Lewa's vision clinic: Guest Blogger Naweza's Optometrist Dr. Sidiqa

 A young patient is fitted with the refractor. A refraction or vision test is as part of a routine eye examination. This test tells the optometrist exactly what prescription may be needed  (February 2018)

A young patient is fitted with the refractor. A refraction or vision test is as part of a routine eye examination. This test tells the optometrist exactly what prescription may be needed  (February 2018)

 Dr. Sidiqa, Lydia in foreground. Background a local clinical nurse who helped with cataract surgeries in Flurospar

Dr. Sidiqa, Lydia in foreground. Background a local clinical nurse who helped with cataract surgeries in Flurospar

Hello everyone! My name is Dr. Sidiqa and I’m the optometrist working with Naweza. This trip was my 7th one with the team; what an honour to be part of this amazing and dedicated medical team! Stacy has asked me to write a little about the Lewa Vision Clinic ("the vision clinic") — what we have achieved, what we are working on at the moment and what we hope to achieve in the coming year ... and I'm super excited to do, because, well, I love what I do with Naweza as it's my life's passion: helping improve people's lives through the gift of sight.  

Before I get to the updates for the vision clinic from this trip, a quick trip down memory lane to remind us of all that we have achieved already.

 Dr. Stephen, a local optometrist who is committed to a regular schedule at Lewa, performing a cataract extraction

Dr. Stephen, a local optometrist who is committed to a regular schedule at Lewa, performing a cataract extraction

 Dr. Sidiqa performing post-cataract treatment on patients in 2016 at the Isiolo Hospital

Dr. Sidiqa performing post-cataract treatment on patients in 2016 at the Isiolo Hospital

In three years: from Ø vision services at Lewa to the in-house, permanent Lewa Vision Clinic

Over the last three years, we have supported the Lewa Clinic to set up their own in-house vision clinic. We kitted the vision clinic with all the equipment required to carry out a comprehensive eye examination—including an auto refractor, trial frame, trial lenses set and an ophthalmoscope. We also arranged for Stephen—a local optometrist—to visit once a month, in order to service the community’s eye care needs.  He works closely with Lydia, the clinical nurse in charge of vision. In 2016, Naweza partnered with local ophthalmologists at Isiolo Hospital to perform cataract surgeries on 21 elderly patients. This project was a great success and appreciated by many, as cataracts are the leading cause of blindness among the 50+ and so easily treatable.

 Lydia with a young patient after he has been outfitted with new glasses for school (February 2018)

Lydia with a young patient after he has been outfitted with new glasses for school (February 2018)

 Lydia, a clinical nurse who specializes in vision, has gained skills and expertise over the years working with Dr. Sidiqa

Lydia, a clinical nurse who specializes in vision, has gained skills and expertise over the years working with Dr. Sidiqa

 Lydia and Dr. Sidiqa: A strong professional relationship

Lydia and Dr. Sidiqa: A strong professional relationship

Working with Clinical Nurse Lydia: training and education

During my visits, I work with Lydia on one-to-one training and eye education. We started off with basic eye anatomy and examination. Lydia is now able to take patient history, assess visual acuity and use the ophthalmoscope to examine the front of her patient’s eyes.  Some of the common conditions at Lewa that Lydia faces regularly include conjunctivitis and severe dry eyes (mainly due to the dry, dusty conditions), as well as basic refractive errors and presbyopia (solved easily with reading glasses—age 40+). Occasionally, environmental factors (including tree branches, wild animals, etc) cause ocular trauma.  Such patients are referred on to the nearby hospital for further care.

Water: essential for vision health

An important segment of Lydia’s training is educating the patient on small changes in personal habits—resulting in significantly improved eye health. A practical example, is to keep hydrated and drink at least naane (eight in Swahili) cups of water a day! We recently had a patient who complained of red burning eyes with foreign body sensation, who barely managed to drink one cup of water a day!!! Lewa provides free clean drinking water facilities around the community.  This goes to show awareness and education need more attention.

Lydia has now mastered the advice needed to be given to a patient with dry eye syndrome: drink lots of water, wash the eyes regularly with clean water and wear a kofiya (hat) when you’re out in the dusty roads!

Cooking areas and ventilation: area of concern

Another major concern is the lack of ventilation whilst cooking using traditional wood in chimney-less and small-window homes. This results in women and young children bearing red, itchy and burning sensations in the eye. Lydia is constantly reminding mothers to either cook outside (which is not appreciated due to the fear of the animals stealing the food!), or at the least refrain from keeping their young ones with them during this task. We recently found out that Lewa is working with the community in providing them with cooking stoves and chimneys, so we hope this will reduce the occurrence of smoke-related red eyes amongst women and children.

 Looking smart with your new specs! On the day after the outreach, three young patients (students) came to Lewa for follow-up treatment and were able to walk away with the right prescription and lenses

Looking smart with your new specs! On the day after the outreach, three young patients (students) came to Lewa for follow-up treatment and were able to walk away with the right prescription and lenses

 Doesn't she look smart?  The spectacles will not only help the children see better, but also protect their eyes from all the dust

Doesn't she look smart?  The spectacles will not only help the children see better, but also protect their eyes from all the dust

Our latest trip: +100 patients seen and treated

During the recent trip, we saw patients at the vision clinic and the outreach (a total of over 100 patients!), and found a few children that required help with their vision. I was able to get them to come to the vision clinic the next day and assess their eyes further. Out of 5 that failed the initial screening, we were able to give glasses to 3 instantly from our stock - wow, the feeling of being able to offer an immediate solution that will lead to better vision (and likely improved education and quality of life) is an indescribable feeling.

The spectacles will not only help the children see better, but also protect their eyes from all the dust! We also gave away almost 25 reading glasses over the last week, something that always makes our elderly patients so happy. They say they will pray for us when they read the Bible at church - just imagining my patients being able to read and live their lives better because of improved vision, made my heart sing.  

 Big smiles from a patient after a vision test led to the right prescription and new glasses

Big smiles from a patient after a vision test led to the right prescription and new glasses

 A vision clinic at a local school

A vision clinic at a local school

 Dr. Sidiqa and the chalkboard while a young student performs an eye examination

Dr. Sidiqa and the chalkboard while a young student performs an eye examination

Vision in the community: Lewa Vision Screening at Schools

The project that Naweza is currently working on in partnership with Lewa Health is Vision Screening at Schools. It is found that 80% of a child’s learning is through vision, so Naweza wants to work with local schools to identify those children with vision problems—such as refractive error and amblyopia (lazy eyes)—early on so that each child is able to reach his or her maximum learning and developmental potential.

Research predicts 4.5% of children screened will require some form of refractive correction to improve their visual acuities.
 Lydia, clinical nurse in charge of vision, demonstrates "Peek", the mobile app vision test, with her own daughters and friends, at Lewa Clinic (February 2018)

Lydia, clinical nurse in charge of vision, demonstrates "Peek", the mobile app vision test, with her own daughters and friends, at Lewa Clinic (February 2018)

The power of "Peek": our mobile app

Lydia has been trained on screening children as young as 4 years old at schools, using a mobile app called Peek Acuity (https://www.peekvision.org/peek-acuity) and recording the results as PASS/FAIL using her mobile on an icloud data collection tool box. The use of mobile technology allows for the screening to be sensitive and specific! I am also able to virtually follow the progress of the screening and give my input.

Any child who ‘fails” to meet the screening requirement is to be referred on to see Dr. Stephen (our local optometrist, coming in on the first Saturday of every month). If the child then requires correction to improve their visual acuity, Naweza has partnered up with a local supplier in Nairobi to provide the child with spectacles at no cost to the child - pricing is a huge obstacle to care for this community, so offering free spectacles makes more children access vision care. 

For this particular project, our supplier has kindly agreed to donate North American-quality frames, ... so Naweza only needs to pay for the lenses! This allows us to help as many children as we can to see better, which in hand improves their opportunities and quality of life.  I am so grateful for the suppliers who joined us in our Naweza mission to support healthier eyes and improved vision!

 Vision care starts young. Informed parents can lead to healthier eyes in the whole family

Vision care starts young. Informed parents can lead to healthier eyes in the whole family

The Naweza Vision Screening aligns well with Medcan’s vision and commitment to prevention medicine as well as the World Health Organization's Vision 2020 initiative (http://www.who.int/blindness/partnerships/vision2020/en/) —to eliminate avoidable blindness in children by 2020, one child at a time, one school at a time!

That is all for me today. Thank you for reading!

And I look forward to sharing more in the future from our next trip.  As always, we’ll keep you in the loop with our daily blog!