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Nurse Training Helps Build a ‘Front Line’ for Vision Screening in Micronesia

Micronesia’s only ophthalmologist Padwick Gallen, MD, center, assists with a nurse education program in December, conducted by the Moran Eye Center.
Micronesia’s only ophthalmologist Padwick Gallen, MD, center, assists with a nurse education program in December, conducted by the Moran Eye Center.

Three John A. Moran Eye Center ophthalmic technicians traveled 6,200 miles to the Federated States of Micronesia (FSM) in December to train 12 nurses from the remote Pacific island nation to conduct thorough vision screenings.

The ultimate goal: build a "front line" of nurses to take on the time-consuming work of pre-screening patients across the islands so that Padwick Gallen, MD, the only ophthalmologist serving the 100,000 citizens of the FSM, can concentrate on performing surgeries.

Learn By Doing

"Hands-on training for local caregivers is key," said Lori McCoy, a program coordinator of Moran’s Global Outreach Division who participated in the training. "Our goal is to transfer skills, provide practice and testing and then to follow up with the nurses on a regular basis. Each nurse trained is a step forward in making eye care more efficient in a country that currently requires its ophthalmologist to travel from island to island, often carrying his own equipment."

An Exchange of Supplies and Skills

During the week-long session in the state of Pohnpei, the nurses practiced screening and interpreting results. On the last day, they joined Gallen in a working clinic where he was able to assess their skills and provide feedback.

The Moran team gave each nurse the supplies necessary to go back to her home state to start screenings—including eye charts and tests, state-of-the-art tonometers (for measuring the internal pressure of the eye), and iPads—to track patients and results. They will follow up with monthly teleconferences to answer questions and continue training.

A Backlog of Treatable Blindness

Underwritten by the Errol EerNisse Family Foundation, this was the first of several training sessions planned over the next three years. In the future, training will be funded through the National Eye Care Plan—an alliance recently established by Moran and the FSM government. It outlines how the FSM will work with Moran: contributing financial support for nurse training, skills transfer, equipment, and hiring a national eye-care coordinator.

The plan is a major step toward sustainability in a region that presents extraordinary challenges. The FSM span more than 1 million square miles of islands and ocean. Geography alone limits access to treatment, and the backlog of curable blindness is staggering. Limited awareness of eye diseases and control measures compound the need for care and education.

Ongoing Care and Training

Since 2013, supported solely by donors, Moran outreach teams have been traveling to Micronesia to provide eye care. To date, the teams have conducted over 2,500 vision screenings, distributed more than 2,500 pairs of eyeglasses and performed some 800 surgeries. Because of the scarcity of skilled personnel in eye care services at all levels, the teams will continue to provide surgical care to patients and transfer elite surgical skills to Gallen.

"As the National Eye Care Plan is implemented, our efforts will have far more impact," said Craig J. Chaya, MD, co-medical director of Moran’s Global Outreach Division. "The challenges are still there, but now we can move forward with renewed optimism."