Boago Modiisane: First Motswana Optometrist
After more than two decades as an optometrist, Boago Modiisane tells RACHEL RADITSEBE how he got into the field, how he serves the community and why the job continues to fulfill him.
Tell us a little bit about yourself My name is Boago Modiitsane, I come from Mahalapye and did my primary school and secondary school at St Patrick’s Primary School and Madiba Secondary School respectively. I am married and have three girls. I currently run my own private practice in Mogoditshane, Eye Care Optometrists!
Your career in optometry: did you have an epiphany moment or was it always part of the master plan? My desire to deal with conditions that affect the human eye started when I was doing my Tirelo Sechaba in Tshane. While there, I used to see eye care personnel coming all the way from Lobatse and Gaborone coming to do outreach in Hukuntsi Primary Hospital and I told myself that one day I will have to be counted as one of eye care professionals in Botswana. During our times, career guidance was not as developed as it is today, we had to do some research on our own regarding careers. So, after some research I settled for Optometry. Government had offered me scholarship to do dentistry but I chose to stick to my first choice - Optometry. After completing my part one BSc at University of Botswana, I was admitted at the University of Auckland in New Zealand to pursue Optometry. Upon completion, I came back home as the first Motswana to graduate as an Optometrist. I have also done a Masters Degree in Public Health with University of Liverpool in the UK. On my return home in 1996, I joined the private sector and subsequently started my private practice in 2000.
What is the difference between an Optometrist, Optician and Ophthalmologist? An ophthalmologist is a physician/surgeon who specialises in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury. The ophthalmologist is the medically trained specialist who can deliver total eye care: primary, secondary, and tertiary care services (i.e. vision services, contact lenses, eye examinations, medical eye care, and surgical eye care), diagnose general disease of the body and treat ocular manifestations of systemic diseases. Optometrist is a primary healthcare professional of the eye and visual systems who provide comprehensive eye and vision care, which includes refraction and dispensing, diagnosis and management of diseases of the eye and the rehabilitation of conditions of the visual systems. Primary care optometry is complete eye and vision care that highlights the importance of optometry in prevention, health education, health promotion, health maintenance, diagnosis, treatment and rehabilitation, counseling, and interdisciplinary consultation. Opticians are primary health care professionals who provide vision care through refraction and dispensing of optical aids such as spectacles. On a day-to-day basis, I am taking care of patients. We are just not providers of eyeglasses or contact lenses; we prescribe medications that treat certain eye-health conditions. If there’s an eye infection or an injury, we are doing minor surgical procedures, as well as prescribing medications to correct eye infections or eye inflammation.
What are the major challenges Batswana are faced with in relation to eye care? What concerns do most of your patients present? Major challenges that Batswana are faced with are blindness and visual impairment that are caused by preventable causes. This has impacted negatively on the quality of life of many, especially children. Top two conditions that cause preventable blindness in Botswana are cataract and uncorrected refractive errors. The increase in prevalence of diabetic retinopathy is also of concern. Most of the patients that I see at my practice have uncorrected refractive errors. November is Diabetic eye disease month, what are some of the harmful eye diseases that can occur as a result of diabetes? And how prevalent are they in Botswana? Diabetic Retinopathy: This is when diabetes affects the small blood vessels that are found in the retina [back part of the eye]. This may lead to leaking of blood contents into the eye as well as swelling of the macular. If not detected and managed earlier these changes can lead to visual impairment and even blindness.
Cataract: this is the clouding of a naturally clear lens inside the eye. Fluctuation of sugar levels associated with diabetes may result in cataract. Diabetes induced Refractive error - Diabetes can also make the eye more short-sighted or more long-sighted within a short space of time such that a patient notices a sudden reduction of vision. In many cases this loss of vision improves once diabetes is controlled.
What precautions can the public take to protect the health of their eyes? Regular examination of the eyes is recommended. I encourage all to have their eyes tested at least once every two years. At risk groups such as people with a known eye conditions or family history of conditions such as glaucoma, diabetes, high amount of short-sight/long-sight must be examined annually. People should also take notice of hazards in their working environments and take precaution or even use personal protective equipment such as goggles to reduce eye injuries.
What do you love most about your practice? As an Optometrist, there is satisfaction in me when quality of life of an individual is improved after an optometric intervention that I have provided, e.g. improved performance of a student at school after their vision has been improved.
What are some challenges? Optometry services are mainly in the private sector and as such not accessible to all especially the poor in the society.
What has been the most important eye care innovation you have witnessed during the course of your career? I am always fascinated by the non-invasive nature of assessing and investigating the eye, especially assessment of the retina. During my career, I have seen assessment of the retina (the back part of the eye) evolve from the use of ophthalmoscope to the use of paper base fundus photography to the use of digital imaging modalities such as those found in Optical Coherence Tomography (OCT). With OCT, a picture of the cross-section of the retina of the retinal is digitally mapped allowing for diagnoses of many conditions of the retina.