“Prevention of eye diseases in the community is vital”

I was born in a small town in Tanzania.

Vision and eyes had always been something I’d wanted to know more about. I came across a lady who could have retained her vision, had her condition had been diagnosed earlier. That was my first introduction to eyes and optometry.

I didn’t want to become a doctor, even though I had got a place to do medicine.

I thought optometry, early screening, and finding people who might have eye diseases that could be picked up and treated in timely manner, was something I really wanted to do. It did help that my brother is an optometrist too.

My first sight of snow was in Bradford.

I’d never seen snow, ever. It looked beautiful in pictures, but when I first arrived in the UK, it was one of the coldest winters for a long, long time. I also didn’t understand the Yorkshire dialect. English was my third language, so things were a bit difficult at the start.

I had a really good undergraduate project, and a brilliant supervisor, called Dr Jim Gilchrist. It was his passion for research that really drove me to want to do a PhD. I loved my time in Bradford so much that I didn’t want to leave.

I graduated in 1984, completed my pre-reg placement, and worked for three months in practice before starting my PhD in 1986.

I got a scholarship from the College of Optometrists to do my PhD. I had a first class honours degree in optometry and was also awarded the best student prize.

My PhD was around how two eyes do or do not work together if one eye had reduced vision. What would happen to the binocular vision? If you had a cataract in one eye, would that influence your binocular vision? I found that, if there was a significant difference between the eyes, the bad eye would influence the good eye and the overall binocular vision was reduced.

When I first became a research fellow at the University of Bradford, after I had just finished my PhD, I went into the senior common room.

I was quite young. A chairman, a white man, came up to me, and said, ‘Secretaries are not allowed in here. You need to leave.’ I left, because I was so embarrassed. All I had wanted to do was to make a cup of tea. I spoke to my PhD supervisor, who then spoke to somebody else, who then spoke to the chairman, who apologised.

I didn’t want to, but I did go back into the senior common room. I realised that this guy wasn’t bad, actually, but it was unconscious bias. He had decided that there was this little Asian girl, who could not possibly be a member of staff. That was it – the start of my crusade to improve gender equity.

I was later invited to give a talk in America about gender equity in academia. I spoke about the problems, and the unconscious bias that people need to be aware of. I also joined the Women in Vision UK group, where I run the leadership portfolio. That incident in the common room was the start of it.

I stayed at Bradford for 10 more years, moving from research fellow to lecturer and then senior lecturer.

I realised there is a real problem with diabetes and diabetic retinopathy in South Asians. We looked to see what the barriers were, and why there was such a difference between Caucasians and Asians in terms of the risk of diabetic retinopathy.

I was then appointed as the first female professor at what was then Anglia Polytechnic University (now Anglia Ruskin University), in Cambridge, in 2001.

I joined the Department of Optometry. People were concerned because there was very little research at that point at Anglia Polytechnic University. We didn’t even have a lab, when I first started. But I thought, ‘I’ve got a completely blank sheet that I can draw upon to develop the research.’ It was a challenge that I thought would be really good to take on.

We developed the research profile and submitted it to the Research Excellence Framework (REF) in 2008, where we got world class scores. Because of that, the university decided to invest in us.

I then set up the Vision and Eye Research Unit, which was part of the Postgraduate Medical Institute. It was really an investment in myself and my two colleagues, who were both ophthalmologists. One is Professor Rupert Bourne, and the other one was Professor Roger Buckley, who has sadly passed away now. We have now integrated to become the Vision and Eye Research Institute within the School of Medicine.

I’ve been researching within India for over 15 years now, because India has got a very high prevalence of diabetes.

I wanted to see if there was a difference between people living there, and Indian people who had come here. We found that there was a high risk of blindness in India, but also here. The problem is that people who had led very active lifestyles would come here, but find language problems or skillset differences. They would then get older, and their lifestyle would become quite sedentary, so their risk of diabetes increased quite dramatically.

This is a real passion for me. I don’t think anybody should have a higher risk of blindness just because they don't know what to do, or because they don’t have that level of understanding or support.

I don’t think anybody should have a higher risk of blindness just because they don't know how to look after it, or because they don’t have that level of understanding or support

I’ve also done quite a lot of work in in Nepal, where we have been working with the Nepal Diabetic Endocrinology Society.

We submitted a case study to the REF in 2021. It talks about the number of people who we have influenced, which is over 125,000, in UK, China, Thailand, and India.

Since 2021, I’ve started working with collaborators in Pakistan, Mexico, and Trinidad and Tobago and Bangladesh. I am also in the process of developing more work in some African countries, including Rwanda and Nigeria, and also in Sri Lanka.

We work with the International Agency for the Prevention of Blindness (IAPB), and have been part of their diabetic workshop for the past year.

The Vision and Eye Research Institute has been working with IAPB for a long time, using my colleagues’ data around the prevalence of blindness in their Vision Atlas.  

I’m also the chair trustee of One World One People, which we set up during COVID-19.

We couldn’t celebrate my birthday during the pandemic, so we decided to do an online concert. I had just come back from Nepal, where it costs $80 for a very basic operation. We said, ‘come to this concert, and if you’d like to support people who can’t afford treatment in remote parts of Nepal, please contribute and we will pay.’

The concert was attended by 800 people from across the world. We raised £8900 pounds, so we had to set up as a charity.

Also, I am from Africa, and there were people there during COVID-19 who couldn’t access food. So, I wanted to provide them with food, which we now do for around 100 people a week in Tanzania. One World One People is about reducing or paying for infant cataract extractions in very remote parts of Nepal, and also feeding people on Fridays in Tanzania.

I’m currently the director of the Centre for Inclusive Community Eye Health at Anglia Ruskin University.

Access to eye health in the community is vital. Unless we can improve access to places and to people that are underserved, we will not be able make much progress. We need to find innovative ways to improve access – right from trying to prevent eye diseases, bringing appropriate care close to home so that it can improve their experience, through to ensuring that those who have been unfortunate to lose their vision get the best care.