During the COVID lockdowns, optometrists in Malaysia were forced to close, classified as retailers instead of primary health care providers.
Now, taking inspiration from models of collaborative care seen in Australia and New Zealand, and working from the concept of ‘Asians helping Asians’, eye care professionals are creating a movement to change that.
When 600 delegates filed into the conference halls of the Kuala Lumpur Convention Centre for the 3rd Asian Optometric Congress (AOC) late last year it was a landmark event.
Not because organisers had initially expected only half that number of attendees; not because the conference was rescheduled twice because of COVID; but because the educational focus of the AOC was an important signal to governments across Asia that optometrists have a crucial role in the delivery of eye health care.
There is, in our country, still some ambiguity around optometrists as primary eye care providers
Delegates to AOC have been told that optometrists need to be mobilised, to improve access to eye health care in Asia.
“Looking at Australia and New Zealand, this is the model of practice that we aspire to,” conference Organising Chair Mr Woon Pak Seong told mivision.
“There is, in our country, still some ambiguity around optometrists as primary eye care providers. While we have six universities providing education and equipping us to be primary eye care providers, still the government is not too sure about who we are and what we do.
“As evidenced in the lockdown, we had to close our practices. That created a lot of problems, we have a lot of patients who rely on us for their regular check-ups. For example, when we are fitting orthokeratology, we have a responsibility to do our follow-ups.”
Mr Woon told mivision that in some Asian countries, while optometrists have the necessary education, they were legally prevented from using diagnostic tools like slit lamps.
“All of us, in each country, are at different levels in terms of our progress at providing optometry. If we can use these conferences to move each other just one step towards the goal, then I think that will be a big achievement,” he said.
Galaxy of Optometric Stars
In his opening speech to the gathering, Mr Woon said the two-day conference had a schedule that was “something not short of crazy”, incorporating eight plenary lectures, 10 industry sessions, 60 workshops, 21 oral presentations, 13 posters and 22 e-posters.
He urged conference delegates to grasp hold of the bigger picture for optometry in the region.
“Looking at all of you, looking at these galaxies of stars in the optometry universe, I see the opportunity for us to be more than just conference delegates. Rather I see the opportunity for us to become a movement, where we can spur each other to excellence, learning from each other, supporting one other, and with the help of our industry partners, bring sight, prevent blindness and impact our nations.”
Need for Increased Screening
In his opening address, Datuk Dr Murphy Chan, President of the AOC, said the Congress provided an opportunity to discuss the rising incidence of vision impairment around the world.
“This is an issue that needs to be addressed urgently. As optometrists, we know that regular eye check-ups can help to detect and reduce the incidence of vision impairment amongst the public.
“However public awareness of the importance of eye health and eye care is not very high.
”Using the example of Malaysia, he said survey findings show that almost 70% of Malaysians had not gone for an eye screen recently. He said many cases of blindness in Malaysia could be prevented with early intervention and treatment.
He said there were 600 ophthalmologists in Malaysia and most Malaysians visited the public hospital system for eye care treatment. This put extraordinary strain on the system, he said.
“One way to ease the burden on hospitals is to mobilise optometrists to help the community in eye healthcare screening,” Datuk Dr Murphy Chan said.
“Mobilising optometrists for community eye health screening will help to reduce the influx of patients checking into hospital for all sorts of eye disorders, some of which could have been easily addressed and managed by seeing an optometrist.”
Importantly, his comments about mobilising the optometry profession were supported by a later speaker to the platform, Dr Mohamed Iqbal bin Hamzah, from the Malaysian Ministry of Health.
He said there were 2,700 optometrists in Malaysia – most in private practice. Mobilising them to perform screening, particularly in rural areas, would reduce congestion in the public hospital system.
He stressed the importance of continuous learning at events like the AOC, to maintain the quality and competency of eye health care.
Practical Focus
The conference program covered a wide variety of topics, from refractive error, and myopia management, to primary eye care, glaucoma, diabetic eye disease, dry eye, sports vision, and vision therapy. As well, the latest in spectacle and contact lens technology was showcased.
Speaking with mivision, Mr Woon said the conference had an incredibly practical focus, with a lot of workshops, so participants could immediately take “nuggets” back to their practice.
“The other thing we did… in order to attend the conference, you had to attend the preconference recordings by the workshop speakers, so you got the theory out of the way. So, when you came to the workshop proper, you went straight into the practical aspects of it.”
Mr Woon said the conference also very deliberately provided a platform for younger speakers to present.
“We want to encourage young rising stars to come and present papers… to give them a platform.”
Asians Helping Asians
Speaking after the conference, Datuk Dr Murphy Chan told mivision that the AOC conference, which was held in conjunction with the 3rd Global Orthokeratology and Myopia Control Conference (GOMCC), was an important step in upgrading the delivery of eye care across Asia.
“There must be a transformation. This transformation needs leadership. It’s the rising of Asians helping Asians.
“We understand the differences in social economy of each country in Asia: the very developed ones like Singapore, the still developing countries like Vietnam and Cambodia and so forth.
“We have the resources; we have the institutions like universities and academies. Because of China, Indonesia and India, our industrial partners are happy to work with us because it’s a big market.
“Let’s be practical, let’s be resourceful … it’s time that we have this movement of Asians caring for Asia.”
He said there were three major focus points for the AOC: education; narrowing the gap in practice standards; and ensuring legislation in different countries recognised and enabled optometrists to act as primary eye care practitioners.
There must be a transformation. This transformation needs leadership. It’s the rising of Asians helping Asians
OK and Myopia Control
Datuk Dr Murphy Chan said myopia was the major issue on the horizon for Asia.
He said the AOC would be opening Myopia Management Institutes in countries across Asia, with Philippines and Malaysia launching early this year. These institutes would be responsible for endorsing optometrists in myopia management, certifying and auditing optometry practices, and delivering continuing professional education.
GOMCC Organising Chair Mr Tan Thok Chuan said myopia management has become significantly important for optometrists and ophthalmologists to combat the ever-growing myopia population, particularly in children and teenagers.
“This is especially evident during the COVID-19 pandemic periods where schools are closed, and students are forced to do online learnings. These factors have resulted in higher incidence of myopia amongst this age group,” he said.
“It is our commitment to provide solutions to manage this fast-growing problem, not just in Malaysia, but in the region as well.
“In this regard, we need to better understand the myriad issues and to update our competence in managing myopia progression among the young population.”
The GOMCC conference presented a full day of workshops, in two streams, followed by plenary sessions the following day.
Mr Tan took the floor for the opening plenary session on managing corneal staining in orthokeratology.
Other speakers included Australians Dr Daniel Tilia, Dr Oliver Woo, Dr Monica Jong, and Mr Hamish Thrum, however it was a truly international line-up with speakers from Switzerland, Chinese Taipei, Singapore, the United States, the United Kingdom, Malaysia, China, Vietnam, and Japan.
