“Life is wonderful for me, I am confident now when I have my new glasses. It gave me a new life.”
Before she participated in the Community Eye Pilot Study, Stefanie Falwasser had never had her eyes checked by an optometrist or doctor.
That all changed in 2021, when researchers from The University of Auckland’s School of Optometry and Vision Science visited the Auckland suburb of Glen Innes. For six-weeks, a temporary optometry clinic operated out of Te Whare Piringa community centre, providing people with funded eye examinations. Thanks to support of the OneSight EssilorLuxottica Foundation, glasses could be provided for everyone who needed them.
For Stefanie, the situation sounded almost too good to be true. Over the last year, she had noticed that her vision was changing, as she struggled to see smaller details, making it difficult for her to read and complete everyday tasks.
Normally an active participant in her community—a mother, committed to her church and community, and a strong love of sports—Stefanie noticed her confidence slipping away as her vision started to change.
“I was not confident with myself when I was asked by the Priest to read the bible and reluctant to go out shopping when I cannot read the fine prints,” she says.
This loss of vision came with a loss of independence. Increasingly, she found herself relying on others to help her complete everyday tasks—at the doctors, church, and the supermarket.
“I asked for help everywhere I go, if I am not able to read anything,” she says. “I know it was so embarrassing, but I really need to ask for help.”
The cost barrier: a common story
Stefanie’s vision problems could be easily corrected with glasses, but she soon found that these were out of her reach.
“I tried to look and shop around for an optometrist to go and check my eyes. The ones I came across were very expensive and I know that I cannot afford to visit them,” she says.
Drawing on their own experiences, her mother and sister suggested that she purchase a pair of $2 reading glasses from the Pharmacy. While this allowed her to read, this option left her without any reassurance that her eyes were healthy.
Stefanie’s experience is far from unique. The results of the Community Eye Pilot Study found that half the participants with vision loss had never had an eye examination before. Cost is the main barrier that prevents many people from accessing eye examinations or spectacles, because Aotearoa New Zealand has very little public funding for eye care services.
Taking the clinic to the community
In this instance, The Community Eye Pilot Study provided Stefanie with the services that she needed—an eye health check as well as spectacles that were custom-made for her eyes.
Stefanie’s surprise at receiving basic eye care services is telling. While outreach community services such as these have a significant impact on participants’ lives, without government support they rely on the generosity of providers and private companies such as OneSight EssilorLuxottica. Clearly a more permanent funding solution is required so that everyone can access the services that they need.
And the need is obvious to anyone who opens their eyes.
“Our people cannot afford to visit an optometry, let alone purchasing the prescribed glasses,” says Stefanie. “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.”
We thank Stefanie and others for their contribution to this work.
The OneSight EssilorLuxottica Foundation is a registered charitable organization dedicated to eliminating uncorrected poor vision within a generation. As part of EssilorLuxottica’s commitment to universal vision care, the Foundation works to expand access for millions in underserved communities worldwide. It is also the global collaborating partner of the World Health Organization’s SPECS 2030 initiative, which focuses on refractive error, myopia prevention, and improving access to vision care in low-resource settings.
In mid-July, the DaSH (Diabetes and Sensory Health) team completed the pilot of our long-awaited DaSH study – a multi-disciplinary project that aims to improve health services for people with eye, hearing, or foot problems, particularly if they also have diabetes.
Working alongside Toi Whānau Health in the Auckland suburb of Onehunga, the team delivered health checks and questionnaires with 25 patients over a five-day period. This gave the study team an opportunity to refine study methods before the main data collection phase begins in earnest in the coming months.
“Being able to get out into the community has been invaluable,” notes A/Prof Jacqueline Ramke, Co-Investigator of the DaSH study, “It was fantastic to work closely with Kelleigh and the Toi Whānau team to support their community in ways that work well for the practice and also for the participants. We learnt a lot and will refine our approach so the survey can run as smoothly as possible for everyone involved.”
Participants of the DaSH pilot study received several health checks including visual acuity screening and checks for diabetic retinopathy, hearing screening, foot neuropathy screening, and screening for diabetes or prediabetes using HbA1c testing. The team was supported by the Vision Bus Aotearoa so that on-the-spot follow-up eye examinations could be provided for participants who needed it.
Feedback from participants was universally positive, and many valued the convenience of receiving multiple health checks during a single appointment.
“Everyone was welcoming, respectful and warm towards me,” noted one study participant. “They were professional and I was well informed when I had questions. The tests were easy and quick and it was all over before I knew it.”
Toi Whānau Health Practice Manager Kelleigh Embers (Ngāti Hine, Ngāpuhi) said that when she was first approached about the study, she knew immediately that this was something her practice should be involved in as it filled a healthcare gap that exists within her community. She noted a key benefit of the study for GP practices is the contribution to the Diabetes Annual Review for whānau with diabetes, receiving their vision and foot screening checks under one roof.
She hopes that other GP practices will see similar benefits for their patients and the wider community.
“There are things that whānau might find through these health assessments that they haven’t been able to get themselves,” she said. “I think it will benefit the practice in terms of supporting whānau to re-engage with us, in areas they may have been avoiding because of barriers such as cost or access.”
With the pilot survey now behind us, the DaSH team is looking forward to rolling out the next phase of the study.
DaSH is a multi-disciplinary project that aims to improve health services for people with eye, hearing, or foot problems, particularly if they also have diabetes. Participants of the DaSH study will be screened for these health conditions and referred for follow-up services if required. From this, we can estimate the number of people living with these conditions and how accessible services are. Find out more about the study…
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:
Jaymie speaks with a survey participant who is picking up her new glasses
Jaymie examines a survey participant at the pop-up clinic
A student optometrist with two survey participants, who are picking up their new glasses
As part of the survey, we offer a full eye examination to all people identified with distance or near vision impairment.
The research team:
Jaymie and Veeran with BOptom students
L to R: Joanna Black, Jaymie Rogers, Jacqui Ramke and Matire Harwood
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.
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.
“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]
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]
Veeran Morar and Jaymie Rodgers during the pilot eye health survey in Glen Innes, Auckland, 2021.
Auckland University researchers have conducted a pilot eye health survey and community eye exams in east-central Auckland, uncovering significant unmet need and serious eye disorders, including retinal tears and severe cataracts.
