Remote diagnosis cuts surgery waiting times

After living for many years with blinding cataract, Mavis Arnott can see her 14-year-old daughter for the first time. Photograph: Alan McDonald.
 

A quiet revolution has been taking place in Indigenous Australian eye care in the Pilbara that is transforming lives and families.

In a first for the West Australian region, telehealth technology has been used to connect patients from the remote communities of Jigalong, Punmu and Parnngurr to an ophthalmologist, Dr Angus Turner, over 1,000 kilometres away.

Dr Turner was able to make a diagnosis with the help of optometrist Stephen Copeland in Jigalong and immediately refer people for surgery at an eye intensive in Port Hedland supported by The Fred Hollows Foundation.

For Mavis Arnott it meant just 48 hours between being screened and having an operation instead of waiting up to 12 months for specialist eye care.

As a result she can see her 14-year-old granddaughter Brianna for the first time. The 75-year-old has returned to Jigalong, 400 kilometres north east of Port Hedland with a spring in her step and her sight restored after living for many years with blinding cataract.

“These efforts represent a novel way to meet eye care needs where there are limited specialists able to reach remote areas,” said Dr Turner, head of Lions Outback Vision.

During the hook-up, patients were able to talk directly about their eye conditions and treatment – an option Dennis Jefferies says was very reassuring because he was “feeling nervous” (about making the trip by plane from Jigalong to Port Hedland). "Long way from home, pretty stressful,” he said.Mavis Arnott boards the plane to Port Headland. Photograph: Alan McDonald

The project involved all the precision of a military manoeuvre. It is the result of partnerships between Lions, The Fred Hollows Foundation, Puntukurnu Aboriginal Medical Service, the Western Australian Health Department and the Indigenous and Remote Eye Health Service (IRIS), which chartered patients from Jigalong to Port Hedland.

The Foundation is supporting an ophthalmology fellow, Dr Hessom Razavi. The Iranian-born Australian-educated senior registrar has spent the past two weeks criss-crossing the Goldfields, Kimberley and the Pilbara screening eye patients and teaching. This frees up Dr Turner to concentrate on surgery.

Dr Razavi: “I always felt that outreach would be what I wanted to do. Our family is from a culture in which you go where the need is. With ophthalmology you can make such a difference."

Jaki Barton, Manager of The Foundation’s Indigenous Australia Program, says “Our aim is to extend eye care to as many people as we can. Ninety four per cent of vision loss in Indigenous adults is preventable or treatable and yet more than a third have never had an eye examination. The key message is for everyone to get their eyes tested.

“We have history in West Australia. Fred Hollows came here in the 1970s to tackle trachoma. Australia’s still the only developed country to have this infectious eye disease, although rates are declining.”

Several of the patients remember Professor Hollows’s visit. His name is revered and people are delighted that his work goes on.

Fifty-eight-year-old Mitchell Biljaba Jangala is a former stockman at Roy Hill Station and a bilingual teacher at Punmu school. He was brought in from the desert when he was 12 after the Maralinga nuclear test.

Mitchell has diabetic retinopathy, which is caused by fluctuating blood sugar levels. He is worried about the alarming increase in diabetes among younger Martu people.

“I gotta see my grandchildren and children," he said. "I gotta be there for them… they really love me and I love them.”

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