Specsavers continued its support of The Fred Hollows Foundation and The Fred Hollows Foundation NZ during COVID-19. Here, the teams explain how their programs were impacted by COVID-19 and what services look like now.
It’s no surprise that COVID-19 has presented a number of challenges to The Fred Hollows Foundation’s program, the Lions Outback Vision Van this year.
The Vision Van, which normally delivers eye care services to rural and remote Indigenous populations throughout Western Australia, was off the road for 41 days, with 10 clinics cancelled, predominantly across the Kimberley and Pilbara regions where inter-regional borders were closed.
Some patients were able to be seen by resident doctors in Broome and some exemptions were given to cross regional borders to attend injection clinics, such as for macular degeneration treatment.
On top of this, to reduce the movement of patients by up to 50%, specialists were able to administer higher doses with the intravitreal injections, covering six weeks instead of four.
Seven regional surgical lists were cancelled with regional hospitals only beginning to reschedule cataract surgery, considered an elective surgery, in late June. Due to these high numbers of elective surgeries cancelled, the number of days available for ophthalmology is likely to be reduced until the end of the year. This will have an impact on the annual number of cataract surgeries for Western Australia.
With most remote Aboriginal communities closed to prevent the spread of the virus to at-risk populations, the team focussed on an audit of all patient records to identify those areas with longer wait lists for services or patients who had missed more than one appointment. An Aboriginal Eye Health Coordinator rang patients who had not attended appointments to identify barriers which included transport problems, fear of the needles, cultural commitments, length of time taken for appointments (including travel), and patients being out of town when the clinics were held.
Doctors rang high-risk patients to check on their eye health and made sure that those in greatest need were elevated to the top of the next available clinic lists.
Lions Outback Vision also established an on-call service for patients to ring if they had urgent eye issues with Broome-based doctors able to assist patients from the new regional hub.
The Lions Outback Vision Van was able to recommence normal work in mid-August with additional days added to the schedule to support communities of highest need. This partly allows for catching up with patients who were missed between March and June but also takes into consideration more stringent processes implemented to increase social distancing and additional time for cleaning down of surfaces after each patient.  One of the outcomes of the interruption to service was an increase in the uptake of services, and a decrease in those not attending appointments when services resumed with 100% attendance at some locations.
The Fred Hollows Foundation NZ has also reported great interruption to services in the Pacific with ophthalmologists and nurses only able to treat urgent sight-threatening conditions and complete online training for three months.
The Mobile Eye Clinic, which normally travels around Fiji offering free sight-saving surgeries, treatment and consultations was inoperative for 11 weeks, meaning 3,850 patients missed consultations and 308 missed surgeries.
The Foundation was forced to cancel three Pacific outreaches and twenty diabetes outreaches, meaning 3,500 patients missed consultations and 300 surgeries were unable to be performed.
The Pacific Eye Institute, The Foundation’s pre-eminent training facility and eye clinic, is expecting to see 8,800 less patients for consultations than originally expected and perform 900 less surgeries over the course of the year. All practical training for eye health students halted, with some students returning to home countries and now trying to return to Fiji to train in person again.
Pacific services have recommenced now with a focus on patients whose sight deteriorated during the COVID-19 lockdown.