The pre-eliminary presentation of Chepang Vision Care Mission 2018

1. Chepang Vision Care
Mission28-30 September
Better Vision Foundation Nepal
Kathmandu

2. Outline
• The Purpose
• Why we are doing this?
• Where is the actual work?
• Who gets benefitted by our
work?
• How?
• Reaching there
• Staying comfortable and
safe
• The actual work
• Vision screening
• Management and treatment
• Research
• Who will work? (workflow)
• Explore and enjoy
• Kathmandu
• In camp site
• Chitwan

3. Why are we doing this camp?
• Our motivation
• Marginalized Chepang Community
• Focus on uncorrected refractive error
• Short and long term focus of BVFN

4. Who are the
beneficiaries?
• About 5000 residents of central and
remote Makwanpur
• Mainly Chepang communities
• School children, women and
elderly
• For most, this is going to be
their first ever eye examination!

5. Where exactly?
250 Km from Kathmandu
Travel Plan:
1. Arrive in Kathmandu
2. Visit Kathmandu
3. Travel to Manhara and rest
Camp days
1. Travel to camp site 1 back to
hotel
2. Travel to camp site 2 back to
hotel
3. Travel to camp site 3 back to
hotel
4. Travel to camp site 4 back to
hotel
Camp site details:
• Raksirang:
• Total population:
• Access road:

6. Stay safe and comfortable
• Do NOT drink tap water
• Weather appropriate clothing

7. Work at the Camp (finally!!!)
• Purpose:
• Perform vision and eye health examination
• Provide basic medical treatment and optical correction
• Refer
• Research
• How?
• Forms
• Instruments
• People
• Time

8. The available human resource
• Optometrist BVFN
• Jeewa
• Rabindra
• Man
• Mukunda
• Sudarshan
• Prateeva
• VOSH
• Dave
• Mark
• Volunteer
optometrist/student
• ?
• OneSight
• Wayne
• Wayne Jr.
• Local volunteers
• 15

9. Workflow/division
Entry
Registration and
record
(2 volunteers)
Visual Acuity
(2 volunteers and 1
optometrist)
Auto-ref
(1 optometrist)
Retinoscopy and
refraction
(2 optometrists)
Anterior and posterior
seg exam
(2 optometrists)
Management
(medicines and
glasses)
(1 optometrist and 1
volunteer)
Counselling and
interview (Research)
(1 optometrist and 2
volunteers)
Exit

10. Workflow/division
• Registration
• Name, age, sex, ethnicity,
address
• Chief complaint (circle listed
symptoms)
• Volunteers
• Visual acuity
• Outdoor
• 2-3 lanes
• 4-6 volunteers and 1
optometrist
• Mobile VA vs Chart VA
• Auto-ref
• 1 optometrist takes and
records the reading on
patient record paper
• Retinoscopy and refraction
• For those with reduced VA
and/or significant error on
auto ref
• Perform subjective refraction
• 2 lanes
• 2 optometrists with
volunteers

11. Workflow/division
• Eye health examination
• 2 optometrists in 2 stations (with
volunteers)
• Ocular motility and cover test
• Anterior seg examination with torch light
and
• In required cases with portable slit lamp
• Posterior segment with direct
ophthalmoscope
• Make diagnosis
• Manage
• Prescribe medication or glasses (be careful
not to overprescribe)
• Refer
• Dispensing and
counselling
• 1 optometrist with
volunteer (1 station)
• Medications
• Proper counselling is
important
• Glasses
• Proper counselling is
important
• Counselling for cataract
• How, when, where, who?

12. Workflow/division
• Research interview
• Willingness to pay
• Barriers to use spectacles
• 1 optometrist with volunteers
(1 station)
• Obtain any comments about
the camp (audio-visual
recording)
• Overall management
• 1 optometrist
• Keeps on moving and filling
the gap and addressing any
operational or other issues

13. Forms and instruments
• Forms
• The actual form
• Instruments
• Retinoscope
• VA chart
• Torch light
• Auto-ref
• Ophthalmoscope

14. • Medications
• Artificial tears
• Antibiotics
• NSAIDs
• Steroids
• Antiglaucoma meds
• Oral meds?
Avoid distributing meds from the
examining table (prescribe and the
person at the end will provide the
meds)
Glasses and medications
• Glasses (free?)
• Simple readers only
• For Chepangs only?
• Others need to purchase
Those at refraction, please
avoid making any promise to
provide eye glasses (the
person at the end will provide
these pairs if available)

15. Still on the camp (almost done now ;)
• Wear masks during close examination!
• How many patients do you have to examine?
• What to do for Cataracts?
• When there is no required medication?
• How to refer and where?
• Whom to report if you have any issue?
• Translation?

16. What next?
• Travel to Chitwan!
• Explore, enjoy and chill!
• Back to Kathmandu