A collaboration between the Fred Hollows Foundation and The University of Auckland’s Centre for Pacific and Global Health and School of Optometry and Vision Science aims to assess the state of eye health in the Pacific using locally-driven research.
Read the full story via The University of Auckland’s news and opinion: 3rd February 2023
In July 2021, the Community Eye Health team conducted a pilot eye health survey in the Glen Innes, Panmure and Ōrākei areas of Auckland. This survey gave us the opportunity to collect information about the state of eye health in a small group of New Zealanders, before we embark on our more ambitious population-based eye health survey in 2023.
Lead Optometrist and PhD candidate Jaymie Rodgers played a key role in the day-to-day operations of this pilot study.
“As part of my research project, I am delivering comprehensive eye examinations to people in this community where we believe there may be unmet eye health needs. In particular, we want to know if there are any differences in access to eye care,” says Jaymie.
Throughout the pilot study, Jaymie together with Optometrist and Professional Teaching Fellow Veeran Morar supervised a team of clinical optometry students as they conducted eye examinations at the Te Whare Piringa community centre in Glen Innes.
Watch Jaymie and team set up the eye clinic at Te Whare Piringa community centre in Glen Innes, above.
Currently, Jaymie is busy analysing data from the survey pilot, and enrolling a cohort of participants for further follow-up. Her PhD research will continue within the population-based eye care survey that will begin in 2023, where she will will follow a group of participants with vision impairment over a 12-month period to understand the barriers that they face in accessing follow-up eye care services.
See inside the pop-up eye clinic, below:
The research team:
Funding:
The research team would like to acknowledge Peter and Rae Fehl, Blind Low Vision New Zealand and New Zealand Association of Optometrists for their support.
Participants in this project are benefiting from the SOVS Community Spectacle Scheme, which is supported by Helen Blake, Barbara Blake and Essilor.
On 12 October, the eve of World Sight Day 2022, at the United Nations in New York, the World Health Organization launched its Report of the 2030 targets on effective coverage of eye care.
The report, which draws on research co-authored by SOVS Associate Professor Jacqui Ramke, will serve as a reference point for countries’ efforts towards meeting the ambitious global eye health targets endorsed by Member States of the 74th World Health Assembly in 2021. These are:
Effective cataract surgical coverage (eCSC) measures the number of people in a population that have been operated for cataract, and had a good outcome, as a proportion of all the people requiring or having received surgery in that population.
Similarly, effective refractive error coverage (eREC) is defined as the proportion of people in need of services to correct refractive error such as spectacles or contact lenses, who have received these interventions and have a resultant good-quality outcome.
You can read more about the importance of these targets and how they came to be adopted by the World Health Assembly — with a view to also making them proxy indicators for Universal Health Coverage — in a blogpost on the International Centre for Eye Health‘s website, written by Jacqui with London School of Hygiene and Tropical Medicine colleagues Professor Matthew Burton and Ian McCormick.
Here in Aotearoa, we continue to collect information on how people are experiencing eye health services, whether they are able to access the services they need, and what solutions might be needed to ensure that everyone who needs eye care in Aotearoa can receive it.
We are excited to soon begin a project that will include Aotearoa’s first population-based survey that will generate our first estimates of eCSC and eREC. These estimates are crucial to inform equity-focused planning, and will also help raise the profile of eye health on global health and development agenda.
World Sight Day is an International Day of Awareness, held annually on the second Thursday of October. This year, World Sight Day is Thursday, 13 October 2022. World Sight Day is coordinated by the International Agency for the Prevention of Blindness (IAPB).
This year, the IAPB, its members and partners is encouraging everyone to take a moment to think about the importance of eye health for everyone, everywhere:
Centre for Ageing Better Images – Pictures Peter Kindersley
Two papers published today (12 October 2022) in The Lancet Global Health mark an important milestone in the inclusion of two indicators of eye care coverage into the monitoring framework for Universal Health Coverage and ultimately the global indicator framework for the United Nations Sustainable Development Goals.
Using data from population-based eye health surveys around the World, investigators (including School Of Optometry and Vision Science Associate Professor Jacqui Ramke) have published baseline estimates for effective Cataract Surgical Coverage (eCSC) and effective Refractive Error Coverage (eREC) .
Effective cataract surgical coverage (eCSC) measures the number of people in a population that have been operated for cataract, and had a good outcome, as a proportion of all the people requiring or having received surgery in that population.
Similarly, effective refractive error coverage (eREC) is defined as the proportion of people in need of services for poor eyesightrefractive error such as spectacles or contact lenses who have received these interventions and have a resultant good-quality outcome.
Cataract surgery and correction of refractive error remain two of the most cost-effective healthcare interventions ever. These two indicators serve as ideal proxy indicators not only to track changes in the uptake and quality of eye care services at the global level, but also contribute to monitoring progress towards UHC in general. In 2021, the World Health Assembly set ambitious global eyecare targets for 2030 of a 30% increase in eCSC and a 40% increase in eREC.
The paper on Effective Cataract Surgical Coverage shows the indicator varies widely between countries, with higher coverage in countries with greater income-level, with the highest at 70.3% and the lowest only 3.8%. Higher coverage was also seen among men, highlighting the need to embed equity in efforts to improve access to surgery.
The paper on Effective Refractive Error Coverage estimated that less than half (43%) of people who need glasses for distance vision have had this need met. The paper’s authors note that despite coverage increasing by 19% in the last 20 years, the WHO target will require substantial improvements in quantity and quality of refractive services, particularly for women and among older people.
Speaking on behalf of the WHO at the launch of the “Report of the 2030 targets on effective coverage of eye care”, at the United Nations in New York on 12 October, the eve of World Sight Day, Dr Stuart Keel said: “These two papers set the baseline for what we want to achieve by 2030 and the international collaborative effort demonstrates how well-positioned the eye care sector is to contribute to the advancement of Universal Health Coverage within countries”.
The work for the eCSC study was funded by the Indigo Trust, Peek Vision, and the Wellcome Trust, while the eREC study was funded by WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute and Lions Clubs International Foundation.
Attendees at the Eye Health Aotearoa launch in July 2022: Hon Peeni Henare, Associate Minister of Health (Māori Health) ; Dr Liz Craig MP and Dr Elizabeth Kerekere, Co-chairs of the Parliamentary Friends of Eye Health; Renata Watene, Joint author of the “Eye care in Aotearoa New Zealand 2022” Report; Judy Small, Chair of the RNZFB Board, and Drew Keys from the IAPB; with Eye Health Aotearoa Trustees. Source: Eye Health Aotearoa
In July 2022, Eye Health Aotearoa held an event in parliament to promote the importance of eye health. The event launched a report prepared by Community Eye Health researchers describing the state of eye care services in Aotearoa New Zealand, commissioned by Eye Health Aotearoa and funded by Blind Low Vision New Zealand. Read the full story here.
For a plain language summary of this work, please visit our resources page.
A pilot eye health survey and eye exams in East Central Auckland (Orakei, Panmure and Glen Innes) on Maori and Pacific people uncovered significant unmet need among three population groups living in this area.
Telusila Moala-Mafi Vea is the Community Survey Coordinator for the Community Eye Health team. She holds a Master’s in Public Health from Massey University, with a focus on the health of Pacific people. As a Pacific person herself, Telusila plays a key role in the Community Eye Health team by engaging with the community to understand their needs.
Telusila coordinated the Community Eye Pilot Study that took place in 2021. Currently, she spends some of her time interviewing people who participated in the pilot study, so that we can better understand the challenges they face when seeking eye care.
Here, we share some of Telusila’s insights from working with Pacific people in the community.
“I really enjoy working and helping my own people, particularly Pacific and Māori people. Once they know I am of Pasifika heritage, they expressed themselves freely and tend to tell me their problems. This is because they embraced me as one of them.” [Telusila Moala-Mafi Vea]
When we visited the Auckland suburb of Glen Innes to recruit people for our Community Eye Pilot Study, our team relied on Telusila to engage with Pacific people in a way that valued their culture, tradition, and family histories.
“Where they come from is very important. Pacific people’s beliefs are the priority. Pacific people’s second home is church,” she explains.
Rather than approaching people directly at their doorsteps, Telusila’s first step was to build their trust. She met with church leaders in the community, where she explained what the eye survey involved and why it was important to include as many Pacific people as possible. Her own Pacific culture allowed her to develop rapport with the community, and her efforts were well received.
Telusila engaging with church communities during the Community Eye Pilot Study
“Your coordinator came and talked at our church about your program, it was such a blessing. The coordinator explained the process clearly. I was happy that I will have a chance to check my eyes.” [participant in the Community Eye Pilot Study]
As part of her work in the Community Eye Pilot Study, Telusila has spoken to many Pacific people who can’t access the eye care services that they need. Sometimes this is because people find it difficult to get to their optometrist, particularly if
there isn’t one nearby. Most often though, the cost of eye care is what prevents Pacific people from getting their eyes checked.
“Eye examinations and glasses are very expensive, and people cannot afford to meet these costs. When people cannot afford to go to the optometrist, they will go to the $2-dollar shops and purchase those glasses and use them,” explains Telusila.
“Our people cannot afford to visit an optometrist, let alone purchasing the prescribed glasses. Our people do not have the money, but we need to access the optometry and check our eyes regularly as this is very important for our health.” [participant in the Community Eye Pilot Study]
Some projects and services coordinated by the Community Eye Health team—such as the Community Eye Pilot Study—allow people in the community the opportunity to access eye examinations that they may not otherwise be able to afford. Telusila has received positive feedback from many Pacific people who have received free eye care by participating in the Community Eye Pilot Study, and this has changed their lives for the better:
“Now I got my glasses, I am quite confident to go anywhere without asking for help, at home, shopping and church. This is the first time for me to wear glasses. Now I am comfortable to complete forms at the doctor, read my bible at church, and do my shopping.”
“Life is wonderful for me, I am confident now when I have my new glass. It gave me a new life.”
“I never had this opportunity to fully checked my eyes, this is the first time. Participating in this program is the best thing that ever happened to me, as my eyes are so important to me. This makes me feel happy and grateful.” [participants in the Community Eye Pilot Study]
Telusila Vea training Research Assistants in preparation for the Community Eye Pilot Study
So how can we help more people access these types of services? Telusila has observed a need for affordable eye care in New Zealand, such as free or subsidised eye examinations and prescription glasses, particularly services that are located close to Pacific communities. She speaks highly of the Vision Bus Aotearoa, which provides mobile eye care services to people who need them the most. She hopes that this service will one day reach Pacific communities where it can remove the transportation and financial concerns that some people face when seeking eye care.
“Based on what I had experienced with your service, there is a need for this service to made available for our family and community. It is very important that we take care of our eyes and check them regularly. In saying that, costs should be affordable by our people.” [participant in the Community Eye Pilot Study]
Meanwhile, Telusila feels happy that she could be involved in helping people improve their lives. Her work continues, and we hope she can provide a voice for many more Pacific people in the community.
“I only hope the government can subsidised the cost and see the important of eye health care to us and the community. We all deserve a good quality of life, especially constantly checking our eyes. This is a much valuable program and need to continue.” [participant in the Community Eye Pilot Study]