Travelling eye docs set focus on accessibility

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This article was published 25/11/2018 (2562 days ago), so information in it may no longer be current.

It’s 10 a.m. and optometrist Sonal Trivedi has already examined the eyes of several teens on the mezzanine in the Daniel McIntyre Collegiate Institute library.

She has a stocky, dark-haired teen in her chair when she discovers that he’s 19 and Manitoba Health won’t cover the cost of his exam.

She has him take a seat in a makeshift waiting area — maroon chairs pushed up against the mezzanine railing — and walks to a reception desk set up on a folding table.

Trivedi and her two co-workers do the math, trying to figure out when the student would have had to be born to be eligible for free coverage.

They call over Sean Sylvestre, CEO of Mobile Vision Care Clinic, which is doing the eye tests.

“We’ll figure it out with the school,” Sylvestre tells Trivedi.

“Worst-case scenario we’ll pay you for it.”

Trivedi fetches the teen from the waiting area and finishes the exam. He needs glasses.

They’ve prescribed four pairs of them in the clinic’s first hour today.

By the time they’re done — Sylvestre estimates it will take three weeks — his mobile clinic will have examined about 600 students at the school.

If past experience holds true, 40 per cent of them will need glasses. Over 72 per cent will have never seen an eye doctor.

The Winnipeg School Division ran a one-week pilot of the mobile clinic two years ago, after identifying what it said was a tremendous need for accessible vision care, especially for students living in poverty.

The school division approached Sylvestre, an optician who’d worked as a consultant for new optometry practices, and asked him to develop the mobile clinic. Last year, the clinic visited 20 schools, performed about 4,200 exams and donated or sold about 1,700 pairs of glasses.

The school division said it’s already paying dividends.

“Student data is showing gains in student literacy scores, attendance and engagement in school,” chief Supt. Pauline Clarke said in an October statement.

Nursery to Grade 1 students improved by 1.42 grade levels between October 2017 and May 2018, the time between being tested and getting glasses and a retesting of their reading levels.

The mobile clinic provides students a comprehensive eye exam, dispensing the need to miss school or for parents to book time off work to take their kids to an eye doctor.

Eye exams for students under 18 are covered by the province (in Winnipeg, a typical exam can cost $100 or more). If a student’s family can’t afford glasses, Mobile Vision Care Clinic will donate them.

Thirty-three per cent of families with children in the division live below the low-income cut-off, according to a WSD 2016-17 demographics report.

According to the same report, around 25 per cent of students in the division are immigrants or refugees.

“It’s difficult for families with no transportation to get to appointments,” said Radean Carter, the school division’s senior information officer.

“It’s difficult for families who don’t speak English at home to navigate our health care system. It’s difficult for parents who are working two or three minimum-wage jobs to take the two or three hours required to take their children for a comprehensive eye exam.”

“Finances are usually the bigger barrier,” said Laurie Dyck, principal of Faith Academy’s elementary campus, a private school on Matheson Avenue. “It’s just not a priority when you’re living paycheque to paycheque.”

Proximity may also be a barrier to care. In the North End, there’s one optometrist’s office on Selkirk Avenue. In the West End, there is no eye-care clinic in the wedge between Portage Avenue, Notre Dame Avenue and Empress Street.

Dyck said many families near her school own one car, which is shared between two working parents. Gilbert Plante, a manager at Union Gospel Mission’s Family Life Centre on Pritchard Avenue, said many families in his neighbourhood travel on foot or by bus.

Another difficulty is, unlike illness or injury, poor sight doesn’t cause pain.

“If your child has a toothache, they’re going to complain,” Dyck said. If a child isn’t complaining and the parent can’t afford glasses, the child isn’t likely to get treated.

“We’ve seen really high prescriptions in kids who don’t know they can’t see,” Sylvestre said.

“It’s not like they can try someone else’s eyes.”

Some only realize they can’t see when they try on another kid’s glasses as a joke and suddenly see the world in sharper focus.

Daniel McIntyre Collegiate in the West End and Mulvey School in Wolseley relied on teachers to notice if kids had trouble seeing. But teachers might not know how to spot kids who lagged behind because of vision issues, Daniel McIntyre vice-principal Meghan Davidson said.

“We wouldn’t know otherwise, right?” Davidson said.

“And they would go through years and years of us not knowing if that’s truly what was preventing them from being successful.”

In the past, staff at both schools routinely drove students to eye appointments.

Mobile Vision Care Clinic isn’t a catch-all. The clinic only tests students who hand in consent forms signed by a parent or guardian, meaning some students might not get tested, even if they need glasses.

The clinic has just one team of two optometrists and eight staff. While Sylvestre said they’re looking to expand “big time,” he’s limited by a lack of doctors.

It’s not because being an itinerant eye doctor isn’t lucrative. Sylvestre said that since the doctors see more patients, there is actually more money to be made.

“We really targeted optometrists that believed what we believed in terms of breaking down barriers,” Sylvestre said.

“We can either just have a job, or we can leave a legacy where we’ve made a difference, where when we’re done, we’ve done something that’s going to affect people’s lives.”

Geralyn Wichers is a journalism student with Red River College’s Creative Communications program.