Picking up the mantle for the only public ophthalmologist in Belize

Providing cataract referrals to the indigenous Maya population of southern Belize is not something that appears on many optometry CVs.

But Frank Eperjesi, locum optometrist and former lecturer in optometry at Aston University, can confidently add that string to his professional bow after starting 2025 by volunteering with the Belize Council for the Visually Impaired.

Eperjesi travelled to Belize City in February, and spent a month commuting via propeller plane to clinics along the country’s Caribbean coast – from Punta Gorda in the south to Belize City in the north, via the town of Dangriga.

Sometimes, Eperjesi told OT, he would travel 300 miles across the country in just 20 minutes, taking on work that would traditionally fall under an ophthalmologist’s remit.

For its population of 420,000 people, the country would ideally have seven ophthalmologists, Eperjesi explained.

In reality, it only has three – two of whom are private, with services that are unaffordable for much of the population. This disparity means the country is more than 50% understaffed when it comes to ophthalmological care.

The third ophthalmologist was working full-time for the Belize Council for the Visually Impaired, but took a step back to only work one day a month shortly before Eperjesi flew out to volunteer.

As a result, Eperjesi found himself covering more ground than he had initially expected to.

Originally, the plan was to work solely in a clinic in the coastal town of Dangriga. Instead, Eperjesi found himself travelling to work in ophthalmology clinics around the country.

“My UK qualifications allow me to carry out glaucoma monitoring and change patients’ medication, and start them on medication initially,” Eperjesi explained.

“Working in Belize as an optometrist with a UK qualification, the work is more advanced than it is in the UK.”

His scope as a UK optometrist allowed him to perform pre-operative checks for cataract surgery and confirm when a referral for surgery was needed, Eperjesi said.

“There was a primary level with the optometrist, a secondary level with me, and then a third level with the surgeon,” he explained.

“I was that middle person, saying, ‘yes, there is a cataract,’ or ‘yes, there is some diabetic retinopathy. You need some laser treatment. Let’s get that organised.’”

He added: “When people hear visually impaired, they might think of an old person with macular degeneration. But it was broader than that – some people just needed glasses, and other people needed surgery. There was a big range.”

Frank Eperjesi

Frank Eperjesi travelled to clinics on Belize’s Caribbean coast via propeller plane

Cataracts in Maya communities

Eperjesi was in Belize for four weeks, returning to the UK on Monday 17 March.

He was first inspired to get in touch with the Belize Council for the Visually Impaired after reading a 2024 OT article by his former student at Aston University, Benji Chandra.

Chandra had spent three weeks working with the Belize Council for the Visually Impaired, where he was able to help with training for the country’s three ophthalmologists and treat a dentist with glaucoma, saving his sight.

The charity is based in Belize City, where a primary care optometry unit is housed in the same building as secondary care and surgical units, Eperjesi explained.

He described the charity’s clinic as “like a mini hospital.”

Patients are picked up from various parts of the country via coach and transported to Belize City to receive their treatment, Eperjesi said, adding that accommodation and food for the duration of their trip is paid for.

“The charity covers everything, which I think is wonderful, because people simply wouldn’t be able to afford the journey to get there and the accommodation,” he said.

Eperjesi added: “There are so many different types of people there. In the south, it’s mainly the people who were there before the Europeans arrived – the Mayas, the indigenous people. In the middle and in the north, it’s more mixed.”

Travelling around meant that he was able to see different pathology in different areas, he explained – including a lot of early, severe cataract cases in Mayas in their 50s and 60s, who often work long hours on farms.

“They are working outside pretty much from when the sun comes up at six in the morning to when the sun drops at six in the evening,” Eperjesi said.

“They are working, in the main, 12 hours outside in 40-degree heat, and in all that sunshine. They’re working in it, day-in, day-out, and that causes them to develop severe cataracts at a young age.”

Added to this is a cultural aspect that means Mayas, especially women, dislike wearing sunglasses, Eperjesi said.

For men, the practical issue of not being able to wear sunglasses in the heat whilst working without them slipping off was also a factor.

A group of American, Colombian and Guatemalan volunteer ophthalmologists regularly travel to Belize to perform cataract surgery for free, he said.

Eperjesi added: “There was also a lot of pterygium. This is an opacity that grows on the cornea, usually on the nasal side. Eventually it grows across the pupil, so they can’t see through this growth. There was a lot of that, mainly with the Mayas who are outside.”

The biggest challenge Eperjesi encountered during his month in Belize was sticking to time in clinic.

“There were a lot of people who wanted to come and make use of the clinics, because there might not be another clinician there for another six weeks,” he said.

“There was a constant and steady flow of people. I don’t like to keep people waiting. It was just keeping up with the flow, and doing a good job at the same time, and not keeping people waiting for more than an hour or so.”

People tended to arrive early after having sometimes travelled for two or three hours, Eperjesi said.

Respite came at the weekends, when he was able to travel independently, as well as on 12 March when the clinic was closed due to the country’s General Election.

The trip, his first to Belize, allowed Eperjesi to delve further into a longstanding interest in Central America, he told OT.

As a former British colony, most people in Belize speak English, and it is the country’s official language – but the predominantly Spanish-speaking Maya population was the exception, Eperjesi revealed. Luckily, staff working for the charity were on hand in clinic to help translate.

The trip has led Eperjesi, alongside his existing hobby of dj-ing and a new interest in cardio tennis, to consider picking up a language that he might struggle to find on Duolingo.

“I’ve learned that I need to learn how to speak more Spanish, and I also need to learn how to speak Belize Creole as well,” he said.