Be an optometrist and see the world

There are exciting things happening in eye care if you look to the developing world, says Nick Jackson

Optometry is not perhaps the most exotic career in the world. Most people look for accuracy, patience and diligence rather than a flair for adventure when they are getting their glasses checked.

The lack of quality eye-care services in much of the developing world has, however, created new opportunities abroad for optometrists. Those in the profession who have followed this path can be useful sources of information.

It is important to choose the right project, warns Professor Kovin Naidoo, who teaches optometry at KwaZulu-Natal University in South Africa and works for the International Centre for Eyecare Education (ICEE).

Initiatives such as eye camps, where teams of optometrists visit areas that lack medical facilities and provide free, short-term specialist care, can undermine ongoing local projects. Patients wait for the return of the free treatment, while their eyesight deteriorates. "Well-meaning work can have a negative effect," explains Professor Naidoo. "It doesn't help to jet in for a week, feel good about yourself and then leave without providing a long-term solution."

All that should now be changing, with training local optometrists rather than staging whirlwind tours becoming a priority. "The important thing is that optometrists assist in long-term, sustainable solutions: training clinical staff, supporting developing eye-care programmes and aiding research and planning," he says.

Setting up long-term solutions is harder work than setting up week-long eye camps, but that does not mean volunteers have to be better qualified or more experienced. "It doesn't demand advanced skills," Professor Naidoo points out. "A junior optometrist can train people. It's about having a broader vision of how to interact with a community." Less is more, then, with focused, in-depth development worth more than occasional, wide-reaching initiatives. A broader vision also means a narrower one.

One way to achieve this is through short trips linked to a single project. Andrew Maver has been on five trips to East Timor in the past three years. The ICEE provides emergency clinics in rural areas that have no eye-care facilities, while it trains a team of local optometrists in the capital. With a desperate shortage of qualified optometrists there, Maver felt he had to go. It has not always been easy, but knowing that he is making a difference has kept him coming back. In one area he visited, many of the teachers were unable to read their books because they had no glasses.

East Timor is a long way from Maver's native Australia, where most of his working day is spent adjusting patients' prescription lenses. "Hens with their family of baby chicks, dogs, goats and pigs have all been known to wander through while you're trying to examine someone's eyes," he says. On one occasion, a goat ate his toothbrush; on another, a rat ate a colleague's watchstrap.

Another option is to get involved in a project for the long haul. Dr Jo Hollingsworth returned to the UK from Belize last week after 18 months working for the Belize Council for the Visually Impaired as a clinical trainer and regional optometrist.

Hollingsworth, 33, was travelling around the world after finishing her PhD when the job in Belize came up. "I wanted to do some work abroad as part of my year's sabbatical, and I was a little bit disillusioned with the commercial nature of optometry in the UK," she says. "I knew nothing about this amazing little country at that point. Now I am sad to be leaving."

Hollingsworth has spent most of the past 18 months in the south of Belize, running sustainable eye clinics and taking mobile outreach clinics to Mayan villages. She also trained three local girls who had recently finished studying optometry in Cuba. If you have the time and the skills, Hollingsworth has some simple advice. "Do it! It's easy to get caught up in the trappings of Western society. Being part of the community here has been an amazing experience."

For more information on how to become an optometrist visit www.college-optometrists.org

To donate to optometry projects in the developing world, visit www.givingsight.org.