Orthoptics Australia, Report

On the road with the IDEAS Van

Originating in Queensland, the IDEAS Van has extended its circuit to take in five Victorian centres. Melbourne orthoptist DANIELLE THORBURN recounts her experience with the initiative in Orbost.

Danielle Thorburn, orthoptist.

I first became aware of the Indigenous Diabetes Eyes and Screening (IDEAS) Van when I received a phone call asking me to be involved as an orthoptist. I had no prior knowledge of the service, but quickly got up to speed because ‘closing the gap’ has always interested me – I just never knew how, or where, to get involved.

The IDEAS Van is a fully equipped mobile ophthalmic specialist centre fit out with $1 million of the latest equipment and pharmacological products. It has been servicing Queensland since 2014, helping to prevent blindness due to diabetes in Aboriginal and Torres Strait Islander communities.

The route extended to include five pilot sites in rural Victoria from mid last year as part of the ‘Look Out Project’. This initiative was developed following consultations with the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Aboriginal Community Controlled Organisations (ACCO) and referral pathway mapping and supported by Rural Workforce Agency Victoria (RWAV). 

Victoria’s pilot sites include Wodonga, Wyndham Vale, Heywood, Robinvale and Orbost. I was fortunate to provide the orthoptic service in Orbost twice last year, including its inaugural clinical visit. I live in Melbourne and small planes aren’t my idea of fun, so I drove four hours each way, with an overnight stay, and took my husband and three children to make a ‘long weekend of it’. I also had to take leave from my clinical commitments but, luckily, I was supported in doing so.

The IDEAS Van is an innovative model of care that not only provides high calibre service but is also advantageous to the patient by minimising travel; preventing loss of time and expenses that would have otherwise been incurred with a commute to metropolitan areas for public-based care.

This may be particularly beneficial to those requiring multiple treatments at close intervals such as panretinal photocoagulation or intravitreal injections. The IDEAS Van enables patients to be seen in familiar cultural surrounds within their own community. Transport can be arranged for those that are located in further isolated communities.

The Orbost service takes place at Moogji Aboriginal Council which provides health services to the East Gippsland community. Patients presenting to the clinic have been referred via a retinal screening program within the Moogji ACCO (and externally reviewed), local GPs or the Australian College of Optometry rural service.

At the inaugural visit last July, patient numbers were kept low to allow for orthoptist, optometrist, ophthalmologist, and local Moogji Aboriginal Council staff to test how this would work. Apart from familiarising ourselves with each other, the physical surroundings were also new to us. The van consists of three rooms enabling a comprehensive service by optometrist, orthoptist and ophthalmologist.

The space is much larger than may be expected with the optometric room, fully equipped with all desired testing equipment. Patients enter through the orthoptic area which includes OCT, angiogram facilities, retinal camera and biometric equipment.

The ophthalmology room allows for detailed initial assessment (or review), treatment with various lasers and a safe environment for intravitreal injections. Most of the investigation prior to the patient seeing the ophthalmologist is performed by the optometrist, allowing time for me to assist with injections and laser procedures.

The orthoptic room is also utilised for patients to sit while dilating. This allowed extended time with patients for discussions ranging from local fishing spots and history of the broader community, to the region itself and exchanging stories of our families. I also found myself sitting outside with family and friends of patients, providing further opportunity to hear of a culture that differs from mine.

These shared experiences and rich conversations are the absolute highlight of my IDEAS Van journey thus far and it has been enormously rewarding. It has broadened my understanding and appreciation of the Aboriginal and Torres Strait Island people.

I encourage anyone considering new experiences or wondering how to be involved with ‘closing the gap’ to be bold and volunteer for experiences outside your comfort zone, or postcode.

ABOUT THE AUTHOR: Danielle Thorburn is a Senior Orthoptist at Austin Health, Casual Lecturer in Orthoptics at La Trobe University and newly appointed Clinical Services Manager (Victoria), IDEAS Van. She has a post graduate diploma in health research, is on the Victorian branch Executive Committee for Orthoptics Australia and is also Coordinator of Paediatric Community Vision Screening.

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