Eye problems in Tonga: warning sign of other issues

An Auckland ophthalmologist warns the eye conditions of many older Tongans are placing a burden on the local youth, as they care for their relatives who are unable to work.

Dr Brent Gaskin, of Auckland Eye, says young Tongans are under pressure as they support family members whose impaired vision or blindness limits their ability to live independently.

“This can place a great demand on young people both economically and emotionally, as they spend time looking after older relatives who can’t see. The eye problems of the older generation can have a significant impact on the whole family’s quality of life,” he says.

Dr Gaskin is part of one of several eye specialist groups who visit the island nation annually. His group performs up to 100 eye surgeries, and conducts up to 800 eye checks in Tonga each year.

He says impaired vision among the local people in Tonga can be particularly detrimental to society given their lifestyles.
“Manual work is extremely common in island countries like Tonga, so locals’ vision is fundamentally important to ensure their financial stability.

Also, with many working outdoors, the glare of the sun in Tonga’s warm climate can cause big issues for those with cataracts,” he says.

Dr Gaskin says a significant number of the country’s small population suffer from eye problems that cannot be treated by local health professionals due to a lack of adequate training.

“Hopefully with time, local eye care professionals will up skill and take on the delivery of more of the surgical treatment needed. In the mean time, like many nations in the pacific, Tonga relies on help from trained specialists from overseas,” he says.

“Many patients in Tonga will have visual impairment far beyond what we typically see at home in New Zealand, and some will have waited months for treatment, as prioritisation means only the severely impaired are treated. This would be rare in most developed countries, due to modern demands like driving, and also the relative ease of access to top quality eye care.”

Dr Gaskin says while older Kiwis often develop eye conditions such as cataracts beyond the retirement age, Tongans tend to develop such eye problems earlier.

“I would think 90% of those we operate on when we visit Tonga are over the age of 45, with children and young adults making up only 10% of those we see. In New Zealand, problems like cataracts tend to occur over the age of 60, however Tongan patients experience such conditions when they are often much younger,” he says.

Dr Gaskin says during his trips to Tonga he and his team-of-four may perform up to 100 cataract surgeries and 100 laser procedures.

He says the prevalence of diabetes in the island nation is a significant issue underlying the incidence of eye problems suffered locally.

Dr Gaskin will make his fifth trip to Tonga through the international charity VOSO (Volunteer Ophthalmic Services Overseas) this month.

He says the annual trip is an important contribution to global eye health.

“It is a rewarding experience to be spread your skills around, and it makes sense to begin by helping those closest to home,” he says.

“There are hundreds of Tongans who need our assistance in our own backyard each year, and it is a pleasure to be able to use my knowledge and expertise to improve their quality of life.”

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