Mae Chong - optometrist

00:06S1

This is Studio One on Vision Australia Radio.

00:18S2

Hello, I'm Sam.

00:19S3

And I'm Lizzy.

00:20S2

And this is Studio 1, your weekly look at life from a low vision and blind point of view here on Vision Australia Radio.

00:26S3

On this week's show...

00:27S2

When is the right time to see an eye specialist and what is the right specialist to see? We talk to Mae Chong from Optometry Australia.

00:35S3

As we always say at this point, please do get in touch with the show whether you have experience with any of the issues covered on this week's episode of Studio 1, or whether you think there's something we should be talking about, you never know. Your story and insight may help someone who's dealing with something similar.

00:50S2

You can contact us by email: studio1@visionaustralia.org ... That's studio number one at Vision Australia - dot-org ... and that is indeed what Emma from Perth did. We'll read what she had to say a little later.

01:02S3

Or you can drop us a note on our Facebook page at facebook.com slash VA Radio Network.

01:10S2

So before we start today, as this is Reconciliation Week, we would like to acknowledge the traditional owners of the land on which we meet today, the Kaurna people. I would also like to pay my respects to elders, past and present. Hello, Lizzie.

01:25S3

Hello, Sam. How are you today?

01:27S2

I am OK, but we are not doing the show that I was expecting to do. And, yes, there's issues.

01:35S3

Yes. I don't think we're doing the show that any of us expected to do, to be honest. But it is good. It is?

Yes. I don't think we're doing the show that any of us expected to do, to be honest. But it is good. It is?

01:41S2

Yes. You're sounding a little croaky there. It's not... you practising to do, say, fever? It's, you've actually got a fever.

01:51S3

Yes I do, I've come down with some nasty bug which has rendered me immobile. I cannot leave the house currently. So we're doing this and, you know, yes. Despite the fact that I have the voice that ought to belong to a boy going through puberty, I will get through this.

02:11S2

Well, yes, we're doing use once by using the magic of zoom, zoom zoom zoom zoom zoom. So the person I was going to catch up with, has, well, I made the mistake of thinking she would be available on Reconciliation Week, and, well, she's way too polite to say, hey, I'm very, very busy. So we're actually catching up with her on Friday to interview for next week's show. What else has been going on with your life?

02:36S3

Apart from this? Not a lot. I'm, unfortunately, being sick has meant that... my training has come to a relative standstill. I've been cleared for light training, but we'll see how that goes. But. And apart from that, what's... yeah, not a lot.

02:49S2

What sort of sick person are you? I, some people actually sort of revel in it. They go, Oh, I'm sick. Someone please come and take care of me. May I tend to cut myself off and get grumpy and... not want to talk to anybody?

03:02S3

I'm exactly like you. I don't heed the advice of anyone. I don't listen to anyone or wear any. Tells me that I should take some time off or take this pill or that particular remedy. I just fight it as best I can by myself. I'm a bit of a battler, you know.

03:20S2

My background as an athlete has meant that anyone that says, Oh, you take some cough medicine or something like that, I am very, very reticent to do that because we used to get issued this little book that said, these are all the drugs. You're not allowed to take anything that's not on this book, don't take it otherwise, you need to see a sports doctor who can probably suggest something. And so, yes, I was usually of the issue of if I'm feeling a bit miserable, I'll take an aspirin or a Panadol or something like that.

03:48S3

Well, I've been sticking to the paracetamol lately and I'm also very careful about what I take. I mean, I'm only participating in amateur competitions currently, so it's not a massive deal, but it's saying that I'm usually very careful about what goes into my body. So I'm not really one to just stuff tablets down my throat until I start rattling. Every time I walk.

04:11S2

We can still be you can still be drug tested, that's thing. And you can still be banned. So oh, of course.

04:17S3

Of course.

04:17S2

That's the... problem. So, but anyway, let's go on to who we're talking to today. I made contact with both Optometry and Ophthalmology Australia quite some time ago. And they quite happily got back in touch with me and put us in contact with May, who is a low vision optometrist. And I'd say that it was an interesting interview in that we learnt a whole lot of stuff. And she seemed to learn a lot of stuff from us as well. I mean, what did you think?

04:46S3

Oh, I thought it was a very insightful interview. And, I think the one thing I enjoyed about it the most is that my throat wasn't hurting while I was talking. So I'll be glad to let ask Lizzie do some of the heavy lifting for a while.

04:58S2

Let's hear from May.

05:04S4

Hi, Sam. Thank you for welcoming me.

05:05S2

I think a lot of vision impaired people, well, most vision impaired people will have some sort of experience with eye specialists of some sort. And you've got the more medically minded ones who put the horrible things in your eyes, which mean you can't see for the rest of the day. And then there's the groovy side, apparently. And that's what you do, isn't it?

05:27S4

A little bit. It's a bit of a mix and a match. So just to to set the scene a little bit. I'm an optometrist, and optometrists are primary eye care practitioners, which means that we're often a first port of call for people experiencing eye or vision problems. So people just coming in off the street, and we see a lot of people for glasses and contact lenses. And we also do diagnose and manage early eye disease. It's when things require surgery or more complex medical management. That's when we refer to the ophthalmologists for more specialised care. Now ophthalmologists are doctors who specialise to become eye surgeons. So they they're very much more specialised in the medical side of things. And they are secondary practitioners, which means you actually need a referral from an optometrist or your GP to attend an ophthalmologist.

06:18S2

Lizzie, I don't think you've had much to do with either in your... time really mainly for official purposes, I'm guessing.

06:26S3

Yeah. So I only had to see an ophthalmologist when I got my national classification for Paracycling. And also Centrelink sent me to an ophthalmologist three years in a row, even though they had written on my paperwork each time that my vision would not be changing. And, uh, eventually the optometrist, sorry, the ophthalmologist that I was seeing sent a rather blunt letter saying, do not ask for this again. The vision will not be changing. And, uh, yeah, so but that's pretty much my entire experience, apart from when I was diagnosed with my eye condition. But I was too young to remember that.

07:04S2

So it's a fairly simple thing. The eyes don't work at all.

07:06S3

The optic nerve doesn't work. No, it's not the eyes. But. Yeah.

07:10S4

So yes, unfortunately there's a bit of bureaucracy involved with Centrelink and and the Parasports as well. Sometimes they do require all these little boxes to be checked off every few years. But I can acknowledge it must be very frustrating for you.

07:24S3

Well, it is, considering that my condition is a non-changing, I am permanently, I'm totally blind and have been for the entirety of my life thus far, and will continue to be for the entirety of my life unless they they come up with some miracle scientific treatment. But by I don't know, we'll see what happens.

07:41S2

So am I. Let's hear a little bit about yourself. What got you into this field?

07:46S4

When I was in high school, I was always interested in the eyes and vision, and I suppose it just really started from there. I decided that I, I wanted to be able to focus on, on a patient and be able to provide that care. And that's how I got into optometry. And while I was doing optometry, I became aware of this field, this area of interest, which was low vision. And that's really looking at people who have blindness or low vision and helping them to improve their quality of life and provide them with all the tools and, and things that we can to make life easier or better for them. I love the work, I love meeting people and really discussing what's going on with them and what they need, because everyone's different and everyone needs something different.

08:28S2

You also have, like ourselves, dabbled a little bit in the sporting arena. More on the classification side though.

08:35S4

Yes, yes, I'm not athletic at all, but that doesn't mean I can't classify athletes. So, yes, I, I'm a national classifier with Paralympics Australia and I also do some classification work with other organisations like Tennis Australia, AFL and International Blind Australian Blind bowls. So classification for blind sports is basically grouping athletes. So the competitors know what their level of vision is and can are competing against others with a similar level of impairment.

09:10S3

So can you just talk us through the categories then, of the, like the classification categories for visually impaired people. 

09:18S4

Sure. So the basic categories are we've got international competition. So that's things like your Paralympic Games. And those are usually classified by panel. And it's a face to face panel classification where the athlete is basically showing the panel what they can see and what they can't see. Then we step down to national classification, which is really for people who are competing, um, at a state level or even school sports level, all the way up to a national level. And that tends to be face to face, but just one practitioner. And then of course, we've got recreational leagues as well. So it's not always very, very intense, but it does vary depending on the level of competition somebody's competing in. But in terms of the levels of vision impairment, uh, it actually varies by the league. 

So if we look at the International Paralympic Committee, which tends to be the most common scheme used, or the IPSA scheme as well, the people who are classified, are fall into three groups, and these categories are B1, B2 and B3.

10:26S2

Yes, I'm a B3, I'm the forgotten banana.

10:31S4

Well, it's good that you know your classification because it's really nice to know where you sit. So the classification really depends on what you can see. So how fine your vision is and as well as how wide your vision is. So what your field of vision is. And so the different classifications vary. But generally B1 are your most impaired. And they generally see just um, shapes or shadows or they have no vision at all. 

S3

So that's me then.

10:56S4

And that's yourself. Lizzie. Yeah. Yeah. And B2, actually the somewhere in between. But B3 are your people who are legally blind, but who are able to see a reasonable amount. Still, how Iike to explain it often is so B1 looks after itself someone who is totally blind. They might have some color perception, whereas if you see somebody walking down the street and they're not totally blind, but there's clearly something wrong with their eyes, chances are there are B2. Now, us B3s are a little bit trickier because unless you work within the field, you're not going to be able to pick somebody like that up. 

So if you're a parent of someone with a vision impairment, you can pick a B3 straight away. Whereas if you ask me the time, I don't just look at my watch, I inhale my watch. So and the same thing with my phone. So we don't look blind necessarily until we have to do something. And I think that's a good generic way of looking at those three classifications. I mean, what do you think?

11:58S4

Yeah, that's that's a really good way of defining it. And everyone experiences things differently and there are nuances in it. But yeah, that's that's a pretty good way of explaining it.

12:06S2

So what does it actually take to. Be an optometrist. I mean, what do you need to do? So if you might have someone out there who's going, you know, I'm, you know, the 16 year old in school who does want to do something like that. What what do you need to actually do to get those qualifications? 

12:23S4

Yeah, good. Very good question. So optometry is a bachelor or postgraduate degree. So it's always done through a university. It takes between three and a half and five years depending on the course you're enrolling in. So some courses do a little bit of summer work. So they, they're able to truncate the course and optometrist actually graduate ready to practice. So after those three and a half to five years of study, they're ready to practice and ready to go. So it's a matter of getting into the university degree. So most of that is through vtac, uh, to the undergraduate programs. But some of it is through the  postgraduate medicine system. So it depends on the institution you're going for. And it also depends on whether you already have a bachelor's degree, in which case you could go into a.

Good. Very good question. So optometry is um, a bachelor or postgraduate degree. Um, so it's always done through a university. It takes between three and a half and five years depending on the course you're enrolling in. So some courses do a little bit of summer work. So they, they're able to truncate the course and optometrist actually graduate ready to practice. So after those three and a half to five years of study, they're ready to practice and ready to go. So it's a matter of getting into the university degree. So most of that is through VTAC, to the undergraduate programs. But some of it is through the postgraduate medicine system. So it depends on the institution you're going for. And it also depends on whether you already have a bachelor's degree, in which case you could go into a postgraduate portal.

13:15S3

It all sounds far too scientific for me, that's for sure.

13:19S4

It's... applications and paperwork, a lot of it.

13:22S2

So you are a low vision optometrist. That means you do specialise in... well, people like ourselves. Is it better for me, for example, to see a low vision optometrist predominantly? Or is the fact that I've been had this eye condition my entire life and I know the quirks and stuff like that, it would be just better off me going to the local, I don't know, Specsavers or something like that?

13:48S4

It's an interesting one. So optometrist graduate, ready to practice. And although your local optometrist may have special interest areas so they might be interested in contact lenses or seeing children or or doing colour vision or low vision things, there are actually no formal qualifications required to provide those advanced care services. The exception is therapeutic prescribing. So that actually became part of the pre-registration program in the last 10 to 15 years. So unless your optometrist is more than 15 years experienced, they would have had that all as part of their qualifications. So in terms of special interest, it really depends on the scope of practice your practitioner wants to take up. 

So I work with a number of practitioners who are really happy to start patients on their low vision journey, looking at their glasses, at magnifiers and then saying, hmm, I think we might need to get you a cane. Let's refer you on. But then there are others who think, Oh, magnifiers get a little bit tricky, and I'm not really aware of the range. And so they would refer off to a colleague earlier. So in answer to your question, I don't think there's a right or wrong. If you have a good relationship with your local practitioner I would start with them and then they will guide you and refer you on when you become too interesting for them.

15:07S2

What I've found, actually, is that yes, if you go to your local shop, they're very, very happy to see you because I my eyes are not exactly normal. And it takes, it makes it makes a big difference to their day to be able to run a few tests. And I've often, I've often said, Oh, we can also run this other test that looks at the back of your eye. It will cost a little bit more. And it's like, no, no, I'm I'm right. And then they said, well, and eventually they throw it in for nothing because they actually want to see it themselves.

15:38S4

Okay. Yeah. That's that's right, that's right. A lot of what we do in optometry is seeing patients who have relatively healthy eyes or maybe early eye disease. So I suppose you would be an interesting person to learn from as well. Sam and probably Lizzy as well. It's always good. And I think optometrists are always striving to learn more and understand more. And, yeah, it's if you don't mind being a little bit of a guinea pig, I'm sure they'd love to see both of you.

16:05S2

So once a year or twice a year, usually the change of seasons. And I'm sure I'm not the only one here that anyone that has this happened to them. When the colors are changing and when there's a bit less or more moisture in the air, I start getting paranoid and I'm thinking, am I starting to lose sight? Because I start tripping over things and nearly getting hit by cars and stuff like that. So yeah, what's my best port of call here? Do I make an appointment with an optometrist with a sight chart to to prove that? No, I'm not, I'm just being paranoid. Or do I rush off to a doctor?

16:39S4

Yeah, that's that's a very interesting one, Sam, because, when we talk about vision, you're right. There is the sight chart. But then there's also your contrast perception and your glare sensitivity, your adaptation from light to dark or dark to light and your visual field. So there's a lot of things to measure, to say, yes, things are stable or no, things are changing. So I would always advocate for having a good relationship with a eye care practitioner, someone you can always go to, just for, I just want to check up. For a lot of people, that's their eye doctor, their ophthalmologist. But for some people, it's a local optometrist who they've got those records and those those practitioners who have a baseline and they know know this is normal for you, Sam, or this is not normal for you. 

And of course, if something's not normal, as it were, or not stable, if you're seeing an optometrist, they would then refer you to an eye specialist.

17:35S2

Often when they talk about optometrists, often people will think glasses and contact lenses. But you do more than that, don't you? You mean as a low vision practitioner, you will delve more into visual aids and to magnifiers and things like that. I mean, so I'm presuming that your shop or office or whatever is has got a few interesting items in there. Is there anything in particular that sort of popped up recently that has piqued your interest? And you've thought, I'd really like someone to try one of these out?

18:05S4

Yes, most definitely. So most as I explained, most optometrists really do have a small range of of optical magnifiers just to get patients started on their journey. But really, the advances recently have been in the fields of technology. So looking at things like optical character recognition. So a device that can scan and read out text or can recognize a face, uh, can read currency and say, oh, that's $5 or that's $10, that's always very useful to have. So the tech has been fantastic. And moving forward, things like... iPhones and, you know, having Siri or Google Home or, uh, Google talking to you, that's all fantastic. And those those options make life a lot easier for patients with vision impairment. And it's always nice to be able to discuss them with somebody in the context of low vision, because most people have used Siri. But how do you use Siri if you can't see the screen? 

So it's it's nice to be able to talk to somebody with with that technology knowledge, I suppose, as well as the electronic magnifiers, they're fantastic these days and the prices have really come down compared to when I first started working in low vision.

19:18S3

Not just that, but as you said, a lot of the phones and tablets now, they've got a lot of like inbuilt magnifier software. Now, I know when we go out to restaurants and stuff, my husband will take a photo of the menu or use an app on his phone to magnify it so he can see it larger, because otherwise he has to get right up close to it and squint just to see the fine print.

19:41S4

Definitely. 

S3

So you don't even, you don't even need an external magnifier. You might. But the need for external magnifiers, I think, might be growing less with the invention of the magnifying software.

19:52S4

Most definitely. I think so. And it's, I remember when I first started practicing, it was a case of, well, we're going to get a big TV magnifier for you, but you're still going to need something to take out to a restaurant or the shops. But now people just bring their phone and it's fantastic because they can also save an image of it too. And they can even get software to read it out to them. So that's it's a huge advance. And we're really pleased that with the advancement of tech access has also been born in mind for people who are print handicapped that they can have something read to them. And not just people with a vision impairment. It's also people who may not be literate or who may have problems learning to read.

20:34S2

That's something that I think has benefited us all greatly in, in a lot of ways, is because we now have an aging population who they are losing their sight, they can't see as well as they used to. Any advances that come there, often are done for their benefit as much as for ours. So there are more things becoming more accessible that way. And sometimes it's just fashion there. In the 1990s, uh, it was very, very fashionable for digital watches to have very large clock, very large faces. And. God, I liked it then.

21:09S4

Yeah. Look, you're right. Most of the diseases we know from the National Eye Health Survey, most of the diseases that cause, uh, vision loss are diseases of aging. So the big one in Australia is macular degeneration. But interesting. You mentioned glasses before. The biggest cause of low vision in the Australian population is actually refractive error. So that's basically the need for glasses. So um glasses can do a lot but not for everybody. So it's always worth having an eye test if you're worried about your eyes or anything.

21:41S3

There are actually different types of glasses. I know, I know, my grandmother has reading glasses, but there are glasses for other purposes, aren't there?

21:48S4

There can't be....

21:49S3

Yes, it depends.

21:50S4

On the focal length. So, with your, when you look at a child, when they're looking at things in the distance, they're, they're using their, their vision. When they look at something up close in their hand, like a book or a tablet, they're actually focusing their eyes and using the lens in. Slide their eye to focus. But as we get older, unfortunately we can't do that anymore. Our capacity to accommodate or change our focus reduces. And of course, once people have had their cataract surgery done, they lose that ability pretty much altogether unless they've had a special intraocular lens implanted. So the result is that older people... so this is people not even that old, so 50 and onwards... will need one pair of glasses for the distance, something else for reading. 

And they may also need something for that intermediate level. So that's anything at arm's reach. So as far as your arm can reach. So that would be things like cooking or your computer screen. So there are people who need three pairs of glasses. And we can often get around that by getting them a multifocal or a progressive lens. So that's one lens that has a distance correction at the top, reading at the bottom, and a corridor in the middle where they can do things at that arm's length.

23:08S3

And of course, everyone needs a trusted pair of sunnies, right?

23:11S4

Oh yes. Most definitely. Sunglasses are great because they provide that UV protection. So it's great even for people who don't need glasses. Just that UV protection can really help, as well as that glare protection for people who are driving or who might be experiencing glare because of their eye disorder.

23:30S3

It's funny you should say that actually, because up until recently, I never wore sunglasses. And a couple of years ago, a friend started absolutely grilling me about you need to wear glasses when you go out. Even if he can't see, you need to protect your eyes from the sun. Do you think that's a valid point? 

23:48S4

I think it is, definitely because the skin around your eyes can also be affected by things like, well, by UV, just like you get freckles on anywhere in your body that's not protected by sunscreen and you really can't put sunscreen on your eyelids. So I think it's important to have that sun protection, if anything, just to reduce that... exposure. Because sunglasses do block UV rays.

24:10S2

Now, before we go, we arranged this interview through Optometry Australia, and you're obviously a member of that. Maybe you can tell us a little bit about it. 

24:20S4

Yeah. Optometry Australia is a professional association. And optometrists who are members have access to things like continuing education and professional support. And the organisation also does a lot of advocacy work. So informally informing the public about the importance of sunglasses or eye health checks and providing the support to the community as well as to the profession.

24:46S2

Well, that is all the time we have today. It has been an interesting chat. Thank you for joining us. And, yeah, make sure you go and see somebody if you're ever in doubt. But also, yeah, what is it, every three months that we do somebody see somebody or every six months?

25:03S4

The recommendation from Medicare Australia is every three years for people aged under 65. And every year for people 65 and over. But that said, if you have an eye condition, you should really be guided by your optometrist or ophthalmologist in terms of the frequency of your checkups.

25:21S2

Again, thank you for joining us.

25:22S4

Thanks, Sam. Thanks, Lizzy.

25:27S2

Before we go, we had an email. Now we constantly talk about our email address which Lizzie, what is it?

25:35S3

studio1@visionaustralia.org  

25:38S2

That's right. Well Emma from Western Australia sent us an email. "Hello I'm Emma from Perth, Western Australia. I'm completely blind and I have been since birth. I've always had a fascination with radio and have listened to a couple of your shows." Thank you Emma. Great thing about radio is that it's all listening and they don't show our face. Yes, I agree, I agree with that wholeheartedly. "I love the show you did about if you could regain your sight or get given sight, what would be the first thing you see? That was wonderful. Also, another thing I just want to say that I didn't find that question patronising at all. The girl is said that it's society that destabilises us. Yes. Is that a word? Is right in many ways, but there are some things that our disabilities do stop us from doing, and it's okay to acknowledge that it's okay to dream of the things you could do if you could have the disabled sensor of yourself disabled." 

Thank you Emma. You did write us this a fair while ago, and we are going to get back in touch with you. We need we are going to be doing more of our vox pop questions. And yes, we'd love to talk to you as well.

26:54S3

I think I know who Emma from Western Australia is, so it'd be lovely to get in touch. And if you'd like to do some vox pops, I would be more than happy to host it.

27:03S2

There we are. But that's a wrap for this week.

27:05S3

And big thank you to Mae, Trixie and Lauren.

27:08S2

And of course, thank you for listening. Next week it's back to our scheduled programme as we talk to Olympic and Commonwealth Games gold medallist and former Northern Territory Senator Nova Peiris about exactly what reconciliation is.

27:22S3

But between now and then, please do get in touch with the show. Whether you have experience with any of the issues covered on this week's episode of Studio 1, or whether you think there's something we should be talking about. You never know your story, and the insight may help someone who's dealing with something similar.

27:38S2

You can email us at studio1@visionaustralia.org ... that's studio number one at Vision Australia - dot - org.

27:44S3

Or you can drop us a note on our Facebook page at facebook.com slash Nova Radio Network. We want to hear from you.

Org or you can drop us a note on our Facebook page at facebook.com slash Nova Radio Network. We want to hear from you.

27:52S2

And hopefully next week someone else will be feeling a whole lot better. Goodbye for now.

27:57S1

Vision Australia Radio gratefully acknowledges the support of the Community Broadcasting Foundation for Studio 1.