VOSO staff lunch with Kylie Dreaver (third from front at right) and Dr Andrew Riley (front right)

For the first time since the pandemic, Volunteer Ophthalmic Services Overseas’ (VOSO’s) chair Dr Andrew Riley and I made a five-day visit to Nuku'alofa in Tonga in September. A regular volunteer, this was Dr Riley’s 15th trip and my fourth. VOSO’s small team was focused on collegial support and helping Vaiola Hospital’s 10 full-time eye department staff upskill.

The staff were delighted to have VOSO return. They have felt quite isolated during the pandemic and were impacted by the volcanic eruption and tsunami. We were both quite taken aback when we travelled to the western side of the island, where the tsunami had struck, as it had swept away everything, leaving just a deserted beach.

In the clinic, Dr Riley examined patients, often with complex eye disease, and mentored eyecare practitioner (ECP) Savelina Veamatahau on laser treatments and intravitreal injections. There were several interesting cases, including an iris bombe which was treated with laser peripheral iridotomy; an only seeing eye which erupted, with biopsy indicating basal cell carcinoma; and homonymous hemianopia with nystagmus, which was sent for imaging.

Meanwhile, mentoring fellow ECP Bessie Finau on refraction kept me busy. Like Savelina and all the staff, Bessie trained at the Pacific Eye Institute in Fiji. She proved a quick learner, with cases including astigmatism in a young keratoconus patient, high myopes and accommodative esotropia.

ECP Bessie Finau working
the refractor

Fred Hollows and One Sight have each set up programmes in Tonga to enable glasses to be prescribed, which is a game changer for those who are unsuitable for, or require more than, a best mean sphere single-vision option. Medix 21’s Julian Knaggs also sent 600 IOLs and viscoelastic, which all arrived during the team's time in Tonga, complementing the eyedrops and surgical supplies sent by VOSO that Tonga rely on.

It was great to be back in Tonga and working alongside the local eye team. We were warmly welcomed, thanked for the supplies we’ve sent and asked to return next year.

Kylie Dreaver is VOSO secretary, an optometrist in private and public practice and a former practice owner and ODOB board member.