Article appeared in The Sentinel, St Helena Island
Vol. 13, Issue 46 | 27 February 2025
Property of South Atlantic Media Services, Ltd.
Last year in December, St Helena was visited by an optometry team from South Africa. The team consisted of Ophthalmologist, Dr. Freddie van der Colff, Technician,Jean-Luc Neefs, and Optometrist, Stephanie van Dyk.
Dr van der Colff is an eye specialist based in Cape Town at the Cape-Eye practice together with his partner. They perform ophthalmologic surgeries at Panorama Hospital, a hospital Saint Helenians will be very familiar with as this is where medical referrals from the island used to go
for treatment in the past. Dr van der Colff came to St Helena in December to catch up on ophthalmology treatments and cataract surgeries that were due to be undertaken.
During his time on island he managed to do in the region of ten surgeries, while also seeing many more patients with ophthalmological issues. His colleague, Dr. Thomas, will visit
the island during June/July 2025 to undertake some more necessary ophthalmological surgeries.
Jean-Luc, a Technician from Invision Africa,specialising in ophthalmological equipment,
accompanied the group to undertake the installation of a PHACO machine that was used to perform the cataract surgeries and also to assist with the technical side during these surgeries.
This equipment was purchased by the Health Section last year from the FCDO Essential Equipment Funding to facilitate (amongst other things) cataract operations to be performed
on island.
Stephanie works for a big group in South Africa called Spectacle Warehouse who got involved with the Health Portfolio here on St Helena with the aim to provide a high standard of affordable optometric care to the island, while also ensuring more regular visits and shorter
delivery times on spectacles. During her seven days of consultations, she managed to see around 90 to 100 patients for eye tests and assessments.
On both the ophthalmology and optometry side, there is quite a backlog of patients waiting on
treatments, consultations and surgeries. The reasoning behind bringing in the team to do the
surgeries on island is to enable more patients to be treated locally instead of only a couple being sent for treatment in South Africa per annum as medical referrals, making the
limited budget go further. Cataract surgery is probably one of the biggest areas of treatment in ophthalmology. Cataracts occur more often in older people, but diabetes can cause cataracts to form at an earlier age. Diabetes is also an underlying cause for a lot of retinal problems. On the optometry side, the backlog was caused by the service only being accessible on an infrequent basis.
Stephanie said that the condition of eyes change frequently and as such needs to be assessed on a regular basis to make the necessary adjustments. This is one of the reasons the decision was made to come for shorter periods of time but on a more frequent basis.
Stephanie said that during her consultations she identified a variety of pathologies as is always the case when working with the human body. Where more complex cases presented, it was quite helpful to have Dr van der Colff present to consult with and work in collaboration to
find solutions.
When the opportunity to work with the Health Portfolio on St Helena arose, the team at Spectacle Warehouse had to do some out-of-the-box thinking to come up with
creative solutions with regards to the equipment and stock they had to bring to the island. Stephanie said they were quite pleased with how well the clinic was already set up, but they
did have to bring some equipment along as they were determined not to compromise on the quality of service they would be offering here on island. One of the pieces of equipment they brought with them was an auto-refractor which is invaluable to establish a baseline. An auto-refractoris a machine that opticians use to measure how light changes as it comes into the eye,
giving an accurate estimate of the prescription required.
A phoropter is another instrument that was used during their consultations. Comprised of
cylinders, prisms, and lenses that measure the eye’s refractive error to help determine an eye prescription. Phoroptors can also be used to measure the eye’s natural resting position, near-distance focal ability, binocular vision and eye movements. The phoropter provides a more
compact and user-friendly option as opposed to the use of individual lenses. It is also less time consuming and not as bulky to travel with. A phoropter needs a special stand to position it for testing. As this stand is heavy, bulky and difficult to travel with, the director of Spectacle Warehouse built an alternative compact stand that would be more practical to travel with and could be set up in the clinic here on St Helena without compromising the results of the measurements.Another piece of equipment brought in with the team and utilised during consultations is an electronic VA chart (or wall chart).
The partnership with Spectacle Warehouse should be very advantageous to St Helena as they
are a big optometry company in South Africa and one of the few companies that have in-house
labs that can manufacture their own lenses, including bi-focal and multifocal lenses. This will ensure a quicker turn-around time when providing spectacles. It also ensures that a more affordable product can be provided. This is also reflected in the mission statement of Spectacle
Warehouse to offer a wide range of products to meet the client on their level of affordability from entry-level to designer products. The longest turn-around time for manufacturing
lenses would be three weeks for a really complex pair of spectacles. Shipping will have to be factored in when calculating delivery time to St Helena, but the team is determined to provide prescriptions as quickly as possible.
Within the organisation, there are four groups of six optometrists which make it more feasible for them to send an optometrist or two to the island for consultations without impacting any one of their practices in South Africa specifically. Stephanie also reaffirmed their commitment to establishing a long-term relationship with St Helena Island’s healthcare service.
Stephanie is planning to return to St Helena for the next visit with another optometrist on 15 March. On this visit, they plan to see more people with the two optometrists increasing the capacity for consultations. As there is such a big backlog on the optometry side, they are planning to do four visits per year. Continuous treatment is essential in managing certain conditions and these more frequent visits will enable the team to monitor patients more effectively as well as support preventative measures.
This is all very positive news for eye care on the island and if things work out the way it is planned, it could turn out to be a very positive collaboration between the Health Portfolio and Spectacle Warehouse, moving towards a future of clearer vision on St Helena.