2025 Jun 13 | Jamaica mission trip

Some of the optometry students and optometrists had gone on a tour on Sunday night to swim in bioluminescent algae. They said it was really cool.

We started seeing patients on Monday. We had three groups. Two groups went out to different towns each day (A and B), and the third group (C) was at the hospital performing cataract surgeries. We all took large buses to each location.

I was the optometrist in charge of group B, Daphne and Carissa were group A, and Jaime was team C.

Our location on Monday was Queenhythe Health center. There is already a long line of people waiting when we arrive. The other team went to Lime Hall.

The first step is evaluation the room and figuring out the best flow of patients, which determines how we set up each station.

The first step is registration, which helps the patients fill out the top of their eye exam form and gives them a number to stay in order.

Next is checking visual acuities.

Then intraocular pressures, as there is a lot of glaucoma here.

Autorefraction to get an estimate of their refractive error. We only have glasses with equal prescriptions on both sides, and only spherical lenses, so we get as close as we can. Thankfully most patients have fairly equal prescriptions between the two eyes and not too much cylinder. If there's a big difference or a lot of astigmatism, we can instead write them a copy of their prescription to buy glasses elsewhere.

Refraction to finalize their glasses prescription.

Checking their ocular health, including cornea, lens, and retina, especially looking at the optic nerve, again for glaucoma.

If the patients have especially poor vision or we can't get a good view, we dilate them so we can find out why they're not seeing well. The students haven't practiced BIO much, so it's usually the optometrist doing this. Then the optometrist finalizes the glasses prescription(s), gives the patient a year's supply of glaucoma drops if necessary, and discusses any other diagnoses and treatments with the patients. Finally, the patients go to the dispensing table to get their glasses.

The optometry students in our group, who were mostly second-year students at Berkeley.

Optometry isn't really a thing in most of the world, but a few other countries have it. We had a few optometry students from Queensland University of Technology in Australia and one from the University of Warwick in England.

Group B. In addition to optometry, there was also a medical section that went to each location.

I big frog I saw while we were packing up.

And goats outside.

A big house on the drive home.

And a very small one.

Many houses had water containers on the roof. This one also had plants on the steps.

Another big house.

Many cab drivers here.

In addition to the buffets, the resort had a few specialty restaurants you had to make reservations for. Dolce Vita is their Italian one.

I arrived right around sunset.

So I had to run out and look at that.

Clouds over the ocean.

Colorful.

Now time to eat.

Appetizer.

Main meal.

Dessert. The food here was extremely good.

Meanwhile, back in California, Ogii was eating with her coworker.

Good food for them, too.

She saw a hawk.

I saw this cat which many other people staying at the resort noticed, too.

The pool is pretty at night.

One big problem this year is many of our supplies got stuck in customs at Jamaica. Thankfully we had leftovers from last year to get us through Monday, but we didn't have enough for the rest of the week. So Joan had to go and spend the day trying to get all of the new stuff out of customs, and after a lot of work, she finally managed to do it. A ton of boxes showed up at the resort at 9pm.

So we spent some time unpacking and organizing it all.

Packing the bus on Tuesday morning with all of our gear.

The bus had a sign that said, "No eating of patties on board." Now I really want to try a patty.

We switched which station each student was at each day so they could cycle through them and try something new each time.

More goats on the drive.

Today we were at the Church of God, Church of Christ: 7th Day in Murray Mountain. The other team went to Madras.

This was a smaller area, but we still managed to set everything up and send the patients through in a U-shaped pattern. We also had one large fan and a few smaller fans, as it was really hot and we didn't have air conditioning.

Visual acuities.

This guy was very tall.

Autorefraction.

We had one student each day designated as a floater, and they went wherever we were backed up to keep it moving smoothly, which generally worked quite well.

We had two way to check intraocular pressure. An iCare was the fastest and easiest, but it seemed to have problems with the humidity and didn't always work. Sometimes cleaning and drying the probe would make it work again, but not always.

So we had a Tonopen as a backup. This requires anesthetic and disposable tips, so we preferred the iCare, but it was nice to have when the iCare didn't work.

Checking the prescription.

And how well they see with it.

We saw mostly adults, so the kids were a fun and usually easier break.

Looking inside.

And checking pupils.

If the patient's visual acuity was very poor at the first station, we'd check their pupils and anterior chamber angles there instead and then dilate them right away so they wouldn't have to wait quite as long.

The Australian students were fourth years, so they could also perform BIO on dilated patients.

Iva Possner was an optician who dispensed the glasses, and Janice Wilson was her friend who tallied the glasses and drops we gave out.

We usually had a few patients each day who had severe cataracts. We told them to go to the hospital the next day for surgery.

The organizer of this location gave us all hats.

So of course we had to all get a picture with them on.

Another photo with the medical team, too.

People were pretty tired after a busy day and napped on the bus ride home.

Ogii was also driving.

Past Gilroy with all of the goats and other animals.

And the bells.

Dinner at the buffet. There was rabbit tonight.

I also liked grabbing some chips and salsa.

There were multiple little shops at the resort. I finally found one with some neck fans and miniature fans for Iva and Janice since they got really hot out at the clinics and the larger plug-in fans we had didn't reach them as well.

The light-up mannequin is very cool, but it doesn't give a very realistic idea of what the dress will look like on a person.

Ogii flew from San Francisco to Los Angeles.

Nice room.

Peaceful pictures.

Our student station list for Wednesday.

A few of my scrub pants were too long, so Ogii hemmed the bottoms. She did a great job.

A dog on the roof of this house.

Today we are at Harmony Vale Adventist Church. The other team went to Blackstonage.

This again was a tight space, but we figured out how to circle the patients around the stations.

Our eye team ready to go.

We had learned from the previous two days and now were dilating all of the patients with poor vision at the beginning so they don't have to wait as long.

The iCare worked most of the time, but it still had some problems, so we were still using the Tonopen when that happened.

This patient has severe glaucoma, with IOPs of 38 and 39 (normal is 10-20, and most glaucoma is 20-30, so this is a very high intraocular pressure). The glaucoma is so bad the patient has lost vision; 20/100 in the right and no light perception in the left. We can't do anything for the left eye any more, but we can hopefully keep the right eye from going completely blind, as 20/100 is bad, but still much better than nothing.

We gave the glaucoma patients a year's supply of glaucoma drops, usually timolol, but when patients had higher IOPs, we gave them additional drops as well, like Travatan and Simbrinza (which has both brinzolamide and brimonidine). We also sent them to the hospital for SLT. In this patient's case, with IOPs this high, they might even need a more invasive surgery, such as a trabeculectomy or a tube shunt.

This patient already had catarct surgery in their right eye and now have an intraocular lens for good vision, but they need surgery in their left eye now as they're only counting fingers.

This patient has keratoconus, where the cornea gets thinner and scarred. Their vision was so bad that at this point they likely need a corneal transplant in both eyes. We didn't have any surgeons doing that, but we could give them a diagnosis and let them know what type of surgeon they need to see.

This patient had a fairly dense cataract in their right eye, and we could only pinhole them to 20/160.

The cornea of their left eye was completely scarred over, so hopefully they can get to the hospital for surgery.

The ophthalmologists on the trip were also doing a few pterygium surgeries, so if it was into the pupil like this one, we'd send them to the hospital as well.

The medical team at our location.

They gave out many medications.

Our whole group.

The pastor of the church thanked us for coming, and they even sang for us.

The medical team at the other site.

Cute kids.

I was never there, but the surgery team got some photos. Prepping the patient.

A very severe cataract.

One of the doctors performing surgery.

Other one.

One of the patients afterwards.

Driving home. Some of the roads were very narrow. Here a car could barely fit beside us. At other times, only one vehicle could fit, so the other would have to back up a bit to let them by.

Some of the houses here are very colorful.

Cows.

Pretty view.

I'm not sure if this guy is building this or tearing it down.

A local market.

There were many businesses in very small buildings, like this rock bar.

I had dinner at Knife, the steakhouse at the resort.

The chefs cooking the steaks.

I thought the steak was OK, although others said this was their favorite restaurant on the property. I preferred the Italian place.

Ogii saw SoFi Stadium all lit up.

Meanwhile, I saw lights at Xaymaca, the resort's big weekly show.

It went through the history of Jamaican music.

With acrobatic acts...

... and dancing acts for different time periods.

More dancers.

More acrobats.

Jamaica's national motto is "Out of many, one people." I really like that.

A couple of musicians.

There were short video clips of the various performers.

Everyone at the end.

Time for laundry, especially the scrubs as I was sweating non-stop out in the clinics all day.

I squeezed it all into their laundry bag.

It's a resort, so it's expensive, about the same price as on a cruise. But better than having all of my dirty clothes stink up my clean clothes if I pack them all together, and since we're going on a cruise the day after I get back to Miami and I don't want to uber to a laundromat there, I might as well launder them now.

Breakfast.

There were a bunch of Kaiser doctors there, so we all got a picture together.

She had hand-made this great AOJAH banner.

The entire group.

Thursday assigments.

Narrow roads again.

Many of the large houses were in various forms of disrepair.

A local restaurant.

We went to Faith's Pen today.

This was the best location by far. It was large, had many electical outlets all around the room, and had good airflow to keep it cooler.

Eye team picture.

Good to have small trash bags at each station for used tissues and such.

Checking the patients in.

Visual acuity.

Autorefraction.

Subjective refraction.

Checking pupils.

And internal ocular health.

The locals came by and gave us some great fruit snacks.

And drinks.

This setup worked pretty well; the patients flowed more smoothly.

Checking internals.

And with a BIO.

Cute kids in the medical area.

Our group.

The other eye team at Walkers Wood.

We kept track of the glasses and eye drops we gave out each day. It's mostly reading glasses, artificial tears, and allergy drops.

There aren't too many patients with high myopic prescriptions here, but it's good to have a few glasses in that range for the few who do. Our team saw a total of 153 patients on Monday, 137 on Tuesday, 94 on Wednesday, and 104 today.

Each location gave us a great lunch. I usually waited to eat mine until we were done seeing patients. I gave a few bites to this very well-behaved dog who waited patiently.

The students petting the dog.

On the ride home, there was a long line of small kiosks, although it looks like most of them are closed.

We stopped at a grocery store.

There was also a Juici Patties there.

I bought some Blue Mountain Coffee.

Rum cake.

And Red Stripe beer.

Gotta try the local specialties.

A few people wanted some local jerk seasoning but couldn't find it. Once they got back on the bus, someone else told them where it was, so they ran back in to buy it.

A few people also bought patties.

A guy selling stuff out of a freezer across the road.

Another guy going by on horses.

Then we stopped at Devon House I Scream.

We packed the place.

I also bought a coconut biscuit there.

Daphne and I with our ice cream.

It was amazingly good.

Some people ran over to KFC, which is supposed to be very good in Jamaica. There was also a Pizza Hut and Starbucks there.

Grabbing their chicken.

Beautiful sunset.

That evening there was a rock show at the resort.

I loved the white fruit with a red peel they had given us for lunch yesterday, but I didn't know what it was. Thankfully, it was at the breakfast buffet today and was labeled: Jamaican apple.

Today we were staying at the resort and seeing employees there.

It was difficult at the beginning because none of the outlets had power. The people up front ran an extension cord all the way up through a window into a room with power, and eventually the facility management people got power to all of the outlets.

Most of the employees were younger and had healthier eyes than out at the towns, so it was a more relaxing day. We also had air conditioning and much more space.

Plus, we had all four optometrists. Out at the towns, sometimes I'd get backed up having to look at a few different patients' eyes or with referrals.

So having all of us together eliminated delays.

The four of us: Jaime Antonio, Carissa Fleming, me, and Daphne Chan.

Since it was our last day, we gave out many more of the drops we had. Also many of the sunglasses as many of the employees worked outside on the beaches, by the pool, and doing landscaping.

I had dropped of my laundry on Thursday at 7am. Someone had initially said it would be done Thursday evening, but when I dropped it off, the clerk said 24 hours, which would have been this morning at 7am. It wasn't done until 6pm, though, which meant I had to wear some backup scrubs I didn't really like because they didn't have as many pockets. Also, I didn't get all of my laundry back. I'm still missing my aloha shirts and scrubs. Also, they said the laundry room closes at 6pm, and it's after 6pm now, so hopefully they work a bit later and get it back to me tonight because I'm leaving tomorrow morning before the laundry room opens.