Global Perspectives With Carmen Abesamis-Dichoso, OD, MAT, FPCO, FIACLE, FBCLA, FAAO

BRIEFLY TELL US ABOUT YOUR BACKGROUND.

I was born and raised in Manila, the capital of the Philippines, along with my seven siblings. Optometry runs in my family. My grandfather served on the Board of Examiners in Optometry in the Philippines for 9 years, and my father, mother, sister, brother, and one of my cousins are also optometrists. Another of my brothers is an ophthalmologist, and another is a lawyer who initiated a project to review and revise the law regarding optometry. This culminated in the passage of the Revised Optometry Law of 1995. My niece is also an optometrist and works with me in my practice.

My grandfather owned a small optical shop in downtown Santa Cruz, Avenida Manila, which my grandmother managed. Eventually, my father and mother started their own optical shop, where my siblings and I would work during the summer sorting lenses, coating lenses, and selling and adjusting frames. As a high school student, I observed how my father would fit patients with rigid contact lenses back in the days of using the blue light lamp with fluorescein only, without a slit lamp.

WHAT WAS YOUR PROFESSIONAL TRAINING LIKE?

While I was studying at the Central Colleges of the Philippines, I would stay at school so late because I was so fascinated with optometry. I would browse through all the books our college dean, who was an ophthalmologist, had brought back from his trips abroad, attending optometry meetings such as the International Optometry and Optical League, which eventually became the World Council of Optometry (WCO).

After I graduated and passed the board examination, my college invited me to become a faculty member, and so I taught optometry classes in the morning and practiced optometry in the afternoon. It was the best blend of work: practicing what I taught and teaching what I practiced. I became very active in the Manila Optometric Society, and became the youngest member of the Board of Directors of the Samahan Ng Optometrist Sa Pilipinas.

In 1994, I was fortunate to be chosen as a recipient of the International Association of Contact Lens Educators Educator Fellowship Program, through the invitation of the late Luigina Sorbara, OD, MSc, of the School of Optometry at the University of Waterloo, Canada. This program introduced me to the way optometry is taught and practiced in North America. It was an eye-opening experience and an inspiration to share with fellow Filipino optometrists how we can learn from our North American colleagues. I also represented the WCO at the World Health Organization meeting in Manila in 2018 (Figure 1).

Through my consistent attendance at various international conferences of optometry, namely the American Academy of Optometry, the Global Specialty Lens Symposium, the Asia Pacific Optometry Congress (APOC), the College of Vision Development, the British Contact Lens Association, and the American Academy of Orthokeratology and Myopia Control, I keep myself abreast of the latest advances in optometry and ophthalmic technology and industry. I will always come back to the Philippines and share my learned techniques through local conferences and meetings.

I also served as president of the Optometric Association of the Philippines and eventually became the International Committee Affairs representative to the APCO and WCO Legal Regulations and Standards Committee and to the World Health Organization Glaucoma Intervention Committee.

YOU WERE AN EARLY CHAMPION OF ORTHOKERATOLOGY (ORTHO-K) IN THE PHILIPPINES, AND YOU FREQUENTLY TRAVEL TO LECTURE AND GIVE WORKSHOPS ON MYOPIA MANAGEMENT, AMONG OTHER TOPICS. WHY IS IT IMPORTANT TO YOU TO HELP EDUCATE OTHERS IN YOUR FIELD?

Myopia should be the concern of every eye care practitioner—optometrists and ophthalmologists alike. It cannot be solved or addressed by a stand-alone effort by each profession. It is not only affecting children, but adults as well, and dry eye is no longer an age-related condition, either—it also affects children. Myopia and dry eye are present in patients of all ages.

Optometrists can access resources online through the hundreds of free webinars sponsored by industry, which is great. However, I am a strong advocate of face-to-face, real-time discussion of myopia management. Even 20 to 30 years back, patients and parents were asking if there was a noninvasive way to manage or control their myopia or their child’s myopia. We didn’t have an answer then, but now we have options.

I welcome colleagues and students to come to my clinic for myopia management training. We are big in ortho-k and combination treatment modalities. We’ve seen it work in our patients, and we want optometrists to witness it for themselves.

DESCRIBE YOUR PRACTICE.

My practice is a combination primary eye care and contact lens practice, focusing on specialty lens fitting and ortho-k. It was not easy introducing my clinic to patients as a specialty practice, but word-of-mouth advertisement has been extremely helpful. Happy patients bring in their friends and families. That’s how my practice grew. Social media also helped, along with establishing good relationships with other medical professionals.

In the Philippines, the law allows optometrists to use diagnostic pharmaceutical agents, diagnose eye diseases, and perform cycloplegic refraction. Contact lens fitting is dominated by optometrists.

I have two associate optometrists and three additional staff working with me. My brother is an ophthalmologist locally, and I have established a good network with other ophthalmologists in different subspecialties across the city. I refer my patient to the location that is most convenient for them. I see patients almost every day, from primary to specialty care.

WHAT IS THE STATE OF HEALTH CARE AND EYE CARE IN THE PHILIPPINES?

Health care in the Philippines has come a long way. Because we are composed of more than 7,600 islands, there is a problem in accessibility to care. And, because we are a developing country, affordability is always an issue, especially in far-flung areas outside the city, where people survive mainly on fishing and farming.

Because accessibility, availability, and affordability are still major concerns related to health care, this translates to eye care as well. Although the government has established the National Council for Sight Preservation, there is still a great need. Nongovernmental organizations such as Lions Club International, Rotary International, and the Fred Hollows Foundation continue to serve areas with lack of access to eye care. Colleges of optometry and institutions of ophthalmology provide free eye examinations and surgeries to those who cannot afford them.

Cataract and uncorrected refractive error are still the most common causes of blindness in the country.

YOU HAVE SERVED AS DIRECTOR OF THE SPECIAL OLYMPICS OPENING EYES PROGRAM IN THE PHILIPPINES AND STILL PROVIDE CARE TO INDIVIDUALS WITH INTELLECTUAL DISABILITIES. HOW DID YOU GET INVOLVED IN THIS PROGRAM? DID YOU SEEK OUT THE OPPORTUNITY, OR DID IT FIND YOU?

This was an opportunity that a colleague of mine and I were offered during the 1999 WCO meeting in Germany, where the founder of the Opening Eyes Program invited us to attend the World Summer Games in North Carolina. We were among the first optometrists globally, more than 100 in total, who were trained on how to provide vision care to the intellectually disabled. I was also very fortunate to be part of the team that put together the Global Curriculum sponsored by Lions Club International.

Our task, when we go back in our country after the World Summer games of Special Olympics International, was to get involved in our local program—in our case, the Special Olympics Philippines (Figure 2). We were able to connect and hold numerous events all over the country. We provided training to local optometrists, who, in turn, provided vision care to intellectually disabled individuals all over the archipelago.

My involvement with the Special Olympics has given me the opportunity to meet incredible individuals such as Hidilyn Diaz, the first Filipino Olympic gold medalist and a proud supporter of the Special Olympics.

WHAT RECENT ADVANCES OR NEW TECHNOLOGIES ARE YOU MOST EXCITED ABOUT?

I am most excited about the latest techniques in myopia management and their efficacy. The current available treatment modalities for myopia control, including ortho-k, low-dose atropine, and daily disposable soft contact lenses are promising. Research and development in ophthalmic lens design, coatings, and other features to prevent myopia onset will also be exciting to apply in practice.

HOW DO YOU ENJOY YOUR TIME OUTSIDE OF WORK?

I love cooking for my family and friends. I frequently attend food shows and exhibits to discover new ways to eat healthy and delicious meals. Traveling with family locally in our beautiful country to visit places with soft, sandy beaches and going island hopping to eat fresh seafood and tropical fruits in season allows me to relax and have time to reflect, refresh, and get away from busy city life.