Wednesday, May 25, 2011

"Anyone" can learn...does that mean me?

From a purely egotistical standpoint, it’s been good for me. Since I spend most of my time fretting about the next step for the Genesis co-op and writing grant proposals that are never accepted, I’ve found the last few weeks entirely refreshing. Together with Pat and our volunteer coordinator Liz, I’ve been working with a wonderful Cuban ophthalmologist to learn to do eye checks and hand out glasses to patients.For several years we’ve been working to get an eye correction program up and running at the Nueva Vida Clinic. We received bits and pieces of donated medicines and glasses, and then a year ago we received a grant to purchase a hand-held autorefractor which would allow us to do fast eye checks and give us the flexibility of doing them not only in our clinic, but in places like El Porvenir where people have such need and no access to eye correction.
Through the Cuban doctor, we set up a program last year where optometry students spent one morning a week doing their practicum in our clinic. That worked pretty well, considering that students the world over – and here I’ll insert the Southern phrase bless their hearts – are not known for excelling at follow-through. Although we had hoped to continue with a new group of students this spring, that just hasn’t materialized, and in order to keep the program going, we decided to take the ophthalmologist up on his suggestion that “anyone” could be taught to do this.

So far, Pat, Liz and I have managed to grasp the concept of myopic vs. hyperoptic, spherical vs. cylindrical and have learned that presbyopia is a condition that sets in after the age of 40 that has nothing to do with an irrational fear of Presbyterians. More importantly, we get to play with fun stuff: we can now use a lensometer to check the prescription on glasses, a retinoscope to check eyes for cataracts, the autorefractor to get a starting place on a prescription, and a phoropter to fine tune the prescription. I think I speak for us all when I say we’re feeling pretty good about our ability to catch on to new things.

Of course it’s totally another matter when you’ve got living breathing patients in front of you! (I think that must be why they call it “practicing” medicine!) Last week we went live: in the first 2 days we saw 15 patients all from the Genesis co-op (better to practice on folks you already know) and since then we’ve seen another 15 “real” patients. One of my first was an older man who insisted that every new lens I tried out on the phoropter was better than the last. For about ten minutes I’d say “Which is better, one or two?” And he would say “Two” every time, even while I moved from -3.75 right up to +4.00. I’ll admit I was sweating it…what do you do in that case? Since we are working with donated glasses and can’t find anyone’s exact prescription anyway, I started trying on glasses. And with those he was absolutely unequivocal – he left with the thickest pair of specs I’ve ever seen, and thrilled right down to his toes!

We’ve managed to work out a system of who does what, and Pat is doing a noble job of organizing our donated glasses so we cut the searching time down. We’ve found a table that is the right size for Liz to prop her arm on to get a good reading with the autorefractor without having to physically hold her patients still. We’ve found a picture chart that works better for folks who can’t read, and once we get the phoropter oiled so that the lenses don’t stick and the swing arm doesn’t whap patients across the head anymore, I think we’ll be in business!

Of course our prescriptions aren’t exact – and I’m relieved that the ophthalmologist tells us that much of the eye correction process is purely subjective– but it is very satisfying to take a break from fretting one morning a week and go to the clinic where I am told a problem, can do some tests, and can hand someone a pair of glasses that will help them. -- Becca