World Sight Day was initiated by the SightFirstCampaign of Lions Club International Foundation (LCIF) in 2000. The purpose of the day is to raise awareness around issues concerning eye care, eye diseases, sight-restoring surgeries, and the visually impaired community.

In honour of the 21st annual “World Sight Day” AoS speaks with Dr. Sanushka Moodley, an Ophthalmologist and current chair of the Young Ophthalmologists Society of South Africa about all things eye care, her journey to becoming a specialist and the challenges of being a woman in the field of ophthalmology.

Q. Dr Moodley, thank you for taking time out of your busy schedule to talk with us about all things eye care. Can you please share a highlight reel of your journey to becoming an Ophthalmologist? Who or what inspired you to get in the field? Where and how long did you study, etc…

Thank you for inviting me! Ophthalmology grabbed my attention as a 3rd year medical student at the University of Stellenbosch. I was blown away by the technology and microsurgery and the fact that you could help people regain their sight, for the most part.

I went on to do both my electives in Ophthalmology in my hometown of Gqeberha, and in Canada. Those experiences affirmed my love for the speciality. After my internship and community service I started studying towards specialising.

I went to Lusikisiki and ran an eye clinic at the local hospital, then went on to work in the Ophthalmology departments in Mthatha and Gqeberha before getting a specialising post at the University of the Witwatersrand.

All in all, it took 15 years to become a specialist. I am currently in private practice at the Pretoria Eye Institute, and I am the current chair of the Young Ophthalmologists Society of South Africa.

Q. We read a case study from last year that says, “50%, if not more, of students entering medical school are women.” Is this trend reflected in ophthalmology or is it still a male dominated sector?

I can without a doubt say that my med school class was predominantly female. However, most surgical specialities are still male dominated. The trend though is that there are more and more females graduating in these fields and I’m sure this will balance out in the near future.

Q. So happy to hear that woman are taking up space in the field. However, decreasing the gender gap in terms of presence is only half the battle as women still have to deal with other challenges in forms of macro/microaggressions – a big one being compensation. How have you personally navigated your way through some of these challenges?

During my training, I felt like I sometimes needed to prove myself and my capabilities a little more than my male counterparts – but this wasn’t all the time. It’s difficult to navigate through this and stand your ground, but eventually your surgical outcomes and patient satisfaction speak for themselves. Luckily in the medical field compensation is pretty standardised, particularly in the public sector.

Q. They say that hindsight is 20/20 and if nothing else this pandemic has offered us an opportunity to slow down, reflect and re-evaluate ourselves holistically. If you could speak to your pre-pandemic self, what advice would you give her?

I would tell her that achieving a good work-life balance is SO important. Prioritise time with family and loved ones.  One of my friends posted something recently on Facebook that really resonated with me – She said, “Sis breathe…There is no award for overworked female of the year.”

Q. That is so good! There truly is no award. On that note, what advice would you give a young woman who is currently thinking about studying Ophthalmology or sitting on the fence because of the amount of time it takes to specialise?

For me, Ophthalmology is such a rewarding field of medicine. Restoring sight and giving people a new lease on life feeds my soul. While some specialities are purely surgical (like general surgery) or purely medical (like neurology), Ophthalmology offers you a bit of both. I think it’s a great field for women as you are more likely to achieve a good work-life balance earlier on in your career versus other specialties like obstetrics where you are always on standby in case your patient goes into labour etc. It’s a long road to specializing in Ophthalmology, but it’s worth it in the end.

Q. Today is “World Sight Day”. What are three things that we can do better as a society to increase our personal and collective awareness of our visually impaired community members and how can we intentionally hold space for them to actively lead and participate in our economy? 

Firstly, the most important thing we can do as a society is to encourage the visually impaired members of our communities and families to actually see an Ophthalmologist. Many of them are walking around accepting their blindness or poor vision when they possibly have a condition that could potentially be reversed or treated to prevent further decline.

Secondly, visually impaired individuals still have a lot to offer, many of them are still functionally capable and can make the use of low vision aids to enable them to continue to contribute to business value and realise their own personal ambitions. This does require inclusivity to be managed in accordance with the needs of the visually impaired.

Thirdly, a little kindness goes a long way. Be aware of those around you in public that may be visually impaired and don’t be afraid to assist them. A small act of kindness can make a huge difference in someone’s life.

Q. What are some major eye care issues that need our immediate attention in South Africa? i.e., access to eye care facilities, education etc…

I think patient education is always an important issue to prevent people presenting late to an eye care practitioner. Glaucoma, an irreversible cause of blindness, can be detected and treated early to the point where a patient can retain good vision for the rest of their life – however SO many patients present with advanced disease at which point not much can be done to restore sight and retain good functional vision.

Raising awareness is so important. A condition like cataracts is reversible as long as the eye is otherwise healthy you can go back to having normal vision once they have been removed. In our urban areas, cataract waiting lists are quite long. While there are a few active outreach programs in the country many of those living rurally are unaware of them or have poor access to them.

The Covid-19 pandemic has also adversely affected cataract surgery waiting time in the public sector specifically as elective surgeries were put on hold to free up the doctors to work on the frontline instead. Hopefully once things return to the new normal, doctors can return to operating and address these long waiting lists.

Q. William Shakespeare once wrote that “The eyes are a window to our soul.” What can our eyes tell us about our holistic health?

Your eyes can most certainly give us information or clues to systemic problems in the body. For example, hypertension, diabetes, autoimmune diseases (e.g., rheumatoid arthritis, thyroid dysfunction, lupus, HIV, TB, Sarcoidosis, and even certain cancers can all present with eye symptoms and signs.

Q. Wow! It really is important to pay attention to our eyes for more reasons than just our sight. The theme for this year’s annual “World Sight Day” is #loveyoureyes. What are three mindful practices that we can implement to better care for our eyes?

  1. Invest in good UV protection – a pair of sunglasses with quality lenses.
  1. Be mindful of screen time – prolonged screen time especially if near can cause your near reflex to spasm causing transient blurring of distance vision and headaches. Prolonged screen time can also exacerbate dry eye as your blinking rate is reduced, so if you have to use a screen all day make use of lubricant eye drops to keep your eyes moisturised.
  1. Wear protective eyewear like goggles when doing handy work in the home (trimming trees, using a weed eater, grinding, welding, hammering etc.) or playing certain sports like squash – you could prevent a sight threatening injury.

Q. Many South Africans are experiencing challenging financial times. Can you recommend some free or affordable reputable eye care services and resources?

In Mpumalanga there is an amazing outreach program at Tintswalo hospital, Acornhoek, that offers screening for eye conditions and cataract surgery done by local and international Ophthalmologists who volunteer their time. “Blind SA” is a local organisation that can assist with educational support, employment placement, assistance with mobility and even provide “made to order” braille resources to those who are blind or have low vision so they can keep up with their sighted fellow students or work colleagues.

The South African National Council for the blind also runs rural cataract outreach programs in multiple provinces as well as helping patients with assistive devices and training.

There are also cataract outreach programs in Thohoyandou (Donald Fraser hospital) and Elim in Limpopo where doctors volunteer and do surgery on some weekends. Patients are usually screened initially by the local optometrist at the hospital and then the visiting surgeon prior to surgery. Your local optometrist can also screen for conditions like cataract and glaucoma and refer you to an ophthalmologist for treatment.

Many Ophthalmologists in private offer pro bono cataract surgery to patients with blinding cataracts that don’t have the financial means to afford it without medical aid – they usually do these surgeries for world sight day, eye care awareness week etc. as part of their social responsibility. At the Pretoria Eye Institute specifically, we did pro bono surgery for World Sight Day this year, we were unable to do this in 2020 as we were in the midst of the pandemic. So once again this impacted our waiting list for free surgery as well. The silver lining is that for those lucky enough to be on this year’s list, their lives will change for the better from the 14th of October.

Dr. Sanushka Moodley, thank you for passionately sharing your insight, journey, and time with us at AoS. You will be in our thoughts as you perform free cataract surgeries this World Sight Day.