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Ophthalmology Outreach Clinic at Moree

By Leanne Uren, Rural Cadet, University of Notre Dame, Lithgow

Lauren with Dr Ross Cooper and Dr Roger Welch

On 9 and 10 May 2018 I travelled to Moree to complete a rural outreach clinic, arranged and sponsored by NSW Rural Doctors Network. After a bumpy flight on the small Qantas Dash, I arrived safely and raring to go. At Pius X Aboriginal Medical Service I met with ophthalmologist Dr Roger Welch, his assistants Kimberly and Shelby, and local optometrist Dr Ross Cooper. They have been providing eyecare services to the remote town of Moree for almost 20 years, first through a surgical bus and more recently through Moree Hospital. Dr Welch travels with his assistants from Queensland for three days each month for these clinics.

It was a busy morning, assessing many eye conditions that required specialist review. One lady had a retinal hole that was slowly impairing her vision and Dr Welch used laser to repair the defect. Another patient was one of the few people in Australia that had been given a prosthetic iris after both his irises had been permanently deformed following a bilateral blast injury from a fire hose.

We then went to Cooper and Smith Optometrists where Dr Cooper and Dr Roger Welch ran the pre-op clinic for the following day's surgeries involving the use of slit lamps to assess cataracts and biometry to measure the eyes for the intraocular lens. I also observed Lucentis eye injections for wet macular degeneration and diabetic retinopathy. Dr Welch told me he was still amazed at the advanced stages of eye disease he sees in the area - many cataracts are much more complicated and difficult to treat than you would ever see in the city, due to the significant issues of access. 

After an exhausting day we enjoyed a fine meal together at the local hotel, after which some of us went back and relaxed in the hot artesian spas at our motel.
 

Day two

Treating a patient in Moree

The next day was an early start at Moree Hospital for surgery. It is a small hospital, with only two theatres that operate part-time. The ladies in theatre (Kim, Maureen, Bronwyn and Jill) have worked there for more than 30 years and were lovely and happy to teach. The attending GP anaesthetist, Dr Lauren Vernon, is half way through her Rural Proceduralist training and was most helpful and told me great stories about her experiences so far and gave me some clinical tips.

I observed cataract surgery, which involves sedation, a local eye block, phacoemulsification, and implant of new intraocular lens. After a full day of surgery, we went back to the clinic to follow up on some of the day's patients, and book in more patients for cataract surgery in three months. The last patient of the day was an emergency visit from a nine-year-old girl that had alcohol wash splashed in her eye and had been brought in by her worried Mum.

I am most grateful for the opportunity given to me by the NSW Rural Doctors Network to accompany the Moree Outreach Clinic and extend a big thank you to Dr Welch, Dr Cooper and their teams, the ladies at the Moree Hospital, and Healthwise for assisting with travel arrangements. The experience really opened my eyes (pun intended) to the difficulties of accessing specialist eye services in a remote community like Moree.