WA News Feature Articles Outback Eyes on Vision Van
Outback Eyes on Vision Van
Written by Dr Rob McEvoy
Wednesday, 25 January 2017

 

The Lions Outback Vision Van (LOVV) is one response to a growing problem with vision disorders in WA that result in significant economic, social and quality of life impacts. Proponents of this outreach service are faced with these facts:

  •          Indigenous Australians suffer three times the level of blindness, are 12 times more likely to have cataract-related blindness and 14 times more likely to have diabetes-related blindness (cw the general population).
  •          In remote WA, specialist coverage is about 20 times less than urban Australia and rural residents are three times less likely to have seen an ophthalmologist.
  •          While most vision loss can be corrected overnight, 35% of indigenous adults have never had an eye examination.
  •          Anecdotally, eye care close to home is very important. As an example, a 60-year-old Indigenous man was seen by a visiting optometrist in a remote Kimberley community; he was very shy, was mourning his wife and prepared for an aged-care facility; he had hyper-mature cataracts (legally blind) that were cleared later with prioritised eye surgery at Kununurra thanks to the assistance of clinic staff. He is now back with his community, speaks fluently, and drives a car again.

LOVV, which first hit the road just over 10 months ago, has an ambitious goal – to close the eye health gap in regional and remote WA by delivering outreach services for all major eye conditions where people live. It is normally staffed by a resident doctor, ophthalmologist and nurse/driver and a typical visit lasts from 1-5 days, depending on the size of the community.

Is this outreach service needed and do we have the personnel available? Maybe we should reflect on the early successes and challenges of the LOV Van project.

  •          16 different communities visited and 85 clinics conducted, from Albany to Kununurra
  •          About 1679 patients seen – 707 Aboriginal and Torres Strait Islanders.

201702-Dr-Angus-Turner-LOV-vanDr Angus Turners consults in the Lions Vision Van.According to Dr Angus Turner, enthusiastic ophthalmologist and McCusker Director Lions Outback Vision, LOVV provides access to clinical equipment usually only available in tertiary centres. Equipped with a range of state-of-the art ocular imaging and lasers, the LOVV and its team have provided care that exceeds some tertiary hospital facilities. LOVV saves patients having to fly to Perth to access this care.

“While it was logistically challenging, the LOVV and its team have been given an enthusiastic reception and extra effort from local community health staff,” he said.

“Visiting ophthalmologists who help out on the LOVV for a week at a time are amazed at the facilities available and patients are often a bit shocked at the size of this ‘van’ which is probably the wrong description for a rig of this size.”

“The last decade has seen new technology used in daily practice to monitor and treat common eye conditions. The management of diabetes, glaucoma, macular degeneration and measurements of lenses for cataract surgery have all moved beyond what can be offered on standard outreach eye trips.”

Each week LOV clinicians across the State discuss complex cases and can use the technology on board again to avoid travel to Perth. Where more complex surgery has been required, LOVV works closely with Aboriginal Medical Services and existing health facilities (e.g. cataract removal).

“Other priorities are tele-ophthalmology, building stronger connections between GPs, Aboriginal Medical Services, Aboriginal liaison officers and health workers, robust screening programs for diabetic retinopathy and the identification of local ‘eye champions’ to spread the word about caring for your eyes.”

“LOV often coordinates closely with the AMS health workers, to complement things like the LOV DR [diabetic retinopathy] screening which has retinal cameras located in local health services.” 

“Telehealth transmission of images for retinal screening has been occurring for many years. In November, a new MBS item number for GPs to take retinal photos will improve awareness and access to DR screening. There are also new item numbers for optometrists to do video consults with specialists and help consent patients to surgery, for example, to save waiting times and directly book patients. This has been very successful in 2016 with high attendance, patient acceptance and uptake by optometrists.” 

“It is a wonderful thing to be a part of this great tradition ­– the first mass screening programs for glaucoma by the Lions Eye Institute began in the 1960s – and it is exciting to see what can be