Road-side Care

Out of the regions we’ve visited this week from the streets of downtown Kumasi to the rural dirt roads of Aboabo, downtown Kumasi seems to have the most need.

However, I have seen not very many patients with mature cataract cases come and visit. This I believe is due to the roughly 25 ophthalmologists that work in and around Kumasi.  Most of the patients are in the late 40’s to early 70’s and have presbyopia. Presbyopia is caused by the passage time. As explained to me by Josiah, presbyopia is the slow loss of the eyes ability to focus on objects up close, such as words on your smartphone or bible. This condition is usually corrected by using a + prescription such as +2.00,+1.75 etc. It has been amazing learn how Josiah diagnoses people and how satisfied his patients are as they walk away smiling with a new pair of glasses for the price of ten cedis which comes to approximately 2 US dollars.

He explained to me how he diagnosis presbyopia in the field outside of the clinic. Apparently there is a formula that all optometrists use. You take the age of the person, subtract 10 years and then divide by 2, giving you their reading glasses prescription.

For example let’s use, Gladys, a fictional Ghanaian. She is 50 years old the mother of two. Gladys is walking past her local police station in downtown Kumasi. She hears a public service announcement stating that people are here from the Friend’s Eye Centre and that they are screening people. She looks down at the make shift clinic on the red dirt with three white volunteers working alongside three clinic employees. She walks down the rough concrete stairs to see what this is all about.

If this was today, I would be that Abruni, Ghanaian for white man/person, whose broken Twi and English combo she would have to work through. Boniface, one of the opticians helps get her name and she would go through a basic acuity test for both eyes that looks something like this:

After testing both eyes, Gladys waits with a small white paper on a low, rough concrete wall. In her hand is her small paper with her visual acuity scores on it.        

RE: 6/9  LE: 6/18

The gentleman that just met with the doctor walks by her to another table to get glasses and medicine for his eyes. She stand and walks in to the makeshift tent, a place dim enough for the optometrist Josiah to see the back of her eyes clearly.

  

 As she walks in to the small tent on the side of the busy Kumasi street, her primary complaint is the inability to read her texts from her kids. Josiah after looking at the optic disc and back wall of the eye and noting no abnormalities would subtract ten from her age, giving 40 and then would divide by two. This gives 20 or a prescription of +2.00. Gladys stands up, thanks the doctor and walks out of the tent back into the 90 ^oF and 95% humidity of downtown Kumasi. As her eyes adjust she walks over to the table to get her new +2.00 glasses from another volunteer supporting, AKY another one of the opticians that help Josiah on outreach. The whole process took about 10-15 minutes from start to finish. Gladys walks back up to the street with new glasses and the ability to read her bible and the texts from her kids.

This experience has been shared by the 275 plus people I have helped screen over the past two weeks. It’s been amazing to watch and play a small role in the improvement of the lives of these people.