to have a clear understanding of what you want to achieve.

Going back to study (while working) was challenging but achievable, and ultimately very rewarding. You have to balance work and study, so it helps if you’re organized and set realistic expectations for yourself. I found that planning ahead and dedicating specific times to study made a huge difference. However, it’s also important to have support from family, colleagues, and supervisors.

One thing I would recommend is selecting a project topic that you’re passionate about—something that resonates with your professional interests and goals. Having a personal connection to your research will make the process more enjoyable and meaningful. It requires dedication and the ability to balance your professional and personal commitments.

Why did you decide to do a PhD?

I would say the PhD chose me. I have been working in the optics space for more than 20 years now, and I have seen in the impacts of a privately funded health care model that creates inequities for consumers of Optometry services. In my own clinics I witnessed vast difference in services and outcomes for Māori patients. There is a large knowledge gap around Māori eyecare and use of Kaupapa Māori in Optometry in particular. With some intervention from my tupuna (grandmother) this path felt like the next step in making a meaningful impact in Optometry.

What’s the most challenging part of your studies so far?

The biggest challenge has been returning to academia from a clinical position and multiple community and governance roles. I was fortunate enough to secure a Clinical Research Fellowship through Health Research Council which contributed significantly by reducing the financial deficit that clinicians usually face if they return to do postgraduate studies.

As an alternative pathway applicant, I have had an incredible year of learning opportunities as I get up to speed with my other research colleagues. I think the feeling of imposter syndrome is very real in this space and it was comforting to learn that even those with significant research background still experience the same concerns that I do around progress of projects and validity of their research.

Working in Indigenous research adds another layer of complexity. Ensuring that the research meets the academic rigour of the Western system while being relationally accountable to our research partners and communities is at times near impossible. Working with Indigenous communities means that all processes and should be culturally appropriate and respected and that there is space for ceremony and tikanga. It is critical that I be very intentional to centre Māori and whānau voice as well, as Maori worldviews are important if we are to develop intergenerational strategies that address inequities. The western concept and indigenous concepts of time have been at odds during this process. ‘Mā te wā’ or all in good time.

What’s the most rewarding part?

The most rewarding part has been the opportunity to meet and learn from experts in equity and Indigenous eye health research. There is an obvious appetite from the local and global community toward more equitable outcomes for Māori and Indigenous Peoples, and it has been rewarding to contribute to conversations that address this. It’s a reminder of why I started this journey in the first place.

What was it like officially completing the first year of your PhD?

Giving my confirmation talk and looking back at what was completed during my first year gave me an immense sense of achievement and a clearer sense of direction for my work. But preparing for my provisional year review was challenging! Reprioritising my time and stepping back from several roles has helped me refine my focus and objectives into achievable goals for the remainder of the PhD journey. Like many processes in a PhD, you learn a lot and know how you would do things differently next time.

What are you focusing on now as you head into your second year?

Building on the strong foundation of my first year, I look forward to the next phases of my research and elevating the voices of our Māori, whānau, students, and practitioners in eyecare. I’m focusing on connecting with Indigenous Eyecare experts (and hopefully finding some more along the way!) to help inform a new eye health system that may lead to changes in how eyecare is delivered.