“They made me proud to be an optometrist”
During a trip to Ghana in July 2022, Cardiff University students performed more than 400 eye examinations. Now, the team is looking ahead to next year
21 December 2022
Summer 2022 saw eight Cardiff University optometry students, plus two staff members, travel to Ghana to perform sight tests alongside partners from the University of Cape Coast (UCC).
During the two-week trip, more than 400 sight tests were performed.
The group was led by optometrist Rafique Islam, clinic supervisor at Cardiff University’s School of Optometry and Vision Sciences, and Dr Peter Hong, a teaching associate.
The University of Cape Coast in numbers
- UCC is located 100 miles from Ghana’s capital, Accra
- It was established in 1962 and gained university status in 1971
- The doctor of optometry programme takes six years to complete
- It began in 2002, with only five students
- Around 50 students per year are now enrolled
- The Optometry Department is one of two in the country that is accredited to provide training and assessment towards formal qualification as an optometrist
- Clinical training is provided in two on-campus clinics, which serve the university community as well as the people from the Cape Coast Municipality
- Approximately 400 registered optometrists are practicing in Ghana as of 2022.
The trip was part of a £46,000 Erasmus+ funded teaching and staff exchange programme, designed to strengthen bonds between the two universities through teaching and research, and to help UCC staff provide outreach services to rural communities.
Whilst there, the students joined UCC staff to participate in outreach visits and perform eye examinations for the locals in six rural communities, many of whom are unable to access eye care in their day-to-day lives.
During clinical outreach days, students were accompanied by translators who enabled them to conduct various examinations, including history and symptoms, visual acuity measurement, refraction, and direct ophthalmoscopy. Members of the villages were also dispensed with free spectacles if required.
Outside of outreach clinics, the students also joined UCC staff within the department of optometry’s eye clinic and at the local eye hospital.
Reflecting on the trip as the year draws to a close, Islam said: “UCC told everyone in the village that we were going to do a screening service. Our waiting area was full. We would rotate the patients to different stations so that all necessary eye examinations could be conducted, and I would go to each station and help when needed.”
If required, referrals were made to the university eye clinic or directly to the eye hospital, as happened in a case of juvenile uveitis – something that Islam had never seen before.
He added: “It was challenging, because some of us were new to outreach. The students were new, and I’d never done it before. It was a steep learning curve.
“I truly enjoyed leading the students during outreach clinics in Ghana. The clinics were a true highlight for me. They made me proud to be an optometrist.”
Georgia Davidson, one of the optometry students, shared: “I learnt so much that you can’t learn from a textbook.”
Sharing knowledgeStaff also conducted teaching sessions for the UCC lecturers, which included tutorials on gonioscopy, visual field assessment, and complex contact lens fitting.
A CPD day at UCC was also held, with 80 Ghanaian optometrists attending, some of whom had travelled up to eight hours by road.
During the day, optometrists were provided with an opportunity to develop their skillset in binocular indirect ophthalmoscopy, management of keratoconus, and low vision service provision.
Cardiff University staff also gifted 30 disposable gonioscope lenses, 40 disposable Volk lenses, two headset binocular indirect ophthalmoscopes, two Bausch + Lomb rigid gas permeable contact lens fitting sets and a set of simulation eyes to UCC for teaching purposes.
An ongoing collaboration
UCC has had a ‘partnership of shared knowledge and research collaboration’ with Cardiff University for seven years.
While UCC staff had previously visited Cardiff, this was the first time Cardiff students had travelled to Ghana. A planned trip was cancelled in 2020 due to the pandemic.
Islam, who qualified in 2021 and had been supervising university student clinics one day a week for a year whilst also working in practice and studying towards independent prescriber accreditation, was drafted at short notice to lead the trip a month before it was scheduled to depart, after the previous volunteer was unable to travel.
The weeks before the trip saw him help with organising flights, accommodation, vaccinations, visas, frame donations, and the personal first aid training that was required by the university.
He said: “I was working full-time in practice, and for that month every single patient showed up. I was performing eye tests after which I was constantly checking emails. When I had any time, I was emailing contacts in Ghana, arranging accommodation, speaking to university staff, and gathering donations.”
Equipment, frames and sponsorship for the trip were secured from Cardiff University, independent UK optometrists, and companies including Specsavers, Heine, and Louis Stone.
Islam added: “The trip was a huge success, but it was intense. The university is planning to do it again next year.”
He explained that the experience will allow for further improvements in planning and services that the volunteers are able to offer ahead of next year’s trip.
Islam would like to lead optometry students in school screenings in Ghana, and plans to run an open evening beforehand to provide tuition on techniques and practicalities for testing in an unfamiliar environment.
It would also be helpful to take low vision aids, he said, as many of those tested had advanced eye conditions that could have been picked up sooner if care was accessible, but were now too far progressed to benefit from glasses. The ocular pathologies that were most commonly diagnosed on the trip were end stage glaucoma and advanced cataract.
Staff from UCC explained that low awareness of glaucoma and late presentation and diagnosis are established major challenges in sub-Saharan Africa. To address this, Cardiff University and UCC staff collected pilot data to support their latest research collaboration, which aims to promote knowledge and skill sharing by training UCC staff in glaucoma case detection and enable intra-ocular pressure measurement to be routinely performed during outreach clinics.
Islam believes that the experience was a good one for the students and that it will help during their pre-registration period.
“They performed over 400 tests,” he said. “Most UK optometrists are unlikely to get through that in a whole month. It would be a lot of work for any optometrist, yet the students did that in five days. They saw a lot, they dispensed a lot, they screened a lot. I think they did a fantastic job. The Ghanaians loved the students, they were very thankful for the service that we provided, and they definitely want us to come back.”
Dr Grant Robinson, director of postgraduate taught studies at Cardiff University School of Optometry and Vision Sciences, added: “I found the experience really eye opening (literally). Gaining an insight into the profession in Ghana has enabled me to better understand the challenges faced by optometrists in West Africa and appreciate the resources available to me as a UK optometrist.”
Aarti Sharma, a student optometrist, reflected: “We loved the culture, food, music and how kind the Ghanaians were.”
Hong, the co-lead supervisor, joined the team directly from Malawi, a country he has visited frequently to provide eye care.
He is optimistic about future collaboration between Cardiff University and UCC. He said “It’s been my privilege to work with the optometry team in UCC and help organise the inaugural visit. I hope that this work will lead to greater and more ambitious projects together.”
Wales for Africa scheme
With the additional support provided to buy equipment, UCC has now set up a low vision rehabilitation service that provides care for patients from a large geographical area and actively trains other optometrists to provide low vision services.
Speaking about the July 2022 trip, Dr Enyam Morny, a lecturer at UCC, said: “This trip was the final leg of the mobility project and although it marked the successful completion of that project, it felt more like a launchpad for deeper collaboration between UCC and Cardiff University.
“The visit created an opportunity for staff from either side to meet each other face-to-face and to get to know each other beyond emails and online meetings. The value of in-person interaction to enhance collaboration cannot be overemphasised.”
Lead image: Rafique Islam (left) with the Cardiff University student group and UCC staff whilst on clinical outreach